How to Prevent Diabetes

 

Diabetes is something that we are very passionate about- we know so many close ones affected by this disease, and work day in and day out with patients affected by diabetes. As people of color we are at increased risk. 1 in 3 people in the US have prediabetes and 9% of the US population has diabetes

Risk Factors For Diabetes

• Excessive weight- having a BMI over 25
• Being Black, Latino, Native American, and/or Asian
• Lack of physical activity
• Someone in the immediate family having diabetes (parents, siblings, grandparents)
• Having other co-morbidities (high blood pressure, heart disease, etc)
• Being over 45 years old
• For women, having a history of gestational diabetes OR having had a baby over 9 pounds

If you have any of these risk factors, you should get tested for diabetes

Labs To Look Out For

• There are 2 lab values you want to be aware of- one is fasting blood glucose and the other is hemoglobin A1c

Fasting Blood Glucose

• Fasting blood glucose is your blood glucose taken at one point in time (usually in the morning when you haven’t had anything to eat)
• In someone with no risk for diabetes – fasting blood glucose is under 100 mg/dL
• In someone with diabetes, fasting is 125 mg/dL or higher

• What about someone who is in between those numbers? 100-124 mg/dL is considered pre-diabetes, meaning that you have an increased risk for developing the condition
• Studies show that 1 in 3 people with prediabetes will develop diabetes in the next 3 years

Hemoglobin A1c

• The other lab that you need to know, which is arguably more important than your fasting glucose, is your hemoglobin A1c
• A1c measures your average blood glucose over a 3 month period of time
• You don’t have to fast, and results are not dependant on what you ate last night. It shows a bigger picture about your glucose control
• Normal ranges are an A1c is less than 5.7%
• In someone with prediabetes, the A1c is 5.7 to 6.4%
• A1c’s of 6.5 or higher is consistent with diabetes
• You can get tested for this every three months if your value was elevated- for example, if you go and your A1c is 5.9% and you want to make aggressive lifestyle changes, you can retest in 3 months to see if it has gone down

So What Should You Do?

• The number two things are diet and lifestyle. There was this huge diabetes prevention study, that lasted for 5 years. They took people with diabetes, and divided them into 3 groups:

Group 1 had no intervention – over the 5 years they did no diet or lifestyle changes

Group 2 took metformin, which is a drug that is usually given to people who are newly diagnosed with diabetes

Group 3 ate healthier diets, worked out, and lost some weight

Which group had the best chance of preventing diabetes over the 5 year period?

Group 3. The study found that a loss of 10% of body weight decreased risk of developing diabetes by 85% over the next 3 years

What did these people do?

150 minutes of exercise per week, one-on-one counseling for the first 6 months, and group counseling thereafter. They also ate a well balance diet

Nutrition Recommendations:

There are 4 important things

1. FIBER. Getting enough fiber – study after study shows that fiber is so important in regulating blood sugar levels.Try to get 25-35 grams of fiber in your diet per day. High fiber foods include vegetables, beans, fruit, nuts, seeds, & whole grains
2. VEGETABLES. Try to eat at least 3 cups of non-starchy vegetables per day – think the rainbow – different vegetables have different nutrients and phytochemicals – if you can eat a veggie in each color of the rainbow every single day, you will be doing amazing
3. SUGAR. Cut out added sugars – added sugars are things like cakes, cookies, pies, candy, energy drinks- even juice. These foods are high in simple carbohydrates, which make your blood sugar skyrocket out of control – the goal is to maintain a stable blood sugar over time
4. CARBOHYDRATES. Speaking of carbs, watch them. We usually recommend that people with prediabetes or diabetes don’t go over a certain number of carb exchanges per meal.

This is really technical and if you guys want to learn more we can do a podcast going into more detail, BUT the jist of it is try to not make carbohydrates the base of your meals. Foods with carbs include fruit, grains (oatmeal, rice)- some surprising foods like yogurt, milk, pasta, etc.

These foods are typically healthy and you can eat them, but if you have elevated blood sugar, it’s a good idea to not overdo it on the portions

Useful Links:

• http://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp/Pages/default.aspx
• https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf 
• http://www.diabetes.co.uk/news/2015/jul/skipping-breakfast-with-type-2-diabetes-could-cause-dangerous-spikes-in-blood-glucose-levels-93716047.html