And steps to prevent becoming a diabetic
Photo by Towfiqu Barbhuiya on Unsplash
Diabetes is epidemic in the United States right now. According to the American Diabetes Association website, about 37 million Americans are diabetic. While that number is astounding, another 96 million Americans are pre-diabetic, and about 1.4 million new cases of diabetes are diagnosed each year.
I have written a previous post about diabetes. (Diabetes Control).
However today I want to focus on the concept of pre-diabetes and how you can prevent from becoming a diabetic in the future by taking the right steps.
For the record- I am not a diabetes specialist. I am a general Internal Medicine physician with over 30 years of experience. I have been the past president of the local American Diabetes Association Board, and although I no longer serve on the board, I believe in their mission and will refer to them in this article. And, like most people, diabetes and pre-diabetes has touched many of my family members.
How do I know if I have pre-diabetes?
Probably the first thing that you should know is that pre-diabetes doesn't really have any symptoms. So the diagnosis is essentially made by looking at your laboratory testing; another reason why annual physical exams are important.
One way to know if you have pre-diabetes is to look at your fasting blood sugar level. If your fasting blood sugar is between 100 and 126 mg/dl ( that's milligrams per deciliter but for the remainder of the talk I'll just refer to the numbers by themselves), then you have pre-diabetes.
Your doctor may also measure something called a hemoglobin A1c level. That test looks at what your blood sugar has been like through a different kind of testing that is also measured on a different scale. It actually gives us an idea of what your average sugar was like over the last eight weeks or so. If your level falls between 5.7 and 6.5, you are pre-diabetic.
If I have pre-diabetes am I doomed to become a diabetic?
The simple answer to this question is that you are not doomed to be a diabetic if you take the proper steps. Let's take a look at what you need to do.
Probably the greatest factor driving the whole epidemic of diabetes and pre-diabetes is the fact that about 66% of the US population is either overweight or obese. Body fat basically disables insulin from doing its job, which is to carry blood sugar into your cells where it can be used for fuel.
So one of the first things that you can do to prevent diabetes is to try to achieve an ideal body weight. An ideal body weight would be a body mass index between 20 and 25. Not sure what your body mass index is? Here's a link that you can use to find out.
But don't despair. You don't have to go from where you are to a BMI of less than 25 in order to reap any benefits. According to the Johns Hopkins Medicine site, by simply losing 5-10% of your current body weight, you will decrease your risk of diabetes from developing by 58%.
Do I have to stop eating carbs to prevent from becoming a diabetic?
For starters when it comes to coaching patients about their eating habits I am not in favor of extreme diets. In particular, I don't think that eating a “keto diet” or anything else that eliminates a complete food group is necessarily healthy. I believe in moderation in all things, including moderation!
The truth is, you have to have some carbohydrates in your diet especially if you're going to be exercising. I think a diet that is 40% protein, 30% carbohydrates, and 30% fat, is more reasonable. Some of the commercial diet plans that are available follow this recipe.
That said, if you have access to a dietitian to help guide you, their assistance will be invaluable. Check with your physician if your insurance plan will provide for that type service. If not contact the local American Diabetes Association and see if they have any free resources in your area that may guide you. Their website has an incredible amount of helpful information. Here is another link you can use.
I am in favor of plant-based diets. That's not to say that you can't have the occasional meat chicken or fish. Plant-based diets have proven to help prevent heart disease also. The Mediterranean diet is a popular option.
A word of caution however. People sometimes get carried away with their consumption of fruit. While fruits comes from plants, they have a high content of sugar. So given an option of a vegetable versus a fruit, always go with a vegetable. And no I won't argue with you over whether a tomato is a vegetable or a fruit!
Some foods have a naturally high “glycemic index.” This essentially indicates how high your blood sugar levels will spike after consuming these foods. You can look this up on-line. Obviously, trying to eat lower glycemic index foods is the goal. And by the way, less sugar means less calories.
And let’s not forget…… exercise!
Exercise is good for just about everything when it comes to your overall health- diabetes, obesity, hypertension, depression…. you name it.
But how much exercise?
In a perfect world, where none of us resides, 150 minutes a week of aerobic exercise is recommended. To reach your aerobic heart rate range you will need to do some calculation, so here is a calculator to help you.
CAUTION- don’t start an exercise program without consulting with your doctor first. And by no means would I recommend starting out with 150 minutes a week. Start low and go slow.
Try 15 minutes, 3 days a week if you have been doing no exercise. Do that for a few weeks and add 5 minutes per day every few weeks. Once you reach 30 minutes, try to add another day.
Can’t do 5 days a week? Do what you can. Something is better than nothing. And as I tell my patients, remember, your body does not have a calendar. It only knows you are exercising or you are not. So don’t get hung up on insisting that your exercise needs to be every other day. Do Saturday and Sunday, and add a day during the week. Can’t do that weekday workout due to the kid’s soccer game? No problem, slide to another day for that week.
What is the best exercise?
The best exercise is the one you like to do and can commit to long term. Walking is the exercise with the least obstacles.
I tell my patients that if. you are going to walk, it has to be a “Honey we’re late for the plane” walk and not a “ Oh, look at the pretty butterfly” walk. When you are done, you should look like a glazed donut- glistening with a mild coating of sweat!
So what happens if you ignore the fact that you are a pre-diabetic? I have read reports that there is a 50% chance you will become a diabetic in 5 to 7 years if you don’t heed the warning. If you gain even more weight, the risk goes up and the time frame shortens.
But there is hope, and you now have some tools to work with to change the course of your health.
If you found this information helpful, please share it with a friend. All of my posts can also be found on my website, Yourmedicalupdate.com.
Here is the link
Your Medical Update
Have a great week!