From the Guidelines
Patient education for prediabetes should focus on intensive behavioral lifestyle intervention programs, aiming for 7% loss of initial body weight and increasing moderate-intensity physical activity to at least 150 min/week, as recommended by the most recent guidelines 1.
Key Recommendations
- Patients with prediabetes should be referred to an intensive behavioral lifestyle intervention program modeled on the Diabetes Prevention Program 1.
- Technology-assisted tools, including Internet-based social networks, distance learning, and mobile applications, may be useful elements of effective lifestyle modification to prevent diabetes 1.
- At least annual monitoring for the development of diabetes in those with prediabetes is suggested 1.
Lifestyle Modifications
- Dietary recommendations include reducing caloric intake, limiting refined carbohydrates and added sugars, increasing fiber consumption, and emphasizing whole foods like vegetables, fruits, lean proteins, and whole grains.
- Physical activity goals should include at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming, or cycling, ideally spread throughout the week.
Medication and Monitoring
- Metformin therapy for prevention of type 2 diabetes may be considered in those with impaired glucose tolerance, impaired fasting glucose, or an A1C 5.7–6.4%, especially for those with BMI > 35 kg/m2, aged < 60 years, and women with prior gestational diabetes mellitus (GDM) 1.
- Regular follow-up appointments every 3-6 months are essential to monitor progress and adjust treatment plans as needed.
Importance of Education and Support
- Diabetes self-management education (DSME) and support (DSMS) programs are appropriate venues for people with prediabetes to receive education and support to develop and maintain behaviors that can prevent or delay the onset of diabetes 1.
From the Research
Patient Education for Prediabetes
Patient education for prediabetes is crucial in preventing the progression to type 2 diabetes. The following are key points to consider:
- Intensive lifestyle modification, including calorie restriction, increased physical activity (≥150 min/wk), self-monitoring, and motivational support, can decrease the incidence of diabetes by 6.2 cases per 100 person-years during a 3-year period 2
- Metformin can decrease the risk of diabetes among individuals with prediabetes by 3.2 cases per 100 person-years during 3 years, and is most effective for women with prior gestational diabetes and for individuals younger than 60 years with body mass index of 35 or greater, fasting plasma glucose level of 110 mg/dL or higher, or HbA1c level of 6.0% or higher 2
- Physical activity is inversely associated with the incidence of diabetes, and an intensive lifestyle intervention of eating healthier foods and increasing physical activity can result in an effective decrease in weight and waist circumference after one year 3
- Lifestyle interventions aimed at inducing weight loss, such as healthy diet and regular physical activity, can reduce the risk of progression to type 2 diabetes in prediabetic subjects 4, 5
- Lifestyle intervention is an efficacious, safe, and cost-effective measure to reduce the risk of progression to type 2 diabetes in people diagnosed with prediabetes, with a lower rate of progression to type 2 diabetes after one and three years of follow-up 6
Key Components of Patient Education
The key components of patient education for prediabetes include:
- Weight loss through calorie restriction and increased physical activity
- Healthy diet and eating habits
- Regular physical activity, such as walking or other aerobic exercises
- Self-monitoring of blood glucose levels and other health metrics
- Motivational support and counseling to promote lifestyle changes
- Education on the risks and consequences of progressing to type 2 diabetes, and the benefits of lifestyle modification in preventing or delaying this progression 2, 3, 4, 5, 6