Julie Whittington, RD

Healthy tips from a Registered Dietitian

How to manage and prevent pre-diabetes

An estimated 57 million people in the US suffer with pre-diabetes – a condition where blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes.  While most people know diabetes is a chronic disease and one that impacts your blood sugars, many are confused about it.  And, even more do not understand or know about pre-diabetes.

Pre-diabetes is a precursor to type 2 diabetes – one of the most costly and health-threatening conditions afflicting Americans.  Type 2 diabetes significantly risks one’s health (including one’s life!) and is associated with higher risk for damage to organs like the eyes, kidneys and nerves.  It also increases the risk of coronary heart disease, peripheral vascular disease and stroke.  Many individuals with diabetes also have high blood pressure (hypertension), high cholesterol and obesity.

Research shows someone on his or her way to developing type 2 diabetes will develop pre-diabetes first.  And, if it is identified early enough and preventative measures are put into place, that person can reduce his or her chances of developing type 2 diabetes.  While having pre-diabetes certainly appears to increase the risk of cardiovascular disease and death, it is to one’s benefit to prevent higher risk and further complications by warding off development of type 2 diabetes.

So, how do you know if you have pre-diabetes?  Ask your doctor to test your blood glucose (blood sugars).  If your numbers run high, further testing can be done to determine if you have pre-diabetes or diabetes.  Most importantly, don’t ignore your risk. 
About one in five Americans is at risk of developing type 2 diabetes.  Things that increase risk of pre-diabetes or diabetes include: (1) If you are over 45 years old; (2) family history of diabetes; (3) Belonging to a group with a higher risk of diabetes (i.e. African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders are all at higher risk); (4) sedentary lifestyle; (5) high blood pressure; (6) history of diabetes in pregnancy (gestational diabetes); (7) having low HDL (good) cholesterol and high triglycerides; (8) being overweight or obese.

If you have pre-diabetes, there are several things you can do to bring your blood sugars back into the healthy range, thereby reducing your risk of developing type 2 diabetes.  These changes will also help overall health and focus on reducing risk for other chronic disease and death, as well. Here is a list of things you can do:
• Aim to achieve healthy weight.  If you are obese, just a 5-10% reduction in body weight has been shown to be beneficial.
• Choose whole grains, plenty of fresh fruits and vegetables, lean proteins (including lowfat or fat free dairy or dairy alternatives) and healthy unsaturated fats. 
• Consider your carbohydrate intake.  This includes grains (i.e. bread, rice, pasta, cereals, tortillas, cookies, cakes, candies, crackers, granola bars, etc.), milk, yogurt, fruit and fruit juice, sugary soft drinks, starchy vegetables and even a little from regular vegetables.  Overconsumption of carbohydrate can elevate blood sugars into dangerous levels if your portions are too large.
• Limit animal fats and trans fats, high sodium foods, refined flours and high sugar options.
• Drink water instead of soft drinks.  Lowfat/fat free milk or milk alternatives and 100% juice can also have their places in a balanced meal plan.
• Watch portion sizes when you eat – especially when eating at restaurants.
• Incorporate healthy amounts of physical activity everyday.  Even just 30 minutes per day of moderate intensity activity has been shown to help lower risk. 
• Work with a dietitian to enable you to become educated and stay motivated.
• Maintain regular appointments with your physician, to manage blood work and overall health.
• Consider working with a psychotherapist to uncover underlying reasons contributing to your overweight/obesity and how to make behavioral and thought-pattern changes that will enable to you to achieve your goals.
• Visit www.diabetes.org to learn more.


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