Can you reverse prediabetes


Can Prediabetes Go Away?

Being diagnosed with prediabetes doesn’t mean you will develop diabetes. Your doctor can help you come up with an effective plan to keep your blood sugar low, so that you can keep diabetes away for good.

Prediabetes, the common precursor to diabetes, affects more than 86 million Americans, according to the Centers for Disease Control and Prevention. An estimated 90 percent of people with prediabetes don’t even realize they have this condition. Experts also estimate that three out of four people with prediabetes will eventually develop diabetes.

The good news, however, is that once your doctor determines that your blood sugar is high enough to be classified as prediabetes (but not high enough to be diabetes), there are plenty of preventive measures you can take to stop the onset of full diabetes. The window of opportunity to prevent or slow the progression of prediabetes to type 2 diabetes is about three to six years.

Make sure you take the following steps to be on the right path to fight prediabetes and take the appropriate steps to lower your blood sugar level.

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1. Take the quiz

One of the first things you can do to find out if you are at risk for prediabetes or type 2 diabetes, is take the American Diabetes Association’s Risk Test. The ADA offers a helpful one-minute quiz, which features questions about age, weight and your family history of diabetes. The results will determine if you are at a low, moderate or high risk of diabetes.

2. Check your glucose level

If your quiz results determine that you have a high chance of developing diabetes, be sure to consult with your doctor and ask for a glucose test to check your blood’s sugar level.

3. Reduce calorie and fat intake

Research has shown that losing 5 to 7 percent of your body weight can help decrease blood glucose levels and help other health goals, such as improving blood pressure, raising HDL (good cholesterol) and lowering triglycerides. You can accomplish this goal by consuming fruits, vegetables and whole grains and staying away from processed foods. Nutritionists often recommend sticking with a variety of food, so that your taste buds won’t get bored and you can continue a healthy diet.

4. Stay active

Try to hit 150 minutes of physical activity, or only half-hour a day for five days, in one week. You can achieve many of your health goals by keeping your mind and body trained. Recommended exercises include walking, jogging, running, biking, swimming or group exercises, such as yoga or spinning.

5. Keep monitoring your blood glucose level

The ADA recommends that people who are diagnosed with prediabetes get their glucose levels checked annually. You may even ask your health care provider whether you need a home glucose monitor to check the state of your prediabetes. That’s because the possibility of recurrence always exists. Aging, gaining weight or falling back on habits, such as smoking, overeating or not exercising can cause blood glucose levels to rise again.

6. You may need medication

If you are at high risk of developing diabetes, your doctor may recommend medication to help you manage it. Medications to control cholesterol and high blood pressure may also be prescribed.

If you’re concerned about having prediabetes or are experiencing symptoms of diabetes, it’s a good idea to contact your primary care physician for advice. If you are local to Southern California and are in search of a primary care physician, call (800) USC-CARE (800-872-2273) or visit to schedule an appointment.

by Ramin Zahed

Health Blog

As recently as five years ago, many people had never heard of prediabetes. Lately, more and more people are starting to understand that prediabetes means they have a blood sugar level that is above normal, but not quite high enough to be type 2 diabetes.

Eighty-six million Americans—one out of three adults—now have prediabetes. Yet nine out of 10 of them don’t even know they have it. Without intervention, 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years. People with type 2 diabetes have an increased risk of heart attack and stroke.

Preventing Prediabetes Through Diet and Exercise
The good news is that people with pre-diabetes can often avoid developing type 2 diabetes by eating a healthy diet, getting regular exercise and losing weight. I have heard from a number of patients who have attended classes I’ve taught on pre-diabetes that they lost weight, started exercising more and their blood sugar dropped significantly.

If you have pre-diabetes, you don’t have to lose a lot of weight to reduce your risk of developing diabetes. By losing just 5% to 7% of your body weight, you can reduce your risk. For example, a 200-pound person can reduce their risk just by losing 10 to 14 pounds, and staying active.

