It can be very frightening waiting for your lab results in your doctor’s office and then hear the results as indicating “pre-diabetes”. You are typically given an intimidating book or pamphlet with a brief explanation of diabetes and then sent home with a follow-up visit scheduled to review progress.
So, what now? How do I decipher these pamphlets and get back on track?
Let’s start with what “pre-diabetes” is, pre-diabetes is impaired fasting glucose or impaired glucose tolerance, so basically it means your blood sugars are higher than normal. You may think this diagnosis is not a very frequent occurrence, but according to the Academy of Nutrition and Dietetics, it’s estimated that 86 million Americans have what we call “pre-diabetes” which also raises your risk for developing type 2 diabetes, heart disease, and even stroke.
Within a five-year period at least 15 to 30% of that 86 million will develop type 2 diabetes and be considered a diabetic. The key is to prevent the diagnosis through lifestyle change, and not end up within that 15-30%!
What Are Your Risk Factors For Type 2 Diabetes?
1. Age and Weight
- If you are 45 years or older and considered overweight per your BMI
- If you are younger than 45 years old, overweight with a history of a sedentary lifestyle (physically active three times per week or less) and high cholesterol (low level of HDL or elevated level of triglycerides over 250), high blood pressure (140/90 or higher).
2. Family History of Diabetes
- Having a family history of diabetes places you at increased risk for developing type 2 diabetes.
3. Lab results
- Pre-diabetes is indicated when your A1c is between 5.7-6.4% and fasting plasma glucose is 100 mg/dl to 125 mg/dl.
- Higher prevalence of diabetes is common among African-American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian or Pacific Islander.
- If you have had gestational diabetes or gave birth to a baby weighing 9 pounds or more you have a higher chance of being diagnosed with type 2 diabetes.
The Game Plan!
Identifying the problem areas that you currently experience in your day to day life that may be contributing to pre-diabetes. These behaviors include a mixture of diet and exercise:
- Portion control and consuming larger than recommended portions
- Consuming high-calorie foods and beverages throughout the day including alcohol
- Consuming foods high in simple carbohydrates (sugar) or saturated fats
- A sedentary lifestyle
- Emotional or binge eating
- Fasting or skipping meals
Don’t worry; it’s not just you! If you identified exercise as a behavior that needs work you are among the 80% of adults that do not meet the physical activity guidelines for aerobic and muscle-strengthening activities.
The great news is according to the Diabetes Prevention Program through the National Institute of Health people with increased risk of type 2 diabetes can prevent or delay the diagnosis by losing 5-7% of their body weight through increased physical activity and healthy nutritious diet.
You don’t need to kill yourself in the gym or go on a restrictive diet plan; small steps can make a significant impact! Even if you are 5′ 5″ tall and 185 pounds (BMI: 30.8 or Obese) and you lose* as little as 10-15 pounds by walking 30 to 60 minutes per day 5 days a week will make a difference. It will even get you into a new BMI category from obese to overweight.
If you have a loftier goal keep in mind 250 calories equals one pound so if your goal is 2lbs per week you need to cut 500 calories out your day through diet and exercise. Just think, if you burn 90 to 100 calories per half-hour or 180 to 200 calories per hour in a new walking group you’ve hit almost half your calorie deficit for the day in just exercise alone!
Weight loss* also assists the body in utilizing insulin more effectively and improves* blood circulation which can be impaired. Exercise can improve* chronic diseases like LDL cholesterol and blood pressure which many of those struggling with pre-diabetes are also concerned with.
Tips To Become More Active
- Park further away from your destination to get extra steps in
- Make exercise a family activity and play catch in a park or go for a walk after dinner
- Take the stairs instead of the elevator or escalator
- Instead of hiring a gardener mow your own lawn and work on the garden outside
- Do sit-ups, calf raises, jumping jacks or jog in place while watching television
- Purchase exercise videos or apps to do at home
- Join a gym or exercise class
- Consider hiring a personal trainer for 1:1 coaching
- Starting a walking or running group with friends or colleagues
Our typical eating patterns currently do not align with the Dietary Guidelines for Americans, and most exceed recommendations for added sugars, saturated fats, and sodium.
According to the Dietary Guidelines for Americans and the American Diabetes Association, there are several key areas to focus on when it comes to diet:
1. Breakdown of your calories for the macronutrients in your diet according to the Dietary Guidelines for Americans:
- 50-65% of your total calories for the day should come from carbohydrates, <10% from added sugars
- 15-20% of your total calories for the day should come from protein
- < 30% of your total calories for the day should come from fats, <10% from saturated fats
2. Follow a healthy eating pattern as a lifestyle versus the next six months, which is why we don’t call this journey a “diet”.
A healthy eating pattern at an achievable and sustainable calorie level will help maintain a healthy weight, support nutrient adequacy, and reduce* the risk of chronic disease (i.e.: Diabetes and heart disease).
- A tip is to think of the USDA’s “Choose My Plate” icon for a balanced plate when you are planning your meals so think of variety, nutrient dense and correct portion sizes.
- A variety of vegetables including dark green, red and orange colored vegetables is recommended so think color! Also, not many people think legumes (beans and peas), starchy and 100% vegetable juice counts as a vegetable serving too.
- Choose fat-free or low-fat dairy including milk, yogurt, cheese and fortified soy beverages.
- A variety of protein foods including seafood, lean meats, poultry, eggs, legumes, nuts, seeds and soy products.
- Utilize leaner proteins in your favorite dishes, so you don’t feel like you are missing out, for example using ground turkey instead of ground beef in meatballs or meatloaf.
- Select seafood that is high in omega-3 fatty acids which help lower your risk for heart disease and high blood pressure. Proteins that contain omega-3 fatty acids include salmon, herring, sardines, halibut, swordfish, and mackerel.
- Processed meats such as ham, sausage, hot dogs, and deli meats have added sodium so make sure you are reading the nutrition facts label for the best choice.
- Limit saturated fats and trans fats, added sugars, and sodium.
- Many of your favorite dressings, marinades and cooking techniques can be tweaked to jazz up some of your favorite dishes in a healthier way. For example, cooking with lard for your fried chicken versus doing an oven baked fried chicken. You can also make many marinades from scratch instead of buying high sodium prepared products at the grocery store.
Now that you have a few more tools in your tool belt post doctors visit lets set our sights on that lifestyle change you’ve been needing! It may seem intimidating but always remember every step counts on your journey with pre-diabetes.
Also, the changes you make that are sustainable will not only prevent those lab results from increasing* but combat other chronic diseases that may also have resulted further down the road such as heart disease and stroke.
Feature Image: Istockphoto.com
In-Post Image: Istockphoto.com & cdc.gov