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World Diabetes Day , celebrated every November 14th, offers a crucial opportunity to spotlight a silent epidemic sweeping across India—prediabetes.

Recent data indicate that India has a very high burden of prediabetes. A nationwide ICMR-INDIAB study (published 2023) found that about 15.3% of Indian adults have prediabetes. This translates to roughly 136 million people as of 2021.

What is prediabetes, and why should you care?Prediabetes is a condition where blood sugar levels are above the normal but not in the range of diabetes. It is not a benign stage. It significantly increases the risk of developing overt type 2 diabetes, heart disease, and stroke. Research shows that without intervention, the risk of progression from prediabetes to diabetes is substantial—5–10% annually, with up to 70% of individuals with prediabetes expected to develop diabetes over their lifetime if no interventions are undertaken. Yet, lifestyle changes can reduce this risk by more than 50%. Unfortunately, many people with prediabetes have no symptoms, and unless screened, it often goes undetected. This makes awareness and proactive lifestyle intervention crucial.

The diet–insulin connection:
Choose wisely. Our typical diet, rich in refined carbohydrates (white rice, sugar, white bread), contributes to repeated insulin spikes. Over time, the body becomes resistant to insulin—a key player in blood sugar regulation. This “insulin resistance” is the cornerstone of prediabetes. But the reverse is also true. A diet rich in whole grains, fiber, lean proteins, and healthy fats can improve insulin sensitivity.

Key dietary habits that help reverse prediabetes include:
Reducing added sugars and sugary beverages
Incorporating whole grains (millets, brown rice, oats)
Including more vegetables, especially non-starchy ones
Consuming adequate protein to reduce hunger and improve metabolism
Practicing mindful eating to prevent overeating

In short, food is not just fuel—it’s a tool for prevention.

Why exercise works like medicine
Physical activity is not optional—it’s therapeutic.

International organizations like the American Diabetes Association (ADA) and the World Health Organization (WHO) offer clear, actionable advice for individuals with prediabetes:

• Aim for at least 150 minutes per week—about 30 minutes most days—of moderate-intensity aerobic exercise, such as brisk walking, cycling, or swimming.
• Combine aerobic activity with resistance training (twice weekly), such as bodyweight exercises or light weights, for maximum benefit.
• Even short bouts of movement, like 3 minutes of activity every 30 minutes, can reduce blood sugar surges, especially if you spend much of your day sitting.
• The goal is at least 2.5 hours of moderate exercise weekly, with higher benefits seen at up to 300 minutes/week, and to limit sedentary behavior as much as possible

Notably, the Diabetes Prevention Program (DPP) study demonstrated that lifestyle changes were more effective than medications in halting the progression from prediabetes to diabetes.

Final thoughts: A wake-up call. Not a life sentence Prediabetes is a red flag, not a destiny. With timely changes in diet and physical activity, this condition is not only reversible but also offers a chance to transform your overall metabolic health. As we observe World Diabetes Day, let us shift the focus from treatment to prevention—and from awareness to action. If you’ve been diagnosed with prediabetes, it’s time to take control. Your plate and your walking shoes are your best weapons. Use them well.

Dr. Akhil Krishna, Consultant, Department of Endocrinology and Diabetes, KIMSHEALTH Thiruvananthapuram