Takeaways

• Prediabetes is a precursor to type 2 diabetes that should be managed with care.

• Most individuals do not experience symptoms.

• Prediabetes can be reversed through diet and lifestyle modifications.

What is prediabetes?

Prediabetes is a condition where the blood glucose levels are higher than normal, but not at a level that can be diagnosed as diabetes.

It is a condition that can worsen to become type 2 diabetes if no actions are taken to address the underlying cause. In fact, studies show that between 5-10% of individuals with prediabetes may develop diabetes each year.

Both Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) can be classified as prediabetes.

Signs and symptoms of prediabetes

Most individuals with prediabetes do not experience symptoms, which is why most individuals who have prediabetes are unaware unless they have been tested for it.

Some individuals (but rarely) with prediabetes may experience the following symptoms:

• Increased thirst

• Increased frequency of urination

• Increased hunger

• Fatigue

• Weight loss

• Blurry vision

• Increased frequency of infections

Diagnostic test for prediabetes

There are 3 tests that can be used to diagnose prediabetes:

1. Fasting blood glucose test (or fasting blood sugar). This test requires you to fast overnight before getting your blood drawn. It can also be done via a finger prick.

2. Glycated hemoglobin (HbA1C) test. This test does not require you to fast and provides an indication of your blood sugar levels in the last 3 months.

3. Oral Glucose Tolerance Test (OGTT). For this test, you will need to fast overnight and then drink a sugary liquid at the doctor's office. Blood sugar levels are tested before the sugary drink and two hours after the drink.

These tests are the same tests used to diagnose diabetes and most clinics in Singapore offer them. NOVI Health’s clinic also offers these tests. You can contact us to book an appointment.

Blood sugar range for prediabetes in Singapore

If you are taking a fasting blood glucose test, a blood sugar reading of between 6.1-6.9 mmol/L (110 to 125 mg/dL) will be considered as having prediabetes.

For HbA1c test, a result between 5.7 and 6.4% is considered prediabetes.

For OGTT, a level from 6.1 to 6.9 mmol/L (110 to 125 mg/dL) for the first measurement, and a reading between 7.8 mmol/L and 11.0 mmol/L (140 and 199 mg/dL) for the second measurement indicates prediabetes.

How to manage prediabetes with diet

In many cases, prediabetes can be effectively managed through dietary improvements.

In general, individuals with prediabetes should aim to adopt a diet that follows these guidelines:

1. Consume an appropriate amount of each food group by following the healthy plate concept. Each meal should consist of 1/4 carbohydrates, 1/4 protein, and 1/2 fruits and vegetables.

2. Whenever possible, choose unrefined carbohydrates instead of refined carbohydrates. e.g. Choose brown rice or whole meal bread instead of white rice or white bread.

3. Consume vegetables and protein first before carbohydrates.

4. Avoid sugary drinks whenever possible. Choose sugar replacements (e.g. stevia) instead of white/brown sugar.

5. Understand what is your daily calorie expenditure, and consume no more than your daily calorie expenditure.

Instead of changing your diet completely overnight, we recommend making small, progressive tweaks to your current diet so that you can stick with it over the long term.

If you would like help in improving your diet, check out our NOVI Magnum program which is designed to help individuals improve their blood sugar safely and sustainably.

Does exercise help with prediabetes?

Exercise can help with blood sugar control in a few ways.

1. Exercising 20 - 30 minutes after a meal can help to reduce the spike in blood glucose levels after the meal. Even a short 15 minutes walk can be helpful.

2. Exercise increases the amount of calories you burn, which makes it easier for you to lose weight. Weight loss is associated with better health outcomes for prediabetes.

3. Exercising builds muscle, which helps to absorb glucose from your blood and reduces blood sugar levels.

We recommend aiming for at least 150 minutes of exercise per week, and incorporating both aerobic exercises and resistance training into your routine.

Learn more about how exercise helps with blood sugar control in this article.

Medical treatment for prediabetes

Medication could be a possible treatment option for individuals with prediabetes, particularly those at high risk of developing diabetes or who have high cardiovascular risk.

Medication has been shown to reduce the risk of developing diabetes by up to 50%, over the course of 10 years.

Whilst medication has a strong and immediate effect, it does not mean you have to take it lifelong. With the right improvements to your diet and lifestyle, it may be possible to stop taking the medication safely.

Continuous Glucose Monitoring for prediabetes monitoring

A Continuous Glucose Monitor (CGM) is a device worn on your body that can show you your blood sugar levels in real time.

It is becoming increasingly popular in Singapore as it is able to show individuals how their diet and lifestyle affect their blood sugar levels.

By observing their blood sugar trends, they can then make changes to their diet or lifestyle accordingly.

Learn more about how the CGM works in this article. Keep an eye on our store for promotions on CGMs!

Can prediabetes be reversed?

Through a combination of better diet, sleep and fitness, it is possible to reverse prediabetes.

Once prediabetes is reversed, you should stick to the new diet and lifestyle in order to keep your blood sugar in the healthy range.

This is why it is important to keep a long term view when modifying your diet and lifestyle. Make sure that the changes you are making are things that you can maintain for the rest of your life.

We keep an updated library of articles with tips and advice for blood sugar control. Hopefully some of the articles will be helpful to you.

If you are interested in holistic treatment of prediabetes, check out our NOVI Magnum program, where you will receive support from a doctor as well as a dietitian to guide you towards prediabetes reversal.