Ways to prevent and reverse prediabetes

October 3, 2023

For plan members, sponsors and administrators

A guide to understanding prediabetes and its impact on the workplace

Prediabetes is a precursor to diabetes. Without lifestyle changes, people with prediabetes are at an increased risk of developing Type 2 diabetes.¹ It is estimated that men and women aged 45 and over who have prediabetes have a 14 to 25% risk of developing diabetes over 10 years.¹

Prediabetes can impact employees in several ways including an increased risk of heart attacks and stroke.³ Since prediabetes can progress to Type 2 diabetes (which increases the risk of major health complications, like kidney disease, eye problems, nerve problems, and heart disease), it’s important to help your employees with prediabetes manage their condition.²

This article answers many common questions about prediabetes that can be used to help Canadians improve their health and wellness and serves as a guide for employers to provide support and awareness surrounding prediabetes.

What is prediabetes?

Prediabetes means someone has higher blood sugar levels than normal, but the levels are not high enough to meet the threshold for a diagnosis of diabetes.¹

Each year, more and more people are being diagnosed with prediabetes.³ Right now, about 6 million Canadians have prediabetes.³

Prevalence and cost of prediabetes and diabetes in Canada

Causes of prediabetes

The pancreas makes a hormone called insulin which allows sugar (glucose) into the body’s cells so it can be used as energy.⁴ In people with prediabetes, the cells do not respond to insulin properly (a condition termed insulin resistance), which causes blood sugars to rise. ⁴ If this process continues and isn’t addressed, this can lead to Type 2 diabetes.⁴

According to Cleveland Clinic, researchers aren’t exactly sure what causes the cells to become insulin resistant, but weight gain, physical activity levels, stress, sleep, nutrition, environmental factors, and genetics all likely play a role.⁴

Prediabetes symptoms

Many people won’t show signs or symptoms of prediabetes and might not know they have the condition. ⁵ However, there is some evidence to suggest a possible sign of prediabetes might be darkened skin in some areas of the body like the neck, armpits, and groin.⁵

If you start noticing signs and symptoms of Type 2 diabetes, such as increased thirst, frequent urination, fatigue, or blurred vision, it’s best to call your doctor.⁵

Prediabetes risk factors

It is important to understand the common risk factors of prediabetes so you can talk to your healthcare provider about whether you should be tested.⁴

Risk factors for prediabetes include⁴:

• Obesity⁴,
• Being over the age of 45⁴,
• Exercising less than three times a week⁴,
• Having a parent or sibling with Type 2 diabetes⁴,
• And having polycystic ovarian syndrome (PCOS)⁴.

Diabetes Canada offers a free online tool to help you determine whether you might be at risk for prediabetes.

Find out your risk for prediabetes

If you think you could be at risk for prediabetes, contact your doctor. They will be able to measure your blood sugar levels to test for prediabetes.

Prediabetes tests

There are several blood tests that your doctor could use to help to assess your blood sugar levels and check for prediabetes.⁶

A1C Test measures average blood sugar level over the past several months. ⁶

Fasting Blood Sugar Test measures blood sugar after not eating or drinking anything (except water) for 8 hours. ⁶

Glucose Tolerance Test measures blood sugar before and after drinking a liquid that contains glucose (sugar). ⁶

Nonfasting (“Random”) Blood Sugar Test measures blood sugar at the time of being tested, and does not require fasting (not eating).⁶

Treating, reversing, and preventing prediabetes

Making some changes to your current lifestyle could help you treat, reverse, and prevent prediabetes.⁵ Your healthcare provider might suggest these modifications to help treat prediabetes:⁵

• Eating healthy foods and working with a dietitian to plan a healthful diet,
• Getting regular physical activity,
• Losing excess weight,
• Finding ways to manage stress,
• Diagnosing and treating sleep disorders,
• Managing your blood pressure and cholesterol,
• and quitting smoking.⁵

Exercise ideas for your plan members whether they’re young or young at heart

Are there medicines that can treat prediabetes?

While the above-mentioned lifestyle strategies are the best approach to address prediabetes, metformin is sometimes prescribed and, in some cases, may help delay the onset of diabetes.⁷

Complications of prediabetes

If prediabetes is left untreated, there are some complications that could develop.⁸

“Prediabetes can lead to serious health conditions,” explains Pavithra Ravinatarajan, a practicing pharmacist and Director of Plan Sponsor Risk Management and Sponsor Strategy for Key Accounts for Manulife Group Benefits. “It has been linked to several long-term health conditions and can cause damage to the heart, brain and blood vessels.”

In people who are prediabetic, the elevated blood sugar levels over time are resulting in damage to blood vessels throughout the body, which can in particular affect the heart and the brain.⁸

Prediabetes and the workplace

Here are eight workplace strategies that could help you support your employees with prediabetes:

1. Share information about risk factors and prevention of prediabetes and diabetes to employees.
2. Support activities during the day such as movement breaks, gym facilities, or options for active commuting.
3. Support employees around eating a healthy diet, especially if, for example, the company is supplying food for lunch. Be sure to offer healthy options and ask your staff for their input and preferences.
4. Offer health coaching as part of your group benefits plan, where employees can get help from a personal trainer or dietician. 
5. Allow flexibility in the employee’s work schedule so they can attend medical appointments.
6. Support quality sleep for your employees.
7. Provide supports to help employees manage stress.
8. Provide access to blood sugar screening programs in the workplace.

Prediabetes and your group benefits plan

To find out more information about how your group benefits plan can support people with prediabetes, contact your usual Manulife representative.

Lifestyle health coaching