Manager Wang, 42 years old, recently underwent a health check and found that his fasting blood sugar level was 6.5mmol/L, with a hemoglobin A1c of 6.0%. His blood lipid levels were also high, and the doctor informed him that he is in the pre-diabetes stage. His mother has diabetes and needs to measure her blood sugar and administer insulin daily, which scares him. He worries that he will soon become a “sugar person” too.
Do you share the same worries as Manager Wang? What should you do if you are in the pre-diabetes stage?
1. Is there a pre-diabetes stage?
Bad news: There is indeed a pre-diabetes stage. Pre-diabetes is characterized by elevated blood sugar levels that do not yet meet the standards for diabetes, with a fasting blood sugar level of 6.1-6.9mmol/L or a postprandial blood sugar level of 7.8-11mmol/L, and an A1c between 5.7%-6.4%. In our country, the prevalence of pre-diabetes has reached 35.2%-38.1%, with about 7% of individuals progressing to diabetes each year.
Good news: Pre-diabetes can be reversed through proactive lifestyle interventions!
2. High-risk factors for pre-diabetes
Controllable factors:
Overweight/obesity.
Sedentary lifestyle and lack of exercise.
High sugar, high fat, low fiber diet.
Smoking, excessive drinking, and insufficient sleep.
Uncontrollable factors:
Genetics: Family history of diabetes.
Age: Increased risk for those over 40.
History of gestational diabetes or giving birth to large babies.
Diseases related to conditions like polycystic ovary syndrome.
3. How to reverse pre-diabetes to normal blood sugar levels?
1. Control your diet — Diet management
① Adjust dietary structure:
1. Increase dietary fiber intake, primarily using whole grains and mixed beans as staples, while reducing refined rice consumption, recommended at a 1:1 ratio.
2. Increase intake of non-starchy vegetables, with dark leafy greens making up more than half.
3. Choose plant proteins, fish, and low processed lean meats.
4. Limit daily oil intake to no more than 25g; recommend using plant oils such as olive oil and soybean oil, which are rich in unsaturated fatty acids. Reduce animal fat intake and avoid trans fats.
5. Control daily salt intake to no more than 6g.
② Adjust meal sequence: Start with a small bowl of vegetables to protect the stomach, followed by a palm-sized portion of lean meat, and finally consume staples and remaining vegetables.
③ Chew slowly; extend meal duration to half an hour, as increased chewing can enhance satiety.
2. Exercise management
Engage in moderate-intensity aerobic endurance exercises for more than 30 minutes, such as brisk walking, slow jogging, swimming, cycling, aerobics, tai chi, or Ba Duan Jin, one hour after meals, aiming for at least 150 minutes of aerobic exercise weekly.
Perform resistance training 2-3 times a week, on alternating days. This includes bodyweight exercises (squats, planks, push-ups), resistance band training, and dumbbell exercises, starting with low intensity and gradually increasing duration and intensity to avoid injuries. Those with limited time can accumulate exercise time with short sessions. After exercising, avoid excessive eating. Exercise is the best “natural sugar-lowering medication”.
3. Weight management
Weigh yourself each morning on an empty stomach after using the restroom, recording your weight.
Measure your waist circumference every two weeks. Overweight or obese individuals should aim to lose 5%-15% of their body weight over 3-6 months to significantly improve blood sugar, lipid levels, and abdominal obesity. Subsequently, maintain a weight loss of 0.25kg-0.5kg per week, keeping the body mass index (BMI = weight/height²) between 18.6-23.9kg/m², with male waist circumference <85cm and female waist circumference <80cm.
4. Blood sugar monitoring
After adopting an active lifestyle intervention, monitor fasting blood sugar and blood sugar levels two hours after meals every two weeks. After six months, check hemoglobin A1c levels and after one year, screen for fasting blood sugar and a two-hour oral glucose tolerance test. Aim to keep fasting blood sugar below 6.1mmol/L, post-meal blood sugar below 7.8mmol/L, and A1c below 5.7%.
5. Other lifestyle factors
Ensure 6-8 hours of sleep daily, as both insufficient and excessive sleep can be detrimental.
Do not smoke or quit smoking, and either avoid alcohol or limit intake. For those unable to quit, limit alcohol consumption (women <15g/d; men <25g/d; 15g of alcohol is equivalent to 350ml of beer, 150ml of red wine, or 45ml of distilled spirits, with alcohol consumption limited to ≤2 times a week).
In pre-diabetes, let’s control our diets, stay active, and work together for better health!
