The Diabetes Paradox: How Can You Solve a Problem You Don’t Know You Have?

Submitted By Rebecca O’Reilly

Edited By Marcia Bristow MS RDN CSSD CD

About one third of the U.S. adult population is at an increased risk for type-2 diabetes. This condition, called pre-diabetes, is found in people whose blood sugar levels are higher than normal, but not enough to diagnose actual diabetes. Eleven percent of people with pre-diabetes will progress to diabetes each year and up to 70% of people with pre-diabetes will develop diabetes in their lifetime.  Most people with pre-diabetes do not have symptoms and don’t know their risk.  Overweight and obesity, especially when combined with an inactive lifestyle, are major risk factors for pre-diabetes. But there is good news!  Up to 90% of diabetes can be prevented with diet and lifestyle modification.  Once a person has been diagnosed with pre-diabetes, he can take steps that can stop it in its tracks.

Weight loss can be a simple first step to preventing diabetes.  Up to 50% of cases can be taken care of with only a 5%-10% weight loss. For a 180-pound person, losing as little at 10 pounds can lower blood sugar levels and greatly reduce the risk of developing actual diabetes down the road.

It is important to pay close attention to the amount of carbohydrate-rich foods eaten as well as when they are eaten.  Examples of these foods include, potatoes, breads, soft drinks and sweet desserts.  Eating the same amount of these foods at regular times throughout each day can help the body keep blood sugar levels within a healthy range.  It is also important to choose carbohydrate foods that provide good nutrition.  This means regularly choosing whole grains and fruits and vegetables over the refined sugar found in soft drinks and desserts. 

Physical activity has also been shown to help control blood sugar levels.  The Physical Activity Guidelines for Americans suggest 150 minutes of moderate intensity exercise each week, along with the inclusion of muscle strengthening activities two days a week, to maximize health benefits. For example, someone might choose a brisk half hour walk five days a week and yoga on the other two.

More screening and diagnosis can open the door to changing behavior. But diagnosis has to be combined with food and nutrition education to help improve choices or we’re only fighting half the battle.  A registered dietitian or diabetes educator can help set goals and provide help that will lead to modest weight loss and better blood sugar control by improving food choices, carbohydrate control and physical activity. 

References:

1.     Liebman B. Tip of the iceberg: most people with prediabetes don’t know it. Nutr Action. 2014:2-7. http://cspinet.org/iceberg.pdf.

2.     Men’s Health Advisor. Change your lifestyle to prevent pre-diabetes from progressing. Cleveland Clinic. 2012 (12)5:1,7.

3.     Centers for Disease Control and Prevention. How much physical activity do adults need? June 4, 2015. http://www.cdc.gov/physicalactivity/basics/adults/index.htm