Have you been diagnosed with prediabetes or suspect that you may have it? If so, you’re in good company. Prediabetes is a condition that affects more than 97 million people in the US alone, most of whom are unaware that they have it.
Prediabetes serves as a warning signal, indicating an increased risk of developing type 2 diabetes, heart disease, and stroke if preventive measures are not taken.
The good news is that you have the power to turn prediabetes around. Keep reading to learn more about prediabetes and how switching to a ketogenic diet can help you avoid type 2 diabetes and improve your overall health.
What is Prediabetes, and Why Does it Happen?
In prediabetes, blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes.
When you consume carbohydrates –– found in foods like bread, pasta, milk, fruit, and sweets –– they are broken down into glucose (sugar) and absorbed into your bloodstream. This causes blood glucose levels to rise. In response, your pancreas produces insulin, a hormone which helps move glucose from your blood into your cells to maintain stable blood glucose levels.
Prediabetes occurs when the body begins to lose its ability to regulate blood glucose levels effectively. This is because the body’s cells become resistant to insulin’s effects, and the beta cells that make insulin no longer function the way they should.
Consequently, your pancreas compensates by producing more insulin in an effort to normalize your blood glucose levels. So, prediabetes typically involves both insulin resistance and hyperinsulinemia (too much insulin in the blood).
According to the American Diabetes Association, prediabetes can be diagnosed by three methods:
- Fasting Plasma Glucose (FPG): Plasma glucose of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) measured after going without food for at least 10 hours.
- Oral Glucose Tolerance Test (OGTT): Plasma glucose of 140 to 199 mg/dL (7.8 to 11.0 mmol/L) measured two hours after a 75-gram glucose load.
- Hemoglobin A1C (HbA1c): 5.7% to 6.4% measured anytime; reflects average blood glucose levels for the past 60 to 90 days.
Are Prediabetes and Metabolic Syndrome the Same Thing?
Prediabetes and metabolic syndrome are similar conditions that often overlap, but they are not the same.
The only criteria for a prediabetes diagnosis are the abnormal blood glucose values listed above.
In contrast, to be diagnosed with metabolic syndrome, you must have at least three of the following:
- Abdominal obesity:
- Waist circumference over 40 inches (102 cm) for men
- Waist circumference over 35 inches (89 cm) for women
- High triglycerides:
- 150 mg/dL (1.7 mmol/L) or higher
- Low HDL cholesterol:
- Less than 40 mg/dL (1.0 mmol/L) for men
- Less than 50 mg/dL (1.3 mmol/L) for women
- Elevated blood pressure:
- 130/85 mmHg or higher
- Elevated fasting blood glucose:
- 100 mg/dL (5.6 mmol/L) or higher
Even so, people who have prediabetes often meet at least one of the criteria for metabolic syndrome in addition to elevated blood glucose levels.
Risks Factors for Prediabetes
Several factors contribute to the development of prediabetes, including:
- Obesity: Carrying excess fat –– particularly visceral fat in the liver and other organs in the abdominal cavity –– increases your risk for prediabetes. However, not everyone with prediabetes is obese or overweight.
- Sedentary Lifestyle: Lack of physical activity can reduce the body’s ability to use glucose efficiently.
- Genetics: A family history of diabetes increases susceptibility to prediabetes.
- Age: The risk for prediabetes increases with age, particularly after 45 years.
- Ethnicity: Certain ethnic groups –– including African Americans, Hispanics, Native Americans, and Asian Americans –– have higher rates of prediabetes.
Does having prediabetes mean that you will eventually develop type 2 diabetes? Not necessarily. It’s estimated that around 50% of people with prediabetes will progress to type 2 diabetes within their lifetime. However, you can develop complications even if your blood glucose levels remain within the prediabetes range. Researchers report that retinopathy (eye damage), neuropathy (nerve damage), and chronic kidney disease occur far more often in people with prediabetes compared to those with normal blood sugar levels. This is another reason why it’s so important to take steps now to get your blood glucose and insulin levels under control.
The Ketogenic Diet Provides Impressive Benefits for People with Prediabetes
The ketogenic diet –– which is high in fat, moderate in protein, and very low in carbohydrates (carbs) –– has received a lot of attention for its beneficial effects in type 2 diabetes and prediabetes. When you drastically reduce carb intake, you enter a state called nutritional ketosis, where the body switches from using glucose to using ketone bodies and fat as its main fuel sources.