Eating and exercise guidelines for a person with pre-diabetes are similar to those for anyone trying to live a healthy lifestyle. For dinner, take a nine-inch plate and fill half with vegetables, one-quarter with a protein such as fish or chicken, and one-quarter with carbohydrates such as whole-grain pasta. You can add a serving of fruit (such as a small piece of fresh fruit or ½ to one cup of cut up fruit) and a serving of dairy (such as an 8-ounce cup of milk or a 6-ounce serving of yogurt).

Try to be active for 30 minutes a day, five days a week, in whatever way you find enjoyable. Brisk walking is always a good way to keep moving.

Who is at Risk of Prediabetes?
People at increased risk for prediabetes:

  • Are overweight
  • Are at least 45 years old
  • Have a parent or sibling with type 2 diabetes
  • Are physically active fewer than three times per week
  • Have given birth to a baby weighing more than 9 pounds
  • Had diabetes while pregnant

You can also take an online quiz from the Centers for Disease Control and Prevention (CDC) to see if you are at increased risk. If you think you might be at risk, talk to your doctor about getting a blood test to check your blood sugar level. Montefiore Nyack Hospital will be offering a CDC-recognized Diabetes Prevention Program in 2017.

We all know we should eat right and exercise. But getting the results of a blood test that tells you that you have prediabetes gives you extra motivation to make changes now to improve your health and lose weight—and avoid developing diabetes.

Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call.

Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes.

One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care. The U.S. Preventive Services Task Force recommends blood sugar “screening” only in individuals with high blood pressure. (Screening means hunting for hidden disease in the absence of any outward signs or symptoms.) That’s important, because recommendations from the Task Force, an independent panel of experts, are used by many health-care organizations to determine preventive care. In addition, Task Force recommendations will help determine what services are covered under the Affordable Care Act.

Expanding the net

The American Diabetes Association and other organizations recommend routine blood sugar testing in people at high risk for developing diabetes. These include:

  • everyone over age 45
  • younger people who are overweight and who also have one of these diabetes risk factors:
    • little or no physical activity
    • family history of diabetes
    • high blood pressure or high cholesterol
    • previous diagnosis of heart disease or polycystic ovary syndrome
    • diabetes during pregnancy (gestational diabetes) or having delivered a baby weighing more than nine pounds

Some experts are encouraging the U.S. Preventive Services Task Force to expand its recommendation on blood sugar screening.

Why bother?

Not everyone with prediabetes will go on to develop diabetes. Over the short term (three to five years), about 25% of people with prediabetes develop full-blown diabetes. The percentage is significantly larger over the long term.

Getting the wake-up call of prediabetes can be very useful. A three-part strategy can keep many people with it from ever getting diabetes. The strategy includes modest weight loss, increased physical activity, such as walking 30 minutes a day, and choosing a healthier diet. In addition to helping stave off diabetes, these lifestyle changes can also help protect against heart attack, stroke, bone-thinning osteoporosis, and a host of other chronic conditions.

Those efforts are worth it, because diabetes can cause damage throughout the body. Extra glucose (blood sugar) can change the way blood vessels behave, increasing the chances of having a heart attack, stroke, or other form of cardiovascular disease. Diabetes-related damage to small blood vessels can lead to blindness, kidney disease, and loss of feeling. It is a leading cause in the United States of hard-to-treat infections and amputations.

Providing more people with a wake-up call that diabetes may be looming, and heeding that call, could help battle the epidemic of diabetes.

So what is prediabetes?

Prediabetes is a condition where your blood sugar is higher than normal, but not high enough for you to be considered diabetic. According to the American Diabetes Association, prediabetes is diagnosed when:

  • A Hemoglobin A1C reading between 5.7-6.4 percent
  • A fasting blood glucose between 100 -125 mg/dl
  • An oral glucose tolerance test 2 hour blood glucose reading between 140 mg/dl-199 mg/dl

A diagnosis of prediabetes usually indicates insulin resistance, which means your body doesn’t use insulin properly. Insulin regulates your body’s usage and storage of sugar and fat.

How Your Body Should Use Insulin

When your body uses insulin properly, it works like this:

  • Your glucose (blood sugar) rises after you eat.
  • Your pancreas releases insulin, which unlocks your cells.
  • Your unlocked cells are then able to use the glucose for energy.

