Will I always be pre-diabetic?

Print“Once you’re pre diabetic are you for life? Does medication help keep you from becoming full on diabetic? What dietary changes should I be most focused on making for a pre diabetes diagnosis?”

What an excellent question posed by one of our Facebook followers. This question reaches to the heart and nature of integrative medicine.

By very nature, being “diagnosed” with a condition puts us in a bucket. It assumes that the state of our health is black or white. We are “diabetic” or not. Unfortunately, this way of thinking is a product of our modern “disease care” model. There is no room for shades of grey in modern medicine, because there is no treatment modality for these individuals.

To answer the question, if someone is diagnosed as pre-diabetic, that does not mean they will be that way the rest of their life. However, what that means is that the body is trying to communicate something to you and very definite action is needed. Blood sugar dysregulation represents a state of imbalance in the body that needs to be corrected. However, very often making changes in the body is like changing the course of the Titanic. You can turn the steering wheel hard to the right; however, the turn is a slow one and takes time.

What we also know is that the iceberg we can visualize above the water’s surface is only the tip of what lies below the surface. Blood sugar dysregulation represents only the tip of other problems below the surface. Typically ensuing is: weight gain, adrenal exhaustion, hypertension, and lipid dysregulation. (Some research even suggests that blood sugar dysregulation is a precursor to brain-based conditions such as Alzheimer’s).

From an integrative perspective, changes that have to be made to correct the course of blood sugar dysregulation are: an increase in daily exercise, reduction of refined sugars, refined carbohydrates, increase in leafy greens and lean meats. There are some supplements that also aid in blood sugar regulation such as: berberine, chromium, magnesium, alpha lipoic acid, gymnema sylvestre and cinnamon.

We would recommend consulting with a Riordan Clinic provider for in-depth evaluation as well as attending the Food as Medicine course held every Tuesday from 2:30 – 4:30pm.

Post written by: Anne Zauderer, DC

(These statements are not meant to treat any condition. Any changes to medications or supplements must be evaluated by the treating physician.)


Is a person considered “pre-diabetic” as having that status for life once it is diagnosed?  To be diagnosed as Pre-diabetic, a person has to have an elevated blood sugar level or insulin level or hemoglobin A1c (this is a test which reflects the blood sugar average for the previous 3 months).  Since each of these lab values can be gotten back into the normal ranges again with lifestyle changes, I would say that being pre-diabetic can be a condition that is temporary.  BUT, I would also point out that the predisposition to have higher blood sugars may be a lifelong problem because it is influenced by a person’s genetics and lifestyle.  This means that what a person eats, what exercise they do and their body weight can all affect how those genes are expressed.  So I would recommend closely monitoring these labs at least 2-3 times a year.  It is estimated that 35-50% of the adults in the United States meet the diagnostic criteria for having Metabolic Syndrome or Pre-diabetes but not nearly this number are diagnosed or treated so these labs need to be monitored to prevent the damage that having high blood sugars cause the body (these include blindness, kidney failure, amputation, heart attacks, & strokes to name a few.)

Does Metformin keep a person from becoming a full diabetic?  That answer is maybe.  Metformin is one of the first medications that conventional providers are taught to prescribe people with pre-diabetes or diabetes.  It lowers the resistance that the body has to using insulin which lowers blood sugars. It can take a couple months to see the blood sugars get lower from this medication.  While on Metformin, a person needs to have their kidney function checked because the medication can affect how the kidneys work.  They also should take supplements of B12 because it blocks the absorption of this vital nutrient.  A person needs to be sure to tell all providers that they are taking this medication especially if getting IV contrast to do CT scans because this combination can be harmful to the kidneys.

I prescribed a lot of Metformin when I was in conventional medicine and most people experience at least some of the nausea and loose stools that are common side effects of this medication.  Those are better if it is taken with a meal.  There are herbal supplements that can lower blood sugars without these same issues but I would still monitor lab results to be sure that the blood sugars are being controlled regardless of what is done to improve them.

Diet and lifestyle changes are key to getting blood sugars controlled.  I always recommend cutting down on sugars and starches especially those that come from refined sources. Starches are foods such as bread, potatoes, corn, rice, noodles.  These foods are converted in the body to sugar.  Some providers teach their patients to count calories and some use carbohydrate exchanges to know what to eat to control the blood sugars.  An easy way to determine what to eat is to use the plate method — so 1/2 of your plate is colorful, non-starchy vegetables, 1/4 lean protein that is baked or broiled/grilled or cooked in a crockpot (about 4 oz) and 1/4 a starch (no more than 1/2 -1 cup).  Be aware that a lot of the sweeter fruits like bananas and pineapples can increase the blood sugar so maybe try more blueberries or raspberries!

You need to get moving to get the muscles conditioned and the metabolic rate increased because this with the diet changes will lower insulin resistance and make it easier to keep the blood sugars controlled.  I advise my patients to wait about an hour after eating and then do some brisk exercises for even 5-10 minutes to get that blood sugar that peaks about 2 hours after eating down to normal.  I also have been taught that interval training is essential for good fitness and conditioning.

My final advice? Come to the Food As Medicine class to learn more about healthy eating.

Post written by Karen Wheeler, APRN

(These statements are not meant to treat any condition. Any changes to medications or supplements must be evaluated by the treating physician.)