Reversing Prediabetes

Janet O’Mahony, M.D., is an Internal Medicine doctor and a member of Mercy Personal Physicians Downtown in Baltimore. An advocate for patient health, Dr. O'Mahony regularly contributes advice and feedback to media outlets, online resources and publications. Most recently, Dr. O’Mahony offered her insights regarding “Reversing Prediabetes” for a First for Women magazine feature.

A diagnosis of prediabetes is not quite the same as a diagnosis of diabetes, but it is a warning that diabetes could be in your future. Insulin resistance is the underlying feature of type 2 diabetes and this gets worse with age. Prediabetes is a sign that insulin resistance has started. This is more concerning in a young person. About 10 percent of people with prediabetes will develop diabetes each year. There are some things you can do to improve insulin resistance including exercise, diet, weight loss and medications.

The reason to put off developing diabetes for as long as you possibly can is because there are a number of complications that go along with diabetes including heart attack, stroke, kidney disease and blindness.

The diabetes prevention trial used a lifestyle intervention using a group diet and exercise program to prevent prediabetes from developing into diabetes. They also used metformin which is a cheap generic medication and this was also effective at decreasing diabetes incidence. The lifestyle program was more effective and had lasting benefits for the people who participated.

A national program was developed around this concept of a structured lifestyle intervention. This is a yearlong intervention that is led by a lifestyle coach and involves meeting every 1 to 2 weeks in a group setting. The goal is healthy eating, regular activity and weight loss. There is a list of participating programs on the CDC (Centers for Disease Control) website. I would recommend this program for anyone who has prediabetes.

Because insulin resistance worsens with age, this is a lifelong commitment. Diabetes may develop even after healthy lifestyle changes because we continue to get older.

Dr. O'Mahony treats downtown residents and families of Federal Hill, Canton, Fells Point, Baltimore Metro Center and the Mt. Vernon arts and cultural district. Board Certified in Internal Medicine, she received her medical degree from University of Maryland School of Medicine in Baltimore.