What Happens If Your Body is Insulin Resistant

If your body is insulin resistant, here’s what happens:

  • Your glucose (blood sugar) rises after you eat.
  • Your pancreas releases insulin, but your cells resist the insulin and the glucose isn’t introduced to the cells efficiently.
  • The glucose stays in your blood (keeping your blood sugar levels high) because your cells aren’t burning the glucose for energy.

Over time, high blood sugar levels damage your cells and may lead to nerve damage, blood vessel and organ damage, cardiovascular disease and more.

“Prediabetes can be a scary diagnosis,” says Douglas Jones, MD, a physician at the Utah Valley Hospital Diabetes Management Clinic. “But being told you have prediabetes isn’t a death sentence. It can be a wake-up call to pay more attention to your body and make changes that will lead to a longer, healthier life.”

The best treatment for prediabetes? Lifestyle changes.

Lose 5-7 Percent of Your Body Weight

When you have a lot of weight to lose it’s daunting to think of the work it will take to lose all of it. Setting a goal of 5-7 percent (that’s around 7 lbs. for a 150 lb. person), makes losing weight seem more manageable. Weight loss will help reduce inflammation, which is a symptom of insulin resistance.

RELATED: 10 Ways You May Be Sabotaging Your Weight Loss

Move More

Exercise is a big part of reversing prediabetes. “Exercise is good for you no matter what, but if you’re prediabetic, it’s especially helpful to get moving. Your muscles use up some of your excess blood sugar, which helps you lose weight and use the insulin your body produces more effectively,” says Dr. Jones.

RELATED: 7 Unconventional Ways to Squeeze in More Exercise

Eat More Vegetables

When planning your meal, start with vegetables and don’t stop till they take up half the room on your plate. Vegetables have lots of fibers to help manage the levels of glucose in your system. Plus, they’re high in vitamins and minerals that help your body work better. “Even if you don’t love vegetables you can find ways to sneak them in,” says Dr. Jones. “Add spinach to your morning smoothie or add extra veggies to your pasta dish. It all adds up.”

Know Your Carbs

All carbohydrates break down to glucose in your blood. So whether you’re eating carbs in the form of donuts, pasta or whole grain bread, it all breaks down to glucose for your cells to use. That doesn’t mean you should eat cake instead of quinoa, because not all carbs are created equal. There are three main types of carbohydrates:

  • Simple carbohydrates—fast acting carbohydrates that cause an immediate rise in blood sugar. These are found in foods like fruits, juices, maple syrups, milk, yogurt, and honey.
  • Refined carbohydrates—these are also fast-acting carbohydrates. These are plant based, processed foods that have had the whole grain removed during processing.
  • Complex carbohydrates—these carbs take longer for our body to break down and are absorbed into the system more slowly. This helps keep blood sugar stable. Examples of complex carbs include most vegetables, whole grains (unprocessed!) and beans.

Talk To Your Doctor About Managing Your Prediabetes

This may seem like a no-brainer, but make sure you work with your primary care physician to manage your symptoms. Dr. Jones says, “In some cases prediabetes can be managed through changes to nutrition and physical activity. Other people may benefit from a drug to help manage blood sugar levels. Your doctor can also help you learn how to take your own blood sugar so you can monitor yourself between visits.”

Whatever you do, don’t ignore prediabetes. Be proactive and take charge of your health. Make changes to your lifestyle and work with your doctor to help control your blood sugar. You’ll feel better, and you’ll help prevent diabetes.

Taking Steps to Reverse Prediabetes

This is the third in a three-part series about prediabetes, and in previous blogs we looked at what it is and how to live with it. Here we focus on how you can reverse it.

Can you reverse a pre-diabetes diagnosis? In short, the answer is yes. Perhaps you’;ve been prediabetic for a while now, managing the illness pretty well and making improvements in the kitchen and with exercise. If so, you are on the right path and in time you may reverse your prediabetes condition.

The key is consistency and adopting these new habits permanently into your new lifestyle.

Exercise and eat healthy to reverse prediabetes.

As with anyone simply trying to lose weight, you can temporarily change behaviors and achieve success. But the key is keeping with your new healthier habits for the long term.

