June 3, 2015

Learn Prediabetes Is Not Diabetes

Since 2003, when the American Diabetes Association (ADA) convened a group of “experts” to declare the blood glucose levels between 100 and 125 mg/dl (3.9 to 6.9 mmol/L) as prediabetes, all people were aware of was that diabetes started at 126 mg/dl (7.0 mmol/L).  This classification applies only to type 2 diabetes.

Since then the ADA has done little to encourage doctors to screen for prediabetes.  A few doctors have been screening for prediabetes and doing an excellent job at this, but the bulk of people with prediabetes are still unaware they even have this.  The ADA, for all their “expert” knowledge, has done little in the way of education or helping the people that might have prediabetes become aware of what might happen if they do nothing to prevent the onset of full type 2 diabetes.  

Receiving a diagnosis of prediabetes is a serious wake-up event.  It does not necessarily mean that type 2 diabetes is a foregone conclusion.  There are changes that you can make to slow the progression to diabetes and for some people to prevent diabetes.  The following are some suggestions to consider:

Develop an exercise regimen you enjoy.  Doing this is one of the best things you can do to make diabetes less likely.  If it has been a while since you exercised or you are medically able, start by building more activity into your routine by taking the stairs or doing some stretching during TV commercials.  Physical activity is an essential part of the treatment plan for prediabetes, because it lowers blood glucose levels and decreases body fat.  Check with your doctor to see if you have limitations.

Lower your weight if this is needed.  If you're overweight, you might not have to lose as much as you think to make a difference.  In one study, people who had prediabetes and lost 5% to 7% of their body weight (just 10-14 pounds in someone who weights 200 pounds) cut their chances of getting diabetes by 58%.

See your doctor more often if possible.  It is recommended to see your doctor every three to six months.  If you're doing well, you may get positive reinforcement from your doctor.  If it's not going so well, your doctor can help you get back on track.  If you are like me, you will appreciate words of encouragement, and even words needed to put you back on the right path.

Develop a good food plan that your meter approves.  Load up on vegetables, especially the less-starchy kinds such as spinach, broccoli, carrots, and green beans.  Aim for at least three servings a day.  Add more high-fiber foods into your day.  Enjoy fruits in moderation - 1 to 3 servings per day. Eliminate whole-grain foods as much as possible and do eliminate processed grains.  In general, eliminate white rice from your food plan.

Also, swap out high-calorie drinks.  Drink whole milk rather than skim milk and diet soda rather than regular soda.  Choose cheese, yogurt, and low carb salad dressings. Choose fresh fruit when it is available and not fruit juice.

Make sleep a priority and sleep the suggested hours when possible.  Not getting enough sleep regularly makes losing weight more difficult.  A sleep shortfall also makes it harder for your body to use insulin effectively and may make prediabetes and diabetes more difficult to manage.  Set good sleep habits.  Go to bed and wake up at the same time every day. Relax before you turn out the lights.  Don't watch TV or use your computer or smartphone when you're trying to fall asleep.  Avoid caffeine after lunch if you have trouble sleeping.

Get support and ask for help when needed.  Losing weight, eating a healthy diet, and exercising regularly is easier if you have people helping you out, holding you accountable, and cheering you on.  Consider joining a group where you can pursue a healthier lifestyle in the company of others with similar goals.  The right diabetes educator and nutritionist may also help you learn about what you need to do to prevent your prediabetes from becoming diabetes.  Sometimes this will be a doctor, a nurse, or just a friend.

Choose and commit to the task of managing your diabetes.  Having the right mind-set and a positive attitude can help.  Learn to accept that you won’t do things perfectly every day, but pledge to do your best most of the time.  Make a conscious choice to be consistent as possible with everyday activities that are in the best interest of your health.  Learn to tell yourself, I’m going to give it my best.  I’m going to make small changes over time that will become good habits.  These changes will add up over time and help you manage your prediabetes or diabetes if it progresses that far.

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