Dr. Sarah Cimperman, ND
A healthy lifestyle is just as important as a healthy diet when it comes to reversing prediabetes and staying well. In fact, studies show that lifestyle interventions are the most effective treatment for reversing prediabetes, lowering hemoglobin A1C, decreasing high blood pressure, improving physical fitness, and promoting weight loss.1 The following five lifestyle changes will help you accomplish these goals and more.
#1: Avoid Cigarette Smoke
Studies show that smoking cigarettes raises fasting blood sugar levels and increases the risk of developing diabetes (as well as other illnesses like cardiovascular disease and cancer).2 Even if you don’t smoke, being around people who do can have a similar effect. Studies show that people exposed to secondhand smoke have higher levels of fasting blood sugar and hemoglobin A1C, more insulin resistance, and a higher incidence of type 2 diabetes.3 When it comes to quitting, close to 90 percent of successful long-term quitters stopped smoking abruptly, and this cold turkey method has been shown to be twice as effective as nicotine replacement therapy and medications that are taken to reduce cravings.4 These drugs carry side effects like constipation and insomnia, and nicotine replacement isn’t a good choice for people with prediabetes because long-term use can increase levels of insulin and promote insulin resistance.5
#2: Exercise Regularly
Exercise helps reverse prediabetes by reducing inflammation, lowering blood sugar, making cells more sensitive to insulin, and boosting levels of serotonin, which helps reduce food cravings.6 Studies show that regular exercise improves fitness in people with high blood sugar by as much as 40 percent in as little as three to five months,7 and that the combination of aerobic and strengthening exercises is more powerful than either type of exercise alone.8 In one trial, researchers followed more than 32,000 men for 18 years and found that those who performed at least 150 minutes of aerobic and strengthening exercises each week reduced their risk of type 2 diabetes by almost 60 percent.9The best forms of exercise are the ones you’ll do regularly, so find activities you enjoy. Talk to your doctor about your exercise goals, especially if you aren’t already physically active, and consider meeting at least once with a personal trainer who can put together an appropriate routine for you, familiarize you with exercise equipment, and make sure you’re doing the exercises correctly.
#3: Manage Stress
When we’re continuously exposed to stress, whether physical or mental, real or imagined, levels of stress hormones like cortisol are continuously elevated. This triggers inflammation, prompts the body to accumulate fat, and increases the risk of developing diabetes.10 High cortisol levels also deplete serotonin, causing us to crave sweet and starchy foods. One of the best ways to keep cortisol levels low is to find activities that help us manage stress. Exercise is a good one, but other options are also effective, like yoga, meditation, guided imagery, breathing exercises, progressive muscle relaxation, qigong, massage, or simply spending time in nature. Like any skill, relaxation requires practice, focus, and concentration. The more you do it, the easier it will be. Pick activities that feel right to you and practice them daily or whenever the need arises.
#4: Get Plenty of Sleep
Short sleep cycles raise blood sugar levels, cause cells to lose sensitivity to insulin, and increase the risk for diabetes.11 Lack of sleep also causes levels of leptin, a hormone that reduces appetite, to go down, and levels of ghrelin, a hormone that makes you hungry, to go up. In one study, being deprived of just two hours of sleep caused healthy men to crave sugar and eat more of it.12 Another study showed that sleeping seven hours or less overnight prompts our bodies to store fat while sleeping nine hours or more suppresses this effect.13 If you struggle with insomnia, talk to your doctor about sleep hygiene strategies like avoiding electronics before bed, sleeping in complete darkness, and eliminating alcohol, caffeine, and sugar from your diet.
#5: Consider Detox
Toxic compounds permeate our environment and they permeate our bodies. Almost 500 different chemicals have been found in human blood and fat tissue14 and the older we get, the more toxins we contain.15 Studies show that many of these chemicals can cause changes in the body that promote the development of diabetes. These “diabetogens” include pesticides, chemicals in nonstick cookware and plastic food and beverage containers, industrial pollutants absorbed by some of the plants and animals in our diet, and chemicals found in our drinking water. Since 1999 the National Center for Health Statistics, part of the Centers for Disease Control and Prevention, has measured chemicals in the blood and urine of people taking part in the National Health and Nutrition Examination Survey. The most recent report found diabetogens in 100 percent of the 2,500 people studied (CDC 2013).16 We’ll never be able to avoid all of the toxins in our environment, but we can take steps to minimize our exposure and remove them from our bodies through detoxification. If you’re interested in detox, ask your naturopathic doctor to individualize a protocol that will meet your needs and help you reach your goals.
