Preventing Prediabetes and Diabetes

By Bob Greene, TheBestLife.com

Posted on | By Bob Greene

Diabetes and prediabetes have reached epidemic levels in this country. Newly diagnosed cases of diabetes increased by 90 percent from the mid-1990s to the mid-2000s. And the number of Americans with diabetes has tripled from 1980 through 2006. As many as 95 percent of diabetes cases are type 2 diabetes, the type that is often--but not always--triggered by obesity. Based on the number of people with prediabetes, it looks like there's no end in sight to the trend: Nearly one in five people has prediabetes, a pre-cursor of diabetes. (Check out the box below to learn about the different types of diabetes.)

These are sobering statistics, but there is good news. You may be able to avoid these two conditions by making easy but significant lifestyle changes, like the ones recommended on The Best Life plan. And if you already have either of these conditions, you can manage it, ward off complications and stay healthy by making similar adjustments to your diet and exercise plans. This is the premise of my new book (co-authored by endocrinologist John J. "Jack" Merendino, Jr., M,D., and Best life lead nutritionist Janis Jibrin, M.S., R.D.) The Best Life Guide to Managing Diabetes and Pre-Diabetes.  To reduce your risk for prediabetes and type 2 diabetes, use these strategies:

  • Maintain a healthy weight. You'll find many of the same weight-loss guidelines from The Best Life Diet in this plan for fighting diabetes. For instance, in this book, I recommend eating three meals including a nutritious breakfast and two snacks a day (three snacks, if you're eating more than 2,250 calories a day); eliminating alcohol for a short time; and using the hunger scale, a tool that helps gauge physical hunger and fullness. Being overweight or obese significantly increases your risk for prediabetes and diabetes, so taking off extra weight is very important. In fact, people who carry their weight around their middle are most at risk for the disease. In one study, people who had the largest waistlines were 10 times more likely to have diabetes than those who had the smallest. To find out your waist circumference, take a measuring tape and wrap it around your bare abdomen just above your pelvic bone. The tape should be snug, but not pressing into your skin. Exhale a little and measure. The healthy cut-off: Men should be less than 40 inches; women should be less than 35. (If you're of Asian heritage, the numbers are 38 for men and 33 for women.)
  • Exercise regularly. Working out can help you peel off extra pounds if you need to lose or help you maintain your weight if you're at a healthy weight. Then there's a separate one-two punch: Exercise, especially more intense workouts, can help you shed risky abdominal fat (called visceral fat), which increases the risk of diabetes, heart disease and other illnesses. It also makes the body less insulin resistant. Insulin resistance is a common cause of diabetes; if you have insulin resistance, the insulin that's supposed to transport glucose (that comes from the foods you eat) through your bloodstream and into all your body's cells becomes less effective. Exercise helps your cells become more receptive to insulin, making it easier for the hormone to do its job.
  • Go for whole grains. Whole grains contain more fiber than refined grains. Not only does this help with hunger (fiber tends to dampen appetite), but it also helps keep blood sugar levels more stable. When you eat foods made with refined grain, like white bread or corn flake cereal, the glucose is absorbed into the bloodstream very quickly. On the other hand, whole grains take longer for the body to break down, so you get a much slower and less severe blood sugar spike. Start replacing your regular white bread and crackers with whole-grain versions, and trade in white rice for brown rice. Pasta is an exception; because of the way it's made, even regular pasta promotes a relatively slow rise in blood sugar compared to other foods made with refined grains. Whole-wheat pasta is even easier on blood sugar. If you're not a fan, try Barilla Whole Grain, which at 51 percent whole grain gives you some of the benefits but not the gritty taste, or Barilla PLUS, which has added fiber and protein. The meal plans in the book feature a number of tasty ways to incorporate more whole grains into your diet.


The Different Types of Diabetes
Type 1 diabetes
is usually caused by an autoimmune condition that affects the insulin-producing cells in the pancreas (called beta cells). It can also be caused by severe pancreatitis or removal of the pancreas. People with type 1 must take insulin because the body produces little to none. About five to 10 percent of all diabetes cases are type 1.

Prediabetes is a condition in which your blood sugar levels are elevated above normal, but aren't high enough to meet the criteria for diabetes. (Normal blood sugar is under 100 mg/dL; prediabetes is a blood sugar between 100 and 125; diabetes is a blood sugar of 126 or higher.) People with prediabetes usually produce enough insulin, but the body does not respond to the hormone as well as it should (a condition called insulin resistance, which has been linked to obesity and abdominal fat). In fact, people with prediabetes often produce very high levels of insulin--that's what it takes to combat the insulin resistance and get glucose (fuel used for energy) into cells. The condition doesn't always progress to type 2 diabetes--lifestyle changes can reverse the condition.

Type 2 diabetes is, many times, simply a worsening of prediabetes. As with prediabetes, a person with type 2 may have a lot of insulin circulating in their bloodstream, but his insulin resistance has worsened to the point where even high levels of the hormone can't get enough glucose into cells. And after a while, insulin production itself may diminish--one theory is that the pancreas simply wears out from years of manufacturing the hormone at such a high rate. Type 2 accounts for about 90 to 95 percent of all diabetes cases.

Gestational diabetes is a form of diabetes that women can develop when they're pregnant. It usually develops in the second half of pregnancy (doctors typically test for it around the 22nd week of pregnancy), and can put your health as well as the health of the fetus at risk.


From TheBestLife.com, used with permission For more information, check out The Best Life Guide to Managing Diabetes and Pre-Diabetes or TheBestLife.com.

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