Staying physically active and eating a healthy, balanced diet every day is the prescription. Most doctors would agree that their patients can improve their own health by making tweaks to their everyday choices.

According to the Mayo Clinic, without lifestyle changes, people with pre-diabetes are very likely to progress to type 2 diabetes. And if you already are prediabetic, it may have started long-term damage to your heart, blood vessels and kidneys. While prediabetes may not seem life-threatening or even a big deal, more serious consequences can follow (as a type 2 diabetic) such as:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Kidney disease
  • Blindness
  • Amputations

If you recall from our first blog in this series, people with prediabetes don’t process sugar (glucose) properly. Their fasting plasma glucose levels are above a normal range of 100 mg, but not quite the minimum level of 126 mg associated with full-blown diabetes. (See the chart.) Most of the glucose in your body comes from the food you eat. When our food is digested, sugar enters the bloodstream. With pre-diabetes, however, sugars accumulate in the bloodstream instead of fueling the cells.

This can be avoided or corrected if you:

  • Eat healthy foods. Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition.
  • Be more active. Aim for 30 to 60 minutes of moderate physical activity most days of the week. Walking is the best exercise since it’;s free and low-impact.
  • Lose excess weight. If you’re overweight, losing just 5 to 10 percent of your body weight — only 10 to 20 pounds if you weigh 200 pounds — can reduce the risk of developing type 2 diabetes. Stay motivated by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem. You are rewarding your body and not punishing it.
  • Stop smoking. If you don’;t smoke, don’;t ever start. If you do, quit. UPMC Pinnacle offers a smoking cessation program that can support your efforts.
  • Discuss your symptoms with your doctor. Sometimes your doctor will prescribe a medicine called Metformin. In trials, this has been shown to reduce the risk of diabetes by 30 percent. It decreases your appetite and also helps with weight reduction. It also decreases the glucose production from your liver.

For more information about diabetes management and our programs, please visit us at

7 Simple Ways to Reverse Prediabetes

Your doctor broke news you didn’t want to hear: you have prediabetes, a condition where blood sugar is elevated, but not high enough to be considered type 2 diabetes. The thing is, with that info, you’re one of the lucky minority. Prediabetes is common, affecting 84 million American adults, according to the Centers for Disease Control and Prevention, but just 10 percent are aware that they have it. Knowing that you have prediabetes can be enough to push you to make the changes you need, research shows.

Learn more: Prediabetes Symptoms-and How to Know If You’re at Risk

While genes strongly influence whether someone develops prediabetes and type 2 diabetes, you have some control, says Jill Weisenberger, M.S., RDN, CDE, author of Prediabetes: A Complete Guide. “Even for those with a strong family history, lifestyle habits can prevent or delay the onset of type 2 diabetes. And a delay can mean less medications for fewer years and fewer complications,” she says. “The prediabetes stage is the best time to reverse course,” Weisenberger adds. In fact, lifestyle changes have been shown to reduce the risk of prediabetes progressing to type 2, per a 2018 study in Primary Care Diabetes.

The goal: reduce insulin resistance and preserve beta cell function (beta cells are pancreatic cells that produce insulin). Minor weight loss-just 5 to 7 percent of your body weight-can decrease your risk of developing type 2 diabetes by up to 58 percent, says the CDC, in part because a healthier weight generally means better insulin sensitivity. However, improving insulin sensitivity goes beyond the number on the scale. Here are seven ways to do just that.

Stop Focusing on Numbers

You may be prepared for a lifetime of breaking down your food by numbers (calories, fat, carbs), but “that’s much too simplistic and is likely to take you off course. Food quality is your best bet to improve insulin sensitivity,” says Weisenberger. There’s no need to be scared of carbs, including whole grains (Learn more about the benefits of complex carbohydrates). What’s more, just because something is low-carb does not make it healthy. She recommends filling your plate with berries, vegetables, oats, barley, beans and lentils, which are all sources of high-fiber carbohydrates that help reduce risk of disease.

