Prediabetes update

The antechamber of diabetes

Corresponds to a fasting blood sugar above 1.10 g/l and below 1.26 g/l. When it is greater than 1.26 g/l twice, you are diabetic. Previously called glucose intolerance, prediabetes hasn’t always been thought of as a precursor to type 2 diabetes. However, we know that 70 percent of prediabetics will progress to diabetes after 10 years. During this time, there are few or no symptoms. Some people show warning signs: irritability, poor quality sleep, enlarged waist, thick hyperpigmented spots in the neck and armpits… Some deleterious effects are already present, in particular inflammation of small vessels (micro-angiopathy). Good news: Prediabetes is reversible with certain lifestyle and dietary measures.

Good food rules

First pillar to avoid the transition to diabetes: above all, a good food balance is needed. First: drastically reduce your sugar intake. Secondly, choose especially sugars with a low or even moderate glycemic index (legumes win hands down!). If you eat pasta, get the wholemeal one and cook it al dente. Think of gluten-free foods: buckwheat, quinoa, wild rice… Eat lots of vegetables. Special mention to those containing inulin (endive, Jerusalem artichokes, etc.), a probiotic fiber with an anti-inflammatory effect. “Start your meal with vegetables and high-quality proteins such as legumes, fish, meat or eggs,” says Dr. Allouche. Limit your consumption of red meat to two or three times a week. Bet on good fats (for dressing, olive oil mixed with rapeseed oil, avocado, etc.). Do not exceed three fruits per day. Choose sourdough bread or a traditional baguette. Vegetarian? Eat eggs (up to 6 a week) and mix legumes. Go for sheep and goat dairy products, which are higher in omega-3s. Do you want to be trained? Follow Dr. Allouche’s 8-week program, which includes four phases (detox, intensive, progressive, maintenance). Are you thin? Go directly to the maintenance phase.

Regular endurance physical activity

Second pillar: regular exercise, beneficial for the liver. “The liver is the center of blood sugar regulation,” says Dr. Allouche. Important point: if you have a fatty liver (NASH), surely your pancreas is too. In fact, the insulin it secretes can be limited or of poor quality”. Good news: physical exercise (endurance) allows the liver to detoxify itself. Bet on 150 minutes of endurance per week, ideally 3 times 50 minutes. In the first 20 minutes we burn glycogen (sugar) reserves, then fats. If that’s too difficult for you, opt for split training. In the pool, do two laps at a moderate pace and two more at a high speed. Vary the activities to strengthen different parts of the body. Do you prefer 30 minute sessions?

Don’t worry, you will benefit too. Either way, physical activity improves the insulin sensitivity of major muscles and organs.

Muscles secrete myokines, substances with anti-inflammatory effects.

One fasting blood glucose each year

Since the age of 30, we have been testing our fasting blood sugar twice (on prescription, in consultation with your doctor). A fortiori if you have risk factors: gestational diabetes, being overweight, hepatic steatosis (fatty liver)… Heredity also plays a role: you have a 40% risk of being diabetic if you join one of your parents and 70% if you both are concerned. “This test can be supplemented by a glycated hemoglobin, which allows you to have the average blood sugar levels over the last three months,” explains Dr. Réginald Allouche, nutritionist, author The new antidiabetic method (edited by Flammarion) e The hepato-detox method (edited by Albin Michel). “If it’s between 5.7% and 6.4%, that confirms prediabetes.” Although in most cases it is associated with being overweight (with abdominal adiposity), one can be thin and suffer from it. A test called Findrisk ( estimates the likelihood of developing type 2 diabetes within 10 years.

Number side

According to general practitioners, the population’s level of knowledge of prediabetes is very low (3/10). (OpinionWay study for Roche Diabetes Care France, October 20, 2022).

Terrible complications

There are many: cardiovascular disease, atherosclerosis, retinopathy, neuropathy, nephropathy… It is estimated that in 2035 diabetes will affect 10% of the world’s population.

The new antidiabetic methodDr Reginald Allouche, Flammarion Edition, €19.90


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