“Pre” didn’t seem like a scary word. It literally means “before,” suggesting something that’s way off in the future you don’t have to worry about yet.

Yet being the operative word. Especially when the word that follows “pre” is “diabetes.”

I was diagnosed with prediabetes a few years ago, but stupidly believed it wasn’t that big a deal. I ate mostly healthy, right? I worked out. I was prescribed some preventative blood sugar and blood pressure meds, but I wasn’t faithful in taking them. Did I really need them anyway? I wasn’t that old!

Actually, I was just old enough. After years of ignoring the reality, my annual physical in January 2023 revealed that my prediabetes was just one-tenth of a point from being actual diabetes. My cholesterol, which had been historically low pre-menopause, was also high. My blood pressure wasn’t much better.

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It occurred to me that afternoon, staring worriedly at the carbohydrate and sodium counts on the boxes in my pantry, that my husband, Scott, who died at 44 of a heart attack, was a Type II diabetic with high blood pressure who hadn’t paid enough attention to the warnings in his own health. Nine years later, the very real possibility that if I didn’t change my life — that I could orphan my child — terrified me.

I immediately started chucking boxes in the garbage.

I had experienced what Baltimore nutritionist Monica Reinagel calls “a great reckoning.”

“Every generation reaches this sort of wake-up call about the time of life when the consequences of the choices we are making becomes less hypothetical and start to play out,” she said.

So here’s a heads-up to all my fellow cool Generation X folks still sporting your Nirvana and Run-D.M.C. tees: You know that weird ache you can’t define and those out-of-breath moments that you’re putting off investigating till later? There is no later. Don’t let it be too late. And yes, I’m trying to scare you. But it doesn’t have to suck.

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“I see this as a joyful thing, an opportunity that comes with that sort of self-awareness about what is possible,” said Reinagel, who encourages people to think less in terms of lifespan and more about “healthspan.” It’s about “what kind of body we want to live in,” she said. “We would like to be in reasonably good health in our remaining years. Even without being a longevity freak, how do we maximize our quality of life?”

I answered my own ominous health reckoning by making some major lifestyle changes. I started taking my meds regularly. I eliminated most carbs and items with added salt, ordering out less and cooking more, and cut way back on the cocktails. A year and a half later, I’m down 20 pounds and all of my numbers are either normal or much less scary. I have more work to do, but I’m sharing this very personal part of my life because I want you to be honest with yourself in a way I was not.

Reinagel, who also hosts the podcast “Change Academy,” about implementing lifestyle tweaks in a sustainable way, said that people in their 40s and 50s might be more willing to make those alterations because their lives have changed, whether that means watching friends or family deal with serious illness, or perhaps becoming caregivers for their elderly parents.

Those new realities shift our motivation “from wanting to look a certain way, caring about how we look in jeans, to the driving factor being something more focused on health — on ‘how do I want to live out the next 30, 40 years?’ ” she said. “It’s very motivating at our age to remember, ‘This isn’t just about me anymore. I have grandchildren, or I want to live long enough to see them.’ ”

I have been on and off some sort of diet for more than half of my life, mostly because I didn’t like my dress size or my stomach fat. I was perpetually one of the estimated 65 million Americans that return to their pre-diet weight within three years, according to the University of Pennsylvania’s Weight and Eating Disorders Program. But this time, those changes are sticking, because the goal has changed: I don’t want to die anytime soon.

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Still, any of us who have dieted know the danger of jumping in all at once to a super-restrictive food plan or workout routine, in that they suck, are not fun and usually don’t allow donuts. And then we quit. On “Change Academy,” Reinagel suggests making small adjustments, and remembering why you’re doing it.

“You have to look at your ambitions differently. ‘How do I build strength? How do I keep my bones strong? How can I eat in a way that maintains my blood sugar and my blood pressure?’ ” she said. “It’s hard to change not because the new behavior is so difficult, but because we’ve had years and decades of reinforcement of what we have been doing. Carving new behavioral grooves take a while.”

The key is in small incremental actions that you have a better chance of sticking to, said Reignagel, who has asked clients to list 10 possible behavior shifts and rank them in order of their potential impact on their goals. Then she asks them to pick which ones they’re ready to embrace. “Committing to drinking gallons of water every day might not have as big an impact as looking at that three glasses or wine, or dessert,” she said.

That’s what’s worked for me: Instead of swearing off my sushi habit, I switched the white rice rolls for riceless ones and skipped the soy sauce. I gave up prepackaged veggie burgers and vegan meals and cracked open my beloved cookbooks. And instead of two cocktails, I swapped one for a flavored sparkling water.

The result? I feel better. I can walk farther and even run more because there is less weight on my knee. I sleep more soundly. I have more energy. Reinagel said I was in a sweet spot, because I’d “pushed through this important threshold long enough to start seeing the benefit,” so it’s more likely that I will continue.

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“It’s sad that some people give up before they get that positive reinforcement, because they don’t believe they’ll ever get there,” she said.

I’m not there yet. But diabetes and death seem further away than they used to be. That’s a start.

Leslie Gray Streeter is a columnist excited about telling Baltimore stories — about us and the things that we care about, that touch us, that tickle us and that make us tick, from parenting to pop culture to the perfect crab cake. She is especially psyched about discussions that we don't usually have. Open mind and a sense of humor required.

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