Related: The Best 7-Day Diabetes Meal Plan

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Walk More

Exercise helps muscles soak up glucose to be used for fuel, and it’s one of the best ways to improve insulin sensitivity. That said, you don’t have to jump into an intense routine to see effects. Your goal: walk 11 miles per week, or just over 1.5 miles per day, which research in Diabetelogia shows may be just as effective as an approach involving dieting, exercising and losing weight. If that amount feels like too tall an order at first, at least establish the habit by walking 10 minutes five to seven times a week and building from there, says Weisenberger.

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Pictured recipe: Pork & Broccoli Thai Noodle Salad

Eat an Early Dinner

Intermittent fasting (IF)-where you restrict your food intake to a specific window during the day-is on-trend right now. And there is some indication that IF may actually be useful if you have prediabetes. In a study published in Cell Metabolism on men with prediabetes, participants were asked to limit their food intake to a six-hour period (the IF group) or assigned to a control group that ate in a 12-hour window for five weeks. Even though they didn’t lose weight, those in the IF group saw their insulin sensitivity, beta cell function and blood pressure improve, and they also saw their appetite in the evening decrease.

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Stop the Before-Bed Email Check

This diagnosis is your wake-up call to ditch the habits that you know cut into good sleep, like staring at your phone, tapping out just one last email while in bed. “Sleep is not optional, it’s a necessity. Sleep deprivation is linked to obesity, heart disease and type 2 diabetes,” says Weisenberger, who adds that sleep deprivation reduces insulin sensitivity even in adults without diabetes. In one study, people who had poor sleep quality were more than 2.5 times more likely to develop diabetes.

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Pictured recipe: Muesli with Raspberries

Eat More Raspberries … and Fiber in General

Sweet, juicy red raspberries add more than flavor to your morning bowl of oatmeal or smoothie, per new research in Obesity. In a small study on adults who were overweight or obese and had prediabetes, those consuming at least one cup of red raspberries with breakfast experienced an improvement in glycemic control for two hours after the meal, which researchers attributed to improved insulin sensitivity. Raspberries are yummy and a great source of fiber, but it’s important to note that this research was supported by a raspberry industry group-including plenty of other fiber-rich foods in your diet should help as well.

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Practice Self-Care

Daily stressors are a given, but how you deal with them is what counts. What self-care looks like-spending your lunch break in the sunshine, scheduling walking dates with friends-doesn’t matter as much as doing it regularly. “Emotional stress has a way of distracting us from good habits and our health goals. It may also affect glucose metabolism in some people,” says Weisenberger.

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Start Strength Training

If you’re already walking more throughout the day, add in strength training too. In one study where sedentary overweight or obese adults over age 50 with prediabetes performed resistance training twice a week, 34 percent of participants had normal blood sugar levels after three months. You don’t have to bench heavy weights to reap the benefits, either. Start out with simple body-weight exercises (that are easily modifiable) like lunges, squats and push-ups.

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Shift Your Mindset

Achieving an HbA1C level of 5.7 percent or a 5 percent weight loss may bring you back from the brink of diabetes, but thinking only in terms of those numbers can veer you off course. “A lot of people get off track because they focus more on the goal and ignore the process. But it’s focusing on the process that helps us get to the goal and stay there,” says Weisenberger. By being journey-oriented, you can build healthy habits into your life, like making time for movement that feels good to your body or figuring out how to throw together quick dinners during crazy weeks. “Your emphasis should be on habits, not weight loss,” she says.

Related: 12 Healthy Ways to Lower Your Blood Sugar

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Can I reverse prediabetes?

Ask the doctors

Published: November, 2019

Q. My doctor recently told me I have prediabetes. Is this condition reversible?

A. Yes, it is possible to reverse prediabetes. Prediabetes is a condition that affects millions of Americans. The CDC estimates that as many as one in every three American adults has the condition, which is defined as having blood sugar that is elevated, but not high enough to meet the threshold for diabetes. Left untreated, prediabetes can progress to diabetes, a condition in which your body is not able to absorb glucose for energy properly, causing blood sugar to rise. If it’s not managed properly, diabetes can lead to a number of health problems, from heart attack and stroke to blindness, kidney problems, and infections, among others. But making some lifestyle changes can reduce the risk that your prediabetes will develop into diabetes.

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What is pre-diabetes?