This shift can have profound effects on metabolic health, including:
- Lowering blood glucose levels and potentially reversing prediabetes: Strong scientific evidence supports ketogenic diets for improving type 2 diabetes outcomes. Although there is far less research on ketogenic diets for prediabetes, in clinical trials, people with prediabetes have dramatically improved their blood glucose control by switching to a ketogenic diet. In a continuous remote intervention from Virta Health lasting two years, 53% of people with prediabetes who followed a ketogenic diet achieved normal blood glucose levels without taking any medication, along with losing an average of 26 pounds (12 kg) and reducing their fasting insulin levels. Importantly, those who were compliant with the diet and achieved nutritional ketosis –– confirmed by measuring with a blood ketone meter –– were the most successful at reversing their prediabetes and achieving weight loss.
- Improving insulin sensitivity: The reduction in circulating insulin levels and reliance on ketone bodies for energy enhances the body’s sensitivity to insulin.
- Fat loss: A ketogenic diet promotes loss of body fat, especially visceral fat. This is crucial, as excess fat is a significant factor in the development of insulin resistance.
- Decreased inflammation: Chronic low-grade inflammation is a hallmark of metabolic disorders, including prediabetes. By boosting production of ketones, especially beta-hydroxybutyrate, a ketogenic diet could be a potential strategy to reduce inflammation. In studies, beta-hydroxybutyrate has been found to have anti-inflammatory properties and to protect from oxidative stress.
- Improved lipid profile: Contrary to claims that ketogenic diets increase the risk for cardiovascular disease (CVD), recent evidence suggests that this way of eating often leads to improvements in cardiovascular risk factors in people with insulin resistant-conditions like type 2 diabetes, such as increases in HDL cholesterol and decreases in triglycerides, as well as reductions in small LDL particles. Learn more about cholesterol and lipids on a ketogenic diet.
As mentioned earlier, metabolic syndrome and prediabetes are similar but different. However, a ketogenic diet may also be effective for reversing metabolic syndrome. In one trial, Spanish researchers studied the effects of a Mediterranean ketogenic diet in 22 people with metabolic syndrome. After 12 weeks, participants had lost an average of 32 pounds (14.5 kilos) and nearly 7 inches (17 cm) from around their waist. In addition, all the participants no longer met the criteria for metabolic syndrome.
How to Get Started
If you’re ready to reverse your prediabetes by switching to a keto lifestyle, start with the first step: Learning what foods to eat. Then, start exploring the 7 Steps to Keto Success.
Lifestyle Changes Complementing the Ketogenic Diet
While the ketogenic diet is a powerful tool, its effectiveness is amplified when combined with other healthy lifestyle changes, such as:
- Regular Physical Activity: Combining moderate intensity cardiovascular exercise with low-to-moderate intensity resistance training seems to provide the most benefits on blood glucose control, weight loss, and cardiovascular health in people with prediabetes. Aim for a minimum of 45 to 60 minutes of exercise at least three times a week, working up to this amount gradually as needed. Learn more about exercising on a keto diet.
- Adequate Sleep: Poor sleep quality and duration are linked to weight gain, insulin resistance, and increased risk for type 2 diabetes. Strive for 7-9 hours of restorative sleep per night.
- Stress Management: Chronic stress can raise blood glucose and exacerbate insulin resistance. Although you can’t eliminate stress from your life, techniques such as meditation and mind-body practices like yoga and tai-chi can help you manage stress effectively.
Empowering Your Health Journey
Prediabetes is an opportunity to proactively improve your health and prevent the development of type 2 diabetes. The ketogenic diet offers a healthy, sustainable way to reverse prediabetes and optimize metabolic health. By adopting a keto diet and integrating other healthy lifestyle practices, you can avoid type 2 diabetes and embark on a path to better health and vitality.
Note: Be sure to speak with your doctor or other health care provider before starting a ketogenic diet. This is especially important if you take any medications. For instance, blood pressure medication may need to be reduced or discontinued in order to prevent your blood pressure from dropping too low.