- Wing RR and the Look AHEAD Research Group. Long-Term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals with Type 2 Diabetes Mellitus: Four-Year Results of the Look AHEAD Trial. Archives of Internal Medicine. 2010;170(17):1566–75.
- Rafalson L, Donahue RP, Dmochowski J, Rejman K, Dorn J, Trevisan M. Cigarette Smoking Is Associated with Conversion from Normoglycemia to Impaired Fasting Glucose: The Western New York Health Study. Annals of Epidemiology. 2009;19(6):365–71.
- Tweed JO, Hsia SH, Lutfy K, Friedman TC. The Endocrine Effects of Nicotine and Cigarette Smoke. Trends in Endocrinology and Metabolism. 2012;23(7):334–42.
- Dorana CM, Valenti L, Robinson M, Britt H, Mattick RP. Smoking Status of Australian General Practice Patients and Their Attempts to Quit. Addictive Behaviors. 2006;31(5):758–66.
- Eliasson B, Taskinen MR, Smith U. Long-Term Use of Nicotine Gum Is Associated with Hyperinsulinemia and Insulin Resistance. Circulation. 1996;94(5):878–81.
- Thomas DE, Elliott EJ, Naughton GA. Exercise for Type 2 Diabetes Mellitus. Cochrane Database of Systematic Reviews. 2006;(3):CD002968.
- Huebschmann AG, Kohrt WM, Regensteiner JG. Exercise Attenuates the Premature Cardiovascular Aging Effects of Type 2 Diabetes Mellitus. Vascular Medicine. 2011;16(5):378–90.
- Church TS, Blair SN, Cocreham S, Johannsen N, Johnson W, Kramer K, et al. Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients with Type 2 Diabetes: A Randomized Controlled Trial. Journal of the American Medical Association. 2010;304(20):2253–62.
- Grøntved A, Rimm EB, Willett WC, Andersen LB, Hu FB. A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men. Archives of Internal Medicine. 2012;172(17):1306–12.
- Godfrey KM, Inskip HM, Hanson MA. The Long-Term Effects of Prenatal Development on Growth and Metabolism. Seminars in Reproductive Medicine. 2011;29(3):257–65.
- Knutson KL, Van Caute E. Associations Between Sleep Loss and Increased Risk of Obesity and Diabetes. Annals of the New York Academy of Sciences 2008;1129:287–304.
- Van Cauter E, Holmback U, Knutson K, Leproult R, Miller A, Nedeltcheva A, Pannain S, Penev P, Tasali E, Spiegel K. Impact of Sleep and Sleep Loss on Neuroendocrine and Metabolic Function. Hormone Research. 2007;67(Suppl 1):2–9.
- Watson NF, Harden KP, Buchwald D, Vitiello MV, Pack AI, Weigle DS, Goldberg J. Sleep Duration and Body Mass Index in Twins: A Gene-Environment Interaction. Sleep. 2012;35(5):597–603.
- EWG (Environmental Working Group). Pollution in Minority Newborns: BPA and Other Cord Blood Pollutants. [Web page]. EWG website. http://www.ewg.org/research/minority-cord-blood-report/bpa-and-other-cord-blood-pollutants. Accessed September 10, 2013.
- Hue O, Marcotte J, Berrigan F, et al. Plasma concentration of organochlorine compounds is associated with age and not obesity. Chemosphere. 2007;67(7):1463-7.
- CDC (Centers for Disease Control and Prevention). Fourth National Report on Human Exposure to Environmental Chemicals, Updated Tables. [Web page]. CDC website. http://www.cdc.gov/exposurereport/. Accessed September 10, 2013.
Sarah Cimperman, ND is the author of the new book, The Prediabetes Detox: A Whole-Body Program to Balance Your Blood Sugar, Increase Energy, and Reduce Sugar Cravings. She graduated from NCNM in 2002 and has a private practice in New York City. Her expertise has been featured on Fox News and Huffington Post and in Natural Health magazine, Whole Living magazine, and the Well Being Journal, among other publications. Dr. Cimperman also writes two blogs, A Different Kind Of Doctor and The Naturopathic Gourmet.