What steps can help reverse insulin resistance and prediabetes?

By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes. People can decrease their risk by

eating a healthy diet and reaching and maintaining a healthy weight

increasing physical activity

not smoking

taking medication

Eating, Diet, and Nutrition

Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.

In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.

What steps can help reverse insulin resistance and prediabetes?

By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes. People can decrease their risk by

eating a healthy diet and reaching and maintaining a healthy weight

increasing physical activity

not smoking

taking medication

Eating, Diet, and Nutrition

Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.

In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.

This is a simple yet tasty chicken recipe which we are sure you will use over and over again!

Ingredients:

1 medium lemon, juiced

2 teaspoons coconut oil

1 teaspoon Stevia granules

1 teaspoon ground cinnamon

1/2 teaspoon salt

1/4 teaspoon black pepper

1/2 teaspoon tumeric

4 boneless, skinless chicken breast halves

Cooking Method:

Combine lemon juice with next 6 ingredients. Place in a large heavy-duty resealable storage bag. Gently knead bag to mix thoroughly. Add chicken; seal bag, and shake to coat thoroughly. Refrigerate 4 hours or overnight.

Remove chicken from marinade and gently shake to remove excess. Grill chicken 5 to 7 minutes per side until chicken is no longer pink in center, brushing occasionally with marinade. Discard remaining marinade. Serve chicken with grilled vegetables if desired.

Serves 4. Trace of carbs.

Can insulin resistance and prediabetes be reversed?

Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.

The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week.

People at High Risk for Diabetes

DPP study participants were overweight and had prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.

DPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people ages 60 and older.

Approaches to Preventing Diabetes

The DPP tested three approaches to preventing diabetes:

Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.

Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.

Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.

People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.

Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.

People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp .

Can insulin resistance and prediabetes be reversed?

Yes. Physical activity and weight loss help the body respond better to insulin. The Diabetes Prevention Program (DPP) was a federally funded study of 3,234 people at high risk for diabetes.

The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week.

People at High Risk for Diabetes

DPP study participants were overweight and had prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.

DPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people ages 60 and older.

Approaches to Preventing Diabetes

The DPP tested three approaches to preventing diabetes:

Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.

Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.

Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.

People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.

Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.

People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp .

This recipe works well whether you prefer a tomato-based chili, or a tomato-LESS chili. Note the differences in carb counts, though.

Ingredients

2 cloves garlic, minced

1 cup onion, chopped

3 Tablespoons coconut oil

900gms beef, chopped

4 cups canned tomatoes, undrained
OR 4 cups low sodium beef stock or broth

2 teaspoons salt (omit if using salted stock/broth)

2 bay leafs

1 teaspoon oregano

1/4 teaspoon crushed cumin

2-3 Tablespoons chili powder (or to taste)

2  450gms cans Black soy beans, drained

Cooking Method

Use a deep heavy kettle or Dutch oven, and cook the garlic, onion, coconut oil and beef together for about 10 minutes. The meat should be chopped, not ground, and cooked, at this stage, only long enough to lose its red color.

Next add the tomatoes OR beef stock. Add the seasonings and simmer for about an hour or until meat is very tender. Then add the beans and simmer for another 30 minutes.

Make this a day or two ahead if you can, for it gets better with age. It can also be made weeks ahead of time and frozen. Freeze only the meat mixture and add the beans when re-heating. 

Serves 12:  8.5 carbs per serving using tomatoes; 3.2 carbs per serving using broth.

This recipe works well whether you prefer a tomato-based chili, or a tomato-LESS chili. Note the differences in carb counts, though.

Ingredients

2 cloves garlic, minced

1 cup onion, chopped

3 Tablespoons coconut oil

900gms beef, chopped

4 cups canned tomatoes, undrained
OR 4 cups low sodium beef stock or broth

2 teaspoons salt (omit if using salted stock/broth)

2 bay leafs

1 teaspoon oregano

1/4 teaspoon crushed cumin

2-3 Tablespoons chili powder (or to taste)

2  450gms cans Black soy beans, drained

Cooking Method

Use a deep heavy kettle or Dutch oven, and cook the garlic, onion, coconut oil and beef together for about 10 minutes. The meat should be chopped, not ground, and cooked, at this stage, only long enough to lose its red color.

