The incidence of prediabetes is rising. Approximately one third of the people in the United States have prediabetes, 80% of whom do not even know they have the condition. It is important to treat prediabetes because, in addition to being a risk factor in developing type 2 diabetes, prediabetes is a severe metabolic condition that affects the heart, kidney, and liver.

What Is Prediabetes?

Prediabetes is diagnosed when one has a higher-than-normal blood sugar level but not high enough to be in the diabetic range. (In prediabetes, the hemoglobin A1C (HbA1C), the three-month average blood sugar, is between 5.7% and 6.4%. Diabetes is diagnosed when patients have a HbA1C of 6.5 or greater at two different times.)

Our body uses glucose, a simple sugar that comes from the food we eat, as its primary fuel source. Insulin, produced by the pancreas in response to food intake, drives glucose into the cells, where it is burned to create energy. When someone has prediabetes, the process does not work well. The cells do not respond properly to insulin, and instead of glucose entering the cells, a significant amount builds up in the blood stream. This happens either because the cells are resistant to insulin or the pancreas does not make enough insulin. The more common case is the first scenario.

Patients with cancer undergo various treatments including surgery, radiation, and chemotherapy managed by oncology and related specialties. There are certain additional measures that patients can take on their own to improve symptoms and often increase longevity. Lifestyle measures include nutrition, exercise, sleep, stress management, adequate social interaction, and avoiding risky substances. These form the six pillars of Lifestyle Medicine. In addition, spiritual matters are very important.

It has been known that exercise can prevent cancer, but only recently has there been a randomized controlled trial in patients with stage III or high-risk stage II colon cancer that showed decreased mortality with regular exercise. (New England Journal of Medicine 2025: 393:13-25). These are patients whose cancer had spread through the bowel wall to nearby structures or lymph nodes but not distant spread. After surgery and chemotherapy, patients were randomized to a structured exercise program or to only receive health education materials. There was significant improvement in survival in the exercise group versus the education group, without cancer return at five years, as well as decreased mortality at almost eight years. Improvements with exercise are in addition to those seen with the primary therapies.