Hello I was infected with covid in april 2021. I was admitted and received a treatment with remdesivir and steroids. In last week, I was asked to do some test which included hba1c (observed value 5.7 pre diabetic) and glucose fasting (81) and glucose post prandial (98). I am actively involved in drinking and use nicotine gum in case I get cravings for nicotine. I am overweight also with less physical activity. Please advise what lifestyle changes I should adopt to reverse from the prediabetes condition?

Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Mr Vivek, Thanks for the query. I have seen the details given. Your HbA1c% is at borderline of pre-diabetes. However, the fasting & PP glucose levels are quite normal. Criteria for considering a person pre-diabetic are FBG 101 to 125 mg, PP 141 to 199 mg & HbA1c% 5.7 to 6.4%. Since you have mentioned that you drink regularly and also use nicotine patch, plus do very little physical activity. All the three things are bad from the pont of view of being "pre-diabetic". You have not mentioned the weight, height and dietary intake, so difficult comment. However, for a person who wants to remain free from diabetes following life style needs to be adapted. 1) A minimum of 1 hour of daily exercise which can include aerobic activity and strength building exercises for 5 days a week is a must. 2) Waist circumference should be 85 cms and BMI should be 23 kgs/Sq meter or less. 3) Alcohol needs to be avoided as much as possible. Similarly nicotine usage also has to go down or should be eliminated. 4) Dietary intake has to be such that provides 20 k calories/kg per day based on your ideal body weight, not on actual weight if it is higher. All these factors are more important if you have a positive family history of diabetes. If you have any questions please do come back. Thanks. 

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