Next add the tomatoes OR beef stock. Add the seasonings and simmer for about an hour or until meat is very tender. Then add the beans and simmer for another 30 minutes.

Make this a day or two ahead if you can, for it gets better with age. It can also be made weeks ahead of time and frozen. Freeze only the meat mixture and add the beans when re-heating. 

Serves 12:  8.5 carbs per serving using tomatoes; 3.2 carbs per serving using broth.

How are insulin resistance and prediabetes diagnosed?

Health care providers use blood tests to determine whether a person has prediabetes, but they do not usually test specifically for insulin resistance. Insulin resistance can be assessed by measuring the level of insulin in the blood.

However, the test that most accurately measures insulin resistance, called the euglycemic clamp, is too costly and complicated to be used in most health care providers’ offices. The clamp is a research tool used by scientists to learn more about glucose metabolism. Research has shown that if blood tests indicate prediabetes, insulin resistance most likely is present.

Blood Tests for Prediabetes

All blood tests involve drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. Lab analysis of blood is needed to ensure test results are accurate. Glucose measuring devices used in a health care provider’s office, such as finger-stick devices, are not accurate enough for diagnosis but may be used as a quick indicator of high blood glucose.

Prediabetes can be detected with one of the following blood tests:

the A1C test

the fasting plasma glucose (FPG) test

the oral glucose tolerance test (OGTT)

A1C test. 

Sometimes called hemoglobin A1c, HbA1c, or glycohemoglobin test, this test reflects average blood glucose levels over the past 3 months. This test is the most reliable test for prediabetes, but it is not as sensitive as the other tests. In some individuals, it may miss prediabetes that could be caught by glucose tests.

Although some health care providers can quickly measure A1C in their office, that type of measurement—called a point-of-care test—is not considered reliable for diagnosis. For diagnosis of prediabetes, the A1C test should be analyzed in a laboratory using a method that is certified by the NGSP.

The A1C test can be unreliable for diagnosing prediabetes in people with certain conditions that are known to interfere with the results. Interference should be suspected when A1C results seem very different from the results of a blood glucose test. People of African, Mediterranean, or Southeast Asian descent, or people with family members with sickle cell anemia or a thalassemia, are particularly at risk of interference. People in these groups may have a less common type of hemoglobin, known as a hemoglobin variant, that can interfere with some A1C tests.

An A1C of 5.7 to 6.4 percent indicates prediabetes.

More information about the A1C test is provided in the NIDDK health topic, The A1C Test and Diabetes.

Fasting plasma glucose test

This test measures blood glucose in people who have not eaten anything for at least 8 hours. This test is most reliable when done in the morning. Prediabetes found with this test is called IFG.

Fasting glucose levels of 100 to 125 mg/dL indicate prediabetes.

OGTT.

This test measures blood glucose after people have not eaten for at least 8 hours and 2 hours after they drink a sweet liquid provided by a health care provider or laboratory. Prediabetes found with this test is called IGT.

A blood glucose level between 140 and 199 mg/dL indicates prediabetes.

The table above lists the blood test levels for a diagnosis of prediabetes.

Understanding Test Results

A blood test indicating prediabetes means that insulin resistance has progressed to the point where the beta cells in the pancreas can no longer compensate and a person’s blood glucose levels are rising toward type 2 diabetes. The higher the test results, the greater the risk of type 2 diabetes. The level of risk also depends on an individual’s other risk factors, which are listed in the section “Who should be tested for prediabetes?”

Test numbers

For example, people with an A1C below 5.7 percent may still be at risk for diabetes if they have a family history of type 2 diabetes or have gained excess weight around the waist. People with an A1C above 6.0 percent should be considered at very high risk of developing diabetes. A level of 6.5 percent or above means a person has diabetes.

Follow up

People whose test results indicate they have prediabetes may be retested in 1 year and should consider making lifestyle changes to reduce their risk of developing type 2 diabetes.

Varying results

Although all these tests can be used to test for prediabetes, in some people one test will indicate a diagnosis of prediabetes or diabetes when another test does not. People with differing test results may be in an early stage of the disease, where blood glucose levels have not risen high enough to show on every test.

Health care providers repeat laboratory tests to confirm test results. Diabetes develops over time, so even with variations in test results, health care providers can tell when overall blood glucose levels are becoming too high.