Health & Wellness by Jackie Jung, R.N., C.D.E.

Written by Jackie Jung RN on 06 December 2010

Preventing Diabetes

Last time we talked about what Prediabetes meant, how it was diagnosed and what risk factors were for developing it. This article will continue with preventing prediabetes and diabetes. Let’s review – “Prediabetes” is a condition in which your blood glucose levels are high, but not high enough yet to be called diabetes. When people go onto type 2 diabetes, not all do, they continue to have two problems: insulin resistance—a condition in which muscle, liver, and fat cells do not use insulin properly—and reduced insulin production by the pancreas. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body, never fulfilling its role as the body’s main source of fuel.

As with type 2 diabetes, you can have prediabetes without even knowing it. When you have prediabetes, you do have a higher chance of eventually developing diabetes. The great news is your lifestyle habits can make a big difference! You can help to prevent prediabetes from progressing to diabetes. In fact, research shows that making these lifestyle changes may lower your risk of developing type 2 diabetes by about 60-70%!

So what can you do to help to prevent the onset of type 2 diabetes? One of the most important factors in the development of diabetes is genetics (which we have no control over). However, there are things in our environment, things that we have control over that lower our personal risk of developing diabetes. And, frankly, none of it is magic. It has been said: “Prevention of diabetes is a long and winding road. There seems to be no short cut, and a persistent and prolonged intensive lifestyle intervention seems to be the most effective mode to travel on it. (1)

What I have noticed (much to my delight) is that there are a growing number of patients coming to me for education with prediabetes or having a family history, BEFORE they actually have developed diabetes, wanting to know how to prevent it. Education and understanding is the key.

When you’ve been diagnosed with pre-diabetes, it can be difficult to navigate through all the health advice out there. You know you have to watch your diet, exercise more and perhaps even lose some weight. Sometimes it can feel like you’re stuck in a traffic jam. How do you find your way? It’s hard to know which direction to go. But it’s important to remember that you drive the bus when it comes to your health. Avoiding common road blocks can help you put pre-diabetes in reverse.

Reducing the Risk of Diabetes

Having pre-diabetes puts you at a higher risk for type 2 diabetes in the future. But it doesn’t have to mean that you will get type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.

Weight Loss

Weight loss of 5% to 10% — or about 4.5 to 9 kg (10 to 20 lbs.) for a 90-kg (200-lb.) person — has been shown to significantly reduce the risk of diabetes. In patients at risk for diabetes, weight loss can improve insulin sensitivity, delay, and even prevent progression to type 2 diabetes. In patients with overt diabetes, weight loss can play a tremendous role in improving blood sugar control.

Two large studies – one in Finland and the other one U.S. (the Diabetes Prevention Program- DPP) have shown the benefit of weight loss in diabetes prevention. In the Finnish study, more than 500 men and women with prediabetes were assigned to a control group or an exercise/weight loss group. By the end of the study, the weight loss group had lost about 8 pounds, and the control group about 2 pounds. The weight loss group had significantly less participants develop diabetes than the control group. (2)

Eating a Healthy, Balanced Diet

By eating foods that are rich in fibre, reducing the amount of fat in food selections and adding more fruits and vegetables a person can help control their diet and maintain or lose weight. It is also possible to decrease the size and quantity of food servings while still ensuring that you meet healthy nutrient intakes. We are a society of super-sizing and our idea of what a normal portion size has become distorted.

Fast Food and Processed Foods

Fast food and processed foods pack a calorie and fat wallop. A fast food burger and medium fries has 650 calories and 32 fat grams. A homemade burger, made with 95 percent lean ground beef, with oven-baked fries, has 418 calories and 8 fat grams. Making your own burger and fries saves you 212 calories and 24 fat grams. Also, a store-brand chocolate chip cookie has 136 calories and 6.4 fat grams, while a homemade chocolate chip cookie using a low-fat recipe is 65 calories and 2.3 fat grams. A homemade cookie saves you 71 calories and 4.1 fat grams per cookie.

Fruits and Veggies

Eat more fruits and vegetables. Getting more of these nutrients may reduce risk for Type 2 diabetes, stroke, heart disease and other cardiovascular diseases. A diet rich in vegetables and fruits gives your body the nutrition it needs to function properly. Fruits and vegetables are naturally lower in calories and sugar and higher in fiber than processed foods and are helpful for weight loss.

Fibre

The typical Canadian diet is woefully devoid of fibre. Getting more fibre is very beneficial in many ways. Foods high in fibre take longer to digest and keep blood glucose from spiking. Fibre also keeps you full longer and helps you stay regular. Experts recommend 25-50 grams of fibre a day. That’s a lot of fibre. The new high fibre cereals and snack bars may help you reach that goal. Just watch the sugar content of these products. Sometimes it can be quite high. Drink plenty of water when you increase your fibre intake, to help move things along.

Effective nutrition strategies to achieve weight loss include:

Eating 3 regular, balanced meals daily
choosing appropriate portion sizes
increasing intake of fibre-rich foods, vegetables and fruits
decreasing intake of soft drinks and fast food

Canada’s Food Guide suggests eating the recommended amount and types of food each day following the Guide and reading labels on products:

Eat at least one dark green vegetable and one orange vegetable each day.
Choose vegetables and fruit prepared with little or no added fat, sugar or salt.
Have vegetables and fruit more often than juice.
Make at least half of your grain products whole grain each day.
Drink skim, 1% or 2% milk each day. Drink fortified soy beverages if you do not drink milk.
Have meat alternatives such as bean, lentils and tofu often.
Eat at least two Food Guide Servings of fish each week.
Select lean meat and alternatives prepared with little or no added fat, sugar or salt.
Include a small amount of unsaturated fat each day.
Satisfy your thirst with water.
Limit foods and beverages high in calories, fat, sugar or salt.

MORE INFO

Get your copy of Canada’s Food Guide at: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php
Eat Right Ontario is also a valuable resource online @ http://www.eatrightontario.ca
Call 1-877-510-5102 and speak directly with a Registered Dietician from Eat Right Ontario.

For more information on prediabetes, diabetes and your risk factors please call Jackie Jung, Certified Diabetes Educator at the Manitouwadge Diabetes Health & Wellness Program at 826-3251 Ext. 208.