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Lifestyle Medicine Prevents Progression of Pre-diabetes

by Dr. Jamesh Meschino on

December 18, 2023 in

Source: Journal American Medical Association – Internal Medicine (November 2017)
Nutrition / Natural Medicine Update (November 15 2017)

In Canada, there are 2 million diabetics and 7 million people who are on the cusp of developing diabetes – pre-diabetes. – almost a third of the population. Pre-diabetes means that your fasting glucose level is between 5.7 and 6.9 mmol/L.

These individuals usually have other risk factors, such as a waist circumference above 36 inches (men) and 33 inches (women), which means too much abdominal fat.

They may also have any combination of other risk factors including, high blood pressure, high triglycerides or low HDL-cholesterol. In the U.S. 100 million people have diabetes or pre-diabetes. 9.4% of the population already has diabetes – almost a third of the population.

How to prevent  pre-diabetes  to fully develop diabetes?

A study published in JAMA Internal Medicine on November 6, 2017, involved a meta-analysis of 43 international studies of adults with prediabetes. The study looked at how best to prevent pre-diabetes from becoming full-blown diabetes.

The 43 studies reviewed showed that lifestyle changes were the most effective way to prevent the development of diabetes in the long-run in pre-diabetic subjects. Losing a few extra pounds was the most important factor in reducing risk.

They found that every kilogram of weight loss was associated with an additional 7% decrease in risk of progression to diabetes. In the 19 trials with lifestyle modification, during an average treatment period of 2.6 years, overall, the patients using dietary changes, exercise, or both had a 39% lower risk of being diagnosed with diabetes compared with controls.

Combined dietary and physical-activity strategies seemed best, with a 41% risk reduction. In the 21 medication trials, during a treatment period of 3.1 years, overall, patients on medication had a 36% lower risk of being diagnosed with diabetes compared with patients who had been randomized to control.

After a washout period of no formal lifestyle treatment with the patient, after a mean follow-up of 7.2 years, patients who had been introduced to lifestyle modifications had a 28% lower risk of being diagnosed with diabetes compared with the control patients. 

After a washout period of no drug treatment, after a mean follow-up of 17 weeks, patients who had received medication did not have a greater reduction in risk of diabetes diagnosis compared with controls.

The bottom line is that many people are walking around with just that extra bit of body fat, and a blood sugar level that is creeping up towards the diabetic range.

With diabetes comes a shorter lifespan, an increased risk of amputations, blindness, need for dialysis treatment 3 days per week, increased risk of heart attack, peripheral neuropathy, and foot pain, and risk of open foot wounds. It really isn’t worth it.

What rule should we follow to regulate our metabolism?

Remember the simple math – if you simply eat 100 calories less per day (which is nothing), and burn an extra 100 calories per day via a brisk 10-12-minute walk, in one year you will lose 24 pounds of body fat. This applies to everyone regardless of their metabolism.

So, if you are on the cusp of diabetes, as many people are, some simple nutritional modifications and a bit more physical activity can reverse all the major risk factors (blood glucose, waist circumference, triglycerides, blood pressure and increase your HDL-cholesterol).

These studies confirm that you have the power to prevent this leading killer and its undesirable quality of life-changing complications

I’ve included the scientific reference below.


Haw SJ, Glalaviz KI, Straus AN. Long-term sustainability of diabetes prevention approaches. A systematic review and meta-analysis of randomized clinical trials. JAMA – Internal Medicine (November 6, 2017)

Eat Smart, Live Well, Look Great,

Dr. Meschino

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Dr. James Meschino