Diabetes is where insulin – the hormone made by the body to keep blood sugar levels in the normal range – isn’t produced or not enough of it is being made. Complications of type 2 diabetes include problems with the heart, kidneys, eyes, feet and nerves.

Your blood glucose level is the amount of glucose (or sugar) in your blood. With pre-diabetes, your blood glucose level is higher than normal but not high enough to be diagnosed with type 2 diabetes. Your target blood glucose levels vary depending on your age, general health and medications you take.

Pre-diabetes includes 2 conditions:

  • impaired glucose tolerance: higher levels than normal (diagnosed by measuring levels after a sugary drink)
  • impaired fasting glucose: higher than normal after fasting (8 hours for diagnosis)

Am you at risk of pre-diabetes?

Pre-diabetes has no signs or symptoms. The risk factors for pre-diabetes are similar to those for type 2 diabetes:

  • family history of type 2 diabetes or heart disease
  • being overweight
  • inactive lifestyle
  • smoking
  • high blood pressure
  • high cholesterol
  • polycystic ovarian syndrome
  • from an Aboriginal, Torres Strait Islander, Middle Eastern, South Asian, Pacific Islander or North African ethnic background.

Women who’ve been diagnosed with gestational diabetes during pregnancy are also at increased risk of developing type 2 diabetes, says says registered nurse and diabetes educator Kim Welch, a spokesperson for Diabetes Victoria.

“Once gestational diabetes is picked up there’s around a 58% chance that you’ll develop type 2 diabetes within 10 years,” she says.
Welch recommends an annual check-up with your doctor if you’re in any of the risk categories.

Can pre-diabetes be reversed?

If you’re diagnosed with pre-diabetes you’ll likely be recommended the same lifestyle changes as people with type 2 diabetes, including healthy eating, regular exercise and, if necessary, losing weight.

“Pre-diabetes doesn’t have to become type 2 diabetes,” says Welch. “Eat a healthy diet that includes whole foods, lean protein, good fats, lots of fruit and vegetables and good low-GI carbohydrates like grains and pulses.”

Do regular exercise for general health and to help your body use insulin better. High Intensity Interval Training (HIIT) has been found to be particularly beneficial in improving glucose control. If you don’t already exercise regularly, or have other health conditions, consult your doctor before trying HIIT.

Sophia swapped takeaway lunches for homemade food and doing more exercise. The result? Just 6 months later her blood glucose levels were back in the normal range – where they’ve remained for the past 5 years.

“When I looked at what I was eating for lunch, my food was high in carbohydrates with very little protein and vegetables,” she says. “I realised that swimming once a week was insufficient – I needed daily walks as my work is pretty sedentary. Just last month I had my annual blood test and everything is good.”

3 Steps I Took to Cut Sugar From My Diet and Reverse Prediabetes

Medically Reviewed by Kelly Kennedy, RD

“Drink this, and you’ll have no problem with the sugar,” he said. I stared down at the glass of water with cut-up chunks of okra floating in it that he held out to me. “It will filter it out of your blood,” he added.

I felt queasy, and a little annoyed. I had just turned down a plate of apple pie and ice cream that my aunt’s in-laws had offered me in their home, even though I had already explained that I eat a low-sugar diet to prevent the return of prediabetes. The man of the house — who had diabetes himself — meant well, and truly believed that I would rather drink slimy okra water than forgo a sweet treat. Yes, okra is a good source of dietary fiber, which can help slow down the release of sugar into the blood, but it certainly is not a cure that allows people with diabetes or those at risk for the disease to eat desserts with impunity.

More important, I have already done something that he — and many other people — simply do not believe is possible: I have beaten my addiction to sugar and lowered my A1C, thereby reducing my prediabetes diagnosis. The plate of gooey ice cream and flaky apple pie looked barely more appealing to me than the okra water. Turning it down didn’t leave me feeling deprived.

Why I Quit Sugar and How You Can Do It, Too

That’s because five years after reversing a prediabetes diagnosis, I think it’s safe to say I have kicked a lifelong sugar habit. As a tween, that craving was so intense that I would lift sugar packets from a restaurant table when no one was looking, excuse myself to go to the restroom, and, once safely hidden in a stall, pour the crystals straight down my throat.

