I lost my mother to diabetes and my sister has been diagnosed with pre-diabetes or borderline diabetes. Was this a wake up call for me or what?
My sister is determined to beat this disease at all cost. Even though she still indulges in a sweet treat occasionally, she has now started an exercise program which she follows religiously. So far she has been doing good. Her A1c has remained stable in spite of her indulgencies.
The writing was on the wall for me. I knew I had to take the initiative by starting a lifestyle change to include fixing my poor eating habits and lack of a consistent physical activity program. Knock on wood – my latest tests shows no sign of elevated glucose levels. And the old ticker seems to be working okay.
If you are in a similar situation or have any risk factors of diabetes now is a good time to adopt a healthy lifestyle change. Visit with your doctor to get a status update and follow their advice.
Read the following article from US News by Samantha Costa. I was surprised at the rate at which pre-diabetes has grown in such a short time . . . . and the outlook for the near future isn’t too rosy.
You Have Prediabetes — Now What?
Robin Dorsey’s grandparents, mother, siblings and cousins have all had diabetes. She was the lucky one who escaped the grasp of the chronic disease that’s expected to impact 1 in 3 Americans by 2050 — until she became pregnant at age 29. That’s when hormonal changes pushed her body into a state of prediabetes, setting the stage for the full-blown variety, Dorsey says.
Prediabetes wasn’t just bad luck. Dorsey, now 37, was genetically predisposed. Because her mother had Type 2 diabetes, Dorsey’s risk for developing diabetes was already 1 in 7, according to the American Diabetes Association. Some researchers believe the risk is greater if both parents have Type 2 diabetes. The ADA also reports that 86 million Americans age 20 and older had prediabetes in 2012, up from 79 million in 2010.
There aren’t any particular symptoms of prediabetes beyond having blood glucose levels that are higher than average. This elevation in blood sugar — also called glycated hemoglobin or HbA1c in technical terms — is often not high enough to be considered Type 2 diabetes, says Dr. Margaret Powers of the International Diabetes Center at Park Nicollet in Minneapolis.
People without diabetes have a normal HbA1c reading of 5.7 percent or less; those with prediabetes often have a range of 5.7 to 6.4 percent. Beyond that is full-blown diabetes, according to the ADA’s website.
People who are overweight, inactive or have a family history of diabetes have the greatest risk of developing prediabetes. Importantly, Powers adds: “If somebody is diagnosed [with pre-diabetes], it doesn’t mean they will get diabetes, but it does mean they’re at a higher risk than someone without diabetes.”
Prediabetes can be reversed or staved off by staying physically active and consistently eating a healthy, balanced diet. The Centers for Disease Control and Prevention estimates that upward of 30 percent of people with prediabetes will develop full-blown Type 2 diabetes within five years if they make no lifestyle changes.
The biggest challenge for those with prediabetes is to feel motivated enough to make the necessary changes, Powers says. Initially, Dorsey was told the prediabetes, which quickly escalated into gestational diabetes, would go away after she gave birth to her son. So she stuck to her diet and lifestyle. But nine months later, Dorsey learned it wasn’t going away without a fight.
“It took me about five or six years to lose weight and change my eating habits,” she says. “I saw a nutritionist [who] told me all of the things I should or shouldn’t eat.”
Margaret Eckert-Norton, spokeswoman for the Endocrine Society, says making changes to your eating habits could be as simple as assessing how often you eat out. If you go to your favorite takeout restaurant and find yourself waiting 20 minutes for your order, think about what you could have cooked at home during that time.
Eckert-Norton, a diabetes educator, says some people have no idea how to do anything more than microwave. “That’s probably still better than takeout. Frozen vegetables are a perfectly good option,” she says. “It sounds like a drag, but it’s economical and healthful.”
Hillary Wright, a registered dietitian at the Dana Farber Cancer Institute in Boston, director of nutritional counseling at the Domar Center for Mind/Body Health in Waltham, Massachusetts, and author of “The Prediabetes Diet Plan: How to Reverse Prediabetes and Prevent Diabetes Through Healthy Eating and Exercise,” says the most effective way to normalize blood sugar is to lose weight and exercise, a highly effective strategy validated by the often-referenced Diabetes Prevention Program study.
The landmark study, published in the New England Journal of Medicine in 2002, included 3,234 adults age 25 and older with prediabetes across 27 U.S. clinical centers, who were divided into three treatment groups. Patients assigned to the lifestyle intervention group were given an intense education on diet, physical activity and behavior-modification strategies. The second group was put on a commonly used diabetes drug — metformin — and given information about diet and exercise without counseling. The third group was given a placebo pill without active ingredients. Ultimately, the first group yielded the best results, achieving a 58 percent decreased rate of diabetes compared with the placebo group. The metformin group showed a 31 percent reduced risk for Type 2 diabetes compared with the placebo group.
But Dorsey knows firsthand that changing what you eat and how active you are is easier said than done. “It’s a work in progress,” Dorsey says. “Every day is a struggle because you want different things.” She started small, by limiting sweets and gradually bumping up her physical activity level from zero to 5K — 5K races, that is. She’s 80 pounds lighter now and no longer requires insulin injections or metformin to control her blood sugar levels. She doesn’t necessarily participate in races to win, but just to prove she can finish — and she does. She follows a balanced meal plan now, after finding resources through her nutritionist and the ADA’s website.
People often erroneously believe that cutting carbohydrates is the key to losing weight and eating healthier, Wright says, but it’s more about designing a balanced plate. Reserve half of your plate for non-starchy vegetables such as broccoli, spinach, salad, cauliflower or carrots. One-quarter of the plate should consist of lean poultry, meat or plant protein such as legumes or tofu. The final quarter should include a nutrient-dense whole grains, such as brown rice, pasta or quinoa or colorful, starchy vegetables such as winter squash, corn, peas or a sweet potato.
If your primary care provider encourages you to see a specialist, there are ways to prepare for the first appointment, Powers says. First, keep an honest food and physical activity diary for three to five days per week before your visit.
“They can look it over and have a conversation about where the patient feels they could make changes, and often people know what they need to do,” Powers explains. “It’s finding the right support that’s going to help them make the changes they can maintain for their life at that time.”
Feeling discouraged or in denial are big hurdles to overcome when faced with any diagnosis. “Start with baby steps, and don’t set your goals so high that you cannot achieve them,” Dorsey says.
Powers recommends that patients with diabetes, including prediabetes, locate a registered dietitian who can help create a meal and exercise plan. She also advises they seek emotional support from a psychologist if the lifestyle changes become too overwhelming. The CDC has also collaborated with YMCA to develop diabetes prevention programs that can be individualized to meet a participant’s needs, Powers says.
If you can’t afford a gym membership, Eckert-Norton recommends finding an exercise buddy to run up and down a flight of stairs with (if you’re heart-healthy enough to sustain it). If you’re living in a 55-and-over development or senior citizen housing, check to see if your community offers exercise classes. The bottom line: just move more.
Even though Dorsey is no longer on medication, she keeps a close watch on her blood sugar just in case it becomes too high again.
“These eight years have been a journey,” Dorsey says. “It can be done; I did it.”
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P.S. The ADA recommends 150 hours of exercise each week. If you are a novice then you will want to start slowly and build up to that amount. A good walking program has been shown to improve our overall health and helps the body to process sugars more efficiently.
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