We regularly get asked this question on the Diabetes WA Helpline. Read on if you’ve been told you have prediabetes and are wondering what to do next.  

First things first: prediabetes versus diabetes.  

Prediabetes means your blood glucose levels are higher than normal, but not high enough to be diagnosed with type 2 diabetes. This happens when the cells in the body become resistant to a hormone called insulin.  

Insulin is an important hormone in our body, allowing our cells to use glucose from our carbohydrate–containing foods and drinks as fuel. This insulin resistance means the glucose ends up staying in the blood and can’t get into the cells for fuel. 

While there is a lack of recent, publicly available data on prediabetes in WA, in 2002 it was estimated that approximately one in six Australians over the age of 25 (16%) had prediabetes.  

People with prediabetes have a higher risk of developing type 2 diabetes. 

Does having prediabetes mean I will go on to develop type 2 diabetes?  

Not necessarily. Approximately 5-10% of people with prediabetes will go on to develop type 2 diabetes each year.  

Everyone has a certain number of risk factors for how likely they are to develop type 2 diabetes.  

Some of these are modifiable (including things we can change in our lifestyle), while others are non-modifiable (usually traits or genes we have been born with that we cannot change.)  

It is worth understanding your own personal risk factors to identify if there is anything you can modify. 

Examples of modifiable factors include losing weight (particularly the mid-section measurement), eating healthy food, aiming for 30 minutes of physical activity a day and stopping smoking.  

Note that not everyone has modifiable risk factors, and you may already be doing all these things. But that is not a sign to be disheartened – instead, you can feel encouraged to keep doing all these things that will reduce your risk not only for diabetes, but for many other health conditions as well.  

Seek advice from a professional, such as a dietitian or exercise physiologist, if you would like guidance on changing these risk factors. 

Other risk factors are non-modifiable, meaning you can’t change them. These include having a family history of type 2 diabetes, coming from an Aboriginal, Torres Strait Islander, Pacific Islander, South-east Asian, Asian (the sub-continent), Arabic or north African background.  

Having had diabetes in pregnancy (gestational diabetes) is another risk factor.  

While we can’t do anything to change non-modifiable risk factors, it helps us understand that type 2 diabetes is a complex condition, and not one caused by lifestyle factors alone.  

Regardless of your background or medical/family history, it is especially important to prioritise looking after the areas you can change. 

Treatment for prediabetes 

If you are diagnosed with prediabetes, the treatment involves the same lifestyle changes that are recommended for people diagnosed with diabetes.

For most, this will include regular physical activity, healthy eating and, if necessary, losing weight. 

Strong evidence shows that type 2 diabetes may be prevented or delayed in up to 58% of cases through changes in your lifestyle around food and exercise.   

Healthy eating 

• Enjoy vegetables and fruit daily 

• Choose lean proteins such as meat and chicken with fat removed, fish, eggs, nuts, legumes and tofu. 

• Aim for high-fibre, low glycaemic index (GI) carbohydrate (carb) foods, such as wholegrain breads and cereals, legumes and fruit. 

• Replace saturated fats with unsaturated fats such as extra virgin olive oil or avocado. 

• Limit foods high in sugar, saturated fat and salt. 

• Avoid high-sugar drinks such as soft drinks, cordial, iced coffee or flavoured milk. 

• Limit alcohol intake if you choose to drink. 

To work out a dietary pattern that’s right for you, visit an accredited practising dietitian. 

Here at the Diabetes WA clinic, we have dietitians and diabetes educators who can talk to you about your diet and work with you to incorporate healthy, nutritionally balanced meals that also fit your lifestyle, preferences and goals.  

Regular physical activity 

Regular physical activity helps your body to use insulin better, which helps to manage glucose levels. It is useful to aim for at least 30 minutes of moderate intensity physical activity (such as brisk walking or swimming) on most, if not all, days of the week.  

If you exercise vigorously (meaning you wouldn’t be able to hold a conversation during the activity) then you can exercise for a shorter duration. It is important to include some resistance training twice a week to keep your muscles strong. If you aren’t meeting these guidelines at the moment, then start with an achievable amount and gradually work up.  

Finding something you enjoy can make the world of difference, as can thinking about how feeling fitter and stronger will affect your life.  

For support with incorporating physical activity into your routine, working with your other health conditions and goals, talk to an accredited exercise physiologist. 

Medication 

Some people are prescribed medication, most commonly metformin, to manage pre-diabetes and help prevent progression to type 2 diabetes. 

Metformin is a medication that treats the insulin resistance, reduces how quickly we digest our food to create glucose and reduces how much glucose our liver produces, particularly while we sleep.  

Taking metformin may reduce your risk of developing type 2 diabetes by 35%. While this is not as high as interventions mentioned above, there is no reason you can’t combine the two! 

Metformin is considered a safe first-line option for treating pre-diabetes and type 2 diabetes.  

Talk to your GP or community pharmacist about medication and potential side effects, interactions and whether it is right for you. 

Do you have any general questions about diabetes? 

Call our free Helpline on 1300 001 880 to speak to one of our diabetes educators.

We’re here Monday to Friday from 8:30am to 4:30pm.