Over three decades later, in the midst of a divorce, I was self-soothing with weekly slabs of vegan Mississippi Mud pie when my doctor informed me that my A1C was 6.3 percent, on the borderline of a diabetes, which is 6.5 percent and above, according to the Mayo Clinic. Given a family history of type 2 diabetes, she said I was all but certain to develop the condition.

The doctor told me to cut drastically the amount of carbohydrates I was consuming. I complied, but I didn’t go cold turkey. I weaned myself off high-sugar foods one step at a time using my own approach.

Step 1 to Quitting Sugar: Swap Desserts, Sweet Drinks, and Energy Bars for Dried Fruit and Smoothies

Vegan treats (which I ate because of lactose intolerance) were out because, like most popular confections, they are high in carbohydrates including sugar. Ditto energy bars, which are often packed with sugar and other carbs. I had already discovered that dried fruits, such as dates, were very sweet and high in dietary fiber. Fresh-fruit smoothies — ice and fruit with a vegan protein powder, no added sweeteners — provided a great midday pick-me-up. Already my palate was beginning to detect the sweetness in the fruit, which beforehand had always tasted like bland pulp to me.

Step 2 to Quitting Sugar: Move Away From Eating Processed Fruits and Transition to Whole Fruits

The dried fruits became cloying to my newly sensitive palate, and I was aware of another issue, summed up by Amy Campbell, RDN, CDE, a nutritionist at Good Measures: “Dates pack a lot of calories and carbohydrate in a fairly small portion … and because all dried fruits contain a concentrated amount of carbohydrates, they can quickly spike blood sugar levels.” She advises keeping a close eye on portions.

I also switched from smoothies to whole fruit with the skin on to retain all their beneficial dietary fiber, sometimes relying on a trick my parents used when I was a child to bring out the sweetness in fruit: Freeze it.

Step 3 to Quitting Sugar: Stick With Fresh and Whole Fruit, but Eat Less of It

These days, I control all carbohydrate portions more strictly and don’t eat fruit all day long. A trip to the doctor two years ago revealed that my A1C was creeping upward again, and my mind immediately went to my nightly snack of frozen grapes. I cut back, and my readings retreated.

But I do maintain one daily “cheat”: a single packet of sugar — the kind I snuck into the bathroom as a child — with my morning cup of black coffee. That’s it.

That small, daily indulgence, plus the moderation-driven approach of stepping down gradually from sweet stuff, may be why I’ve been able to maintain a low-sugar lifestyle, observes Melissa Joy Dobbins, RDN, CDE, a spokeswoman for the American Association of Diabetes Educators (AADE). “We preach moderation to people because we are afraid of triggering dieting anxiety,” and then relapse, she says, adding, “Feeling deprived is never okay, and it’s never going to work .”

Being “aware and mindful” of what you’re eating — paying attention to when you feel full, how things taste, and how your body feels after a meal — is important for feeling satisfied, Dobbins says. The AADE website lists other healthy eating tactics to help you avoid feeling deprived:

  • Don’t skip breakfast, which helps begin the calorie-burning process that provides you with energy.
  • Space out your meals with four to five hours in between. Waiting longer can trigger excessive hunger, which can lead to overeating.
  • Between meals include small, healthy snacks to help keep your body going.
  • Remember: There is no food that you can’t eat at all, but work with a dietitian or diabetes educator to learn how much of a treat you can eat and when; and how it will affect your blood sugar.

Be Prepared to Defend Your Success With a Low-Sugar Diet

I would add another tip of my own — one that I know can be very difficult to follow if you regularly eat your meals with others, such as friends and family members: Recognize attempts to sabotage your progress as you step down from eating high-sugar food, and stick to your guns.

You are not being a killjoy by protecting your health. That person who is offering you a glass of okra water in one hand and a plate of pie à la mode in the other really just wants your company as they indulge, but by caving in to the pressure to join them, you are relinquishing control over what goes into your body. When and where you enjoy the occasional indulgence should be on your own terms, not someone else’s.

Plus, there will be plenty of other experiences over which you can bond with them during the extra years of healthy living you will gain simply by watching what you eat.

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