A nutrition and supplement plan that can help to keep prediabetes from progressing to type 2 diabetes.

Prediabetes is a wake-up call-one that does not have to be a prelude to full-blown type 2 diabetes. Most people can take steps to reverse prediabetes-wait too long and type 2 diabetes will have to be treated medically. An estimated 70-100 million Americans have prediabetes, most of them undiagnosed. Being overweight or obese, having difficulty losing weight, feeling tired much of the time, and having poor concentration are common symptoms.

Getting Tested
Having either a fasting blood sugar level between 100-125 mg/dl or a HbA1C level between 5.7 and 6.9 percent is a sign of prediabetes. A fasting blood sugar between 90 and 99 mg/dl points to looming prediabetes. It's also important to have your fasting insulin tested-a measure of 11 mcIU/ml or higher indicates that your body is working very hard to control blood sugar. A high fasting insulin is an accurate early predictor of diabetes risk in the coming 10-15 years.

The Cause
In the vast majority of cases, prediabetes is a consequence of eating a diet high in refined carbohydrates, including sugary foods, for many years. These foods include desserts, white bread, white rice, pasta, and bagels. Potatoes and rice wafers have a similar effect on blood sugar.

Conventional Treatments
A variety of drugs are commonly prescribed to people with prediabetes. Like most drugs, they have side effects.

Eating Tips
Improving eating habits is essential. Focus on high-quality protein (fish, chicken, grass-fed beef), which stabilizes and lowers blood sugar levels. Eat plenty of high-fiber vegetables as well. Fiber, particularly soluble fiber, slows the breakdown of carbohydrates and also lowers and stabilizes blood sugar. High-fiber vegetables include dark lettuces, tomatoes, cucumbers, spinach, broccoli, cauliflower, asparagus, radishes, bell peppers, mustard greens, endive, and collard greens. Make a point to avoid salad dressings with added sugars. Some foods, such as vinegar and cinnamon, can help lower blood sugar.

Supplements
Several supplements have been shown to help regulate blood sugar. If you take more than two of these supplements, reduce the suggested dose.

Vitamin D. This vitamin can help maintain normal blood sugar levels and prevent prediabetes and type 2 diabetes. Combining vitamin D with calcium boosts the benefits; both nutrients are involved in regulating blood sugar and insulin. Take: 1,000-4,000 IU of vitamin D, plus 500 mg of calcium citrate daily.

Silymarin. Silymarin, the extract of the herb milk thistle, can dramatically improve blood sugar in people with prediabetes and type 2 diabetes. Three human studies have demonstrated
silymarin's benefits, which include a 15-20 percent decrease in blood sugar, along with decreases in insulin, postmeal blood sugar, and HbA1C. Take: 200 mg three times daily.

Chromium. The body needs this dietary mineral to help insulin work efficiently, but the dose appears key. A study found that low doses didn't help, but taking 500 mcg twice daily helped people with type 2 diabetes. The benefits were noted after just four months. Take: For prediabetes, start at 400 mcg daily, and go up to 1,000 mcg daily if necessary.

Biotin. This B vitamin activates genes involved in the metabolism of carbohydrates, fats, and proteins. It also enhances the blood-sugar-regulating effect of chromium and lipoic acid.
Biotin is needed for the activity of glucokinase, an enzyme that monitors the body's glucose levels. It's safe even in large amounts. Take: 1,000-10,000 mcg daily.

Curcumin, an extract of turmeric root, can help manage blood sugar and prevent diabetes.

Curcumin. An extract of turmeric root, curcumin can help people manage blood sugar. Doctors gave either 1,500 mg of curcumin or placebos daily for nine months to 240 people with prediabetes. By the end of the study, 19 of the 116 people taking placebos had developed type 2 diabetes, while not a single person taking curcumin developed diabetes. Take: 750-1,500 mg of curcumin.

Alpha-Lipoic Acid. This antioxidant has been used in Europe as a medical treatment for diabetic nerve disease. Studies have found that it improves insulin function and in some people might lower blood sugar. At higher dosages, it is also helpful with nerve numbness and pain. Take: 200-400 mg daily.

Pycnogenol. Extracted from French maritime pine bark, this antioxidant complex inhibits the activity of alpha-glucosidase, a carb-digesting enzyme. The mechanism is similar to the diabetes drug acarbose, but a study found that Pycnogenol is 190 times more potent than acarbose in inhibiting alpha-glucosidase. Take: 100-200 mg of Pycnogenol daily.