Diabetes Prevention through the Management of Pre-Diabetes and Metabolic Syndrome

With over 10% of the population (nearly 37.3 million Americans in 2019) having been diagnosed with diabetes, nearly everyone knows someone with diabetes. What you may not know is that approximately 96 million Americans over the age of 18 have a condition known as prediabetes – over one-third of the adult population.1 Prediabetes is defined as higher-than-normal blood sugar levels that are not quite high enough to be considered diabetes. You may or may not have any symptoms, but it is estimated 70% of those with prediabetes will at some point progress to diabetes.2-3 Diabetes is a serious condition that frequently requires lifelong management with one or more medications.

Another condition that may increase your risk of developing diabetes is called metabolic syndrome. There is not a single definition of metabolic syndrome, but it is widely agreed that it is a grouping of some of the following: increased waist circumference (usually greater than or equal to 40” for men, 35” for women), high blood sugar, high triglycerides, abnormal cholesterol levels, and/or high blood pressure.9 In the United States, metabolic syndrome has a prevalence of 19.5% among those ages 20 to 39, 39.4% in those ages 40-59, and 48.6% in those ages 60 and up.10 Luckily, prediabetes and metabolic syndrome can be treated and even reversed through lifestyle changes.4

Some of these lifestyle changes include:5

  1. Minimize sugary drinks such as soda, fruit punch, sweet tea, energy drinks, and sports drinks and replace with water.
  1. Adjust your diet to include more non-starchy vegetables, whole grains, and lean proteins while limiting added sugars, refined grains, and highly processed foods.
  1. Getting enough physical activity is an important part of preventing the progression of diabetes. Start with low-impact exercises such as light walking and increase your goal each week until you’ve created a routine. Any form of moderate-intensity physical activity up to 150 minutes per week over 3-4 days is the recommended goal level for metabolic improvement.
  1. According to the US National Diabetes Prevention Program, lifestyle changes aimed at weight loss, dietary changes, and increases in physical activity decreased the risk of developing type 2 diabetes by 58%.2

While diabetes is a major focus for many health plans, developing a strategy for identification and management of prediabetes and metabolic syndrome is an important strategy to limit the progression of these conditions to diabetes.

Adults who take medication for high blood pressure and high cholesterol are at a high risk of developing diabetes. Talking with a pharmacist who can not only provide expert advice on medication management but also provide education on appropriate lifestyle changes can help minimize the progression to diabetes. Additional consultations with a health coach regarding diet and lifestyle management can also reduce the need for these medications.


  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report website. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed August 23, 2022.
  2. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: A high-risk state for developing diabetes. Lancet. 2012;379(9833):2279. doi:10.1016/S0140-6736(12)60283-9
  3. Nathan DM, Davidson MB, DeFronzo RA, et al. Impaired Fasting Glucose and Impaired Glucose Tolerance Implications for care. Diabetes Care. 2007;30(3):753-759. doi:10.2337/DC07-9920
  4. “Prediabetes.” American Diabetes Associationhttps://diabetes.org/diabetes/prediabetes. Accessed August 23, 2022.
  5. “Myths about Diabetes.” Diabetes Myths | ADAhttps://diabetes.org/tools-support/diabetes-prevention/diabetes-myths. Accessed August 23, 2022.
  6. “Fitness.” Fitness | ADAhttps://diabetes.org/healthy-living/fitness. Accessed August 23, 2022.
  7. Prediabetes: What is It, Who’s at Risk, Symptoms, Can it be Reversed. Accessed July 26, 2022. https://my.clevelandclinic.org/health/diseases/21498-prediabetes
  8. Prediabetes – Your Chance to Prevent Type 2 Diabetes | CDC. Accessed July 26, 2022. https://www.cdc.gov/diabetes/basics/prediabetes.html
  9. Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech. 2009;2(5-6):231-237. doi:10.1242/dmm.001180
  10. Hirode G, Wong RJ. Trends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016. JAMA. 2020;323(24):2526-2528. doi:10.1001/JAMA.2020.4501

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