What is Prediabetes & How Can You Prevent It?
The “diabesity epidemic” is a good example of how overall health has declined in recent years. “Diabesity” is the name given to the ever-growing number of people being diagnosed with dual health challenges — excess weight and difficulties with blood sugar management. These two conditions go hand in hand. And they are wreaking havoc on more and more lives. As I mentioned in last week’s newsletter, millions of people are now living with diabetes, and millions more are classified as “pre-diabetic,” meaning they are at risk for developing the disease — unless they change their ways.
Most of your excess weight is concentrated around your waistline. For example, if you’re a woman and your waist is 35″ or more, or 40″ or more for men, that may signal prediabetes. At my own practice, I’ve noticed a tremendous increase in the number of people with prediabetes, sometimes called metabolic syndrome or Syndrome X. Jamie was one of them. A recent transplant to Southern California, Jamie came here from the Pacific Northwest for a new job. His employer requested a physical for the life insurance benefit, and that examination revealed some information that had Jamie worried. In addition to being 40 pounds overweight, he also had high blood pressure and his blood sugar levels were much higher than they should have been. “The insurance people told me to see a doctor, and now I’m concerned. My dad died of a stroke in his 50s,” Jamie explained. “But high blood pressure runs in my family and my brothers and I are all big guys. Nothing I can do about that.”
Actually, there was a lot Jamie could do about it. He may have been genetically pre-disposed to certain conditions, but genes aren’t the end of the story. In his case, for example, having a large frame is one thing; being overweight is another. You can’t change the first, but you can certainly do something about excess weight and high blood pressure. But first, Jamie needed to understand that these factors were not isolated conditions or things that would go away if he ignored them.
As I explained to Jamie, he was pre-diabetic, or insulin-resistant. Symptoms of prediabetes include excessive weight, especially around the waist; high levels of triglycerides (a fat found in the bloodstream); elevated blood sugar and blood pressure; and low levels of “good” HDL (high-density lipoprotein) cholesterol. An individual who has at least three of these markers is considered to be pre-diabetic. In other words, such a person is at risk for developing full-blown type 2 diabetes, with the likelihood of heart attack, stroke, and certain cancers greatly increased.
Prediabetes Details: Know Your Numbers
Being aware of your own health information is an important element in taking control of your health, something I suggest to all of my patients. Here’s a simple chart to help determine if you’re heading into a danger zone:
You may be suffering from prediabetes if you have any three of the following:
- Your BMI (Body Mass Index) is 27 or higher. If you don’t know what your BMI is, simply put “BMI” in your favorite search engine to find one of the many online sites with a tool that calculates it for you.
- Your HDL (“good”) cholesterol is less than 50 mg/dL for women or less than 40 mg/dL for men.
- Your triglycerides are greater than 150 mg/dL.
- Your blood pressure is higher than 130/85 mmHg.
- Your fasting blood sugar is greater than 85 mg/dL.
- Your A1C is higher than 5.5.
In addition to these symptoms, many people report uncontrollable sugar cravings and feeling fatigued no matter how much sleep they get.
Avoid Simple Carbohydrates
Now for the good news: prediabetes can be turned around. Like diabetes, prediabetes is your body’s cry for help, a signal that things need to change. I understand that change can be frightening, but it can also be a good thing. And the changes I will explain benefit your health in so many ways, far beyond blood sugar management. So let’s take a deep breath and see what can be done about the condition.
Two areas — diet and activity level — are crucial to conquering prediabetes. An intriguing new study is showing that it’s possible to not only improve insulin resistance but to reduce weight, too — all without the usual diet agony. The secret? Avoid simple carbohydrates (bread, rice, potatoes, and pasta) for two days every week.
Although the study involved women who were at high risk for developing breast cancer, the findings apply to anyone who wants to reduce weight and reverse insulin resistance. The best result in terms of insulin improvement — 22 percent! — was achieved with the two days of low-carb dieting per week and no more than 650 calories total on each of those days. A second group that also skipped carbs two days per week but had no calorie restriction (in other words, they were allowed to eat as much protein and good fats as they wanted on low-carb days) had a 14 percent improvement in insulin resistance. A third group on a typical Mediterranean diet of 1,500 calories daily had insulin resistance improve by 4 percent. Members of all groups lost weight, with the best results occurring in the first group.
Drink Tea Instead of Soda
Improved diet is not the only change I recommend. Choosing the right beverages can help fight prediabetes, too. Sodas, energy drinks, designer coffees, and most juices are loaded with the sort of simple carbohydrates that can send blood sugar soaring, not to mention add to your waistline. Green tea is just the opposite. A growing body of research shows that drinking two to four cups of green tea daily prevents high blood sugar from damaging various organs in the body. It also increases weight reduction by boosting metabolism. If you’re not fond of green tea’s taste, supplements of the active ingredient — epigallocatechin gallate (EGCG) — are also available.
Unsweetened cranberry juice is another smart beverage choice. Cranberry juice has already been shown to benefit heart and urinary tract health. Now, a new study has found that it improved several markers of prediabetes in women. I suggest mixing 28 ounces of fresh, filtered water with ½ cup of unsweetened cranberry juice and drinking it all day long. Avoid the “no added sugar” juices, which usually contain some form of corn syrup or an artificial sweetener, both of which can be harmful.
Get Some Exercise
Just a handful of decades ago, everyday life was a workout, with fewer cars and labor-saving gadgets. Most appliances, like wringer washing machines, required us to work almost as hard as the machine itself. Television didn’t exist yet, and the only refrigerators were tiny iceboxes that held a block of ice and a bit of food. There was very little prepared food; if you wanted to eat, you had to cook something!
I’m sure you’re as grateful as I am for our labor-saving devices, but we still need to move. In fact, our bodies are designed for activity. I don’t think it’s a coincidence that as fast and prepared food has become increasingly available and labor has decreased, people have become far heavier. Like too many of my patients, Jamie did not exercise and made it clear he was not going to be frequenting a gym. “I’m fine with changing my diet,” he told me. “My wife’s been after me to do that for a long time. But exercise? Don’t think so. I don’t have time.”
If I had a nickel for every patient who has told me, “I don’t have time to exercise,” I would be independently wealthy. But the truth is, lack of time is no longer an acceptable excuse for not exercising. Two recent studies show that even very short exercise sessions benefit insulin resistance and other prediabetes markers. Both studies involve high-intensity interval training on stationary bicycles. In one, participants exercised three times weekly for ten minutes at a time. During the ten-minute sessions, they were asked to step up the intensity and go “all out” — but only for 10, 20, or 30 seconds at a time. Even with this minimal amount of exercise — just 30 minutes total per week! — insulin sensitivity increased by an impressive 28 percent, and aerobic capacity improved, as well. An earlier, related study had similar results. A stationary cycle at home was ideal for Jamie, and he agreed that he could find 10 minutes on most days to work out.
If you have not been exercising, you need your physician to give the go-ahead for any type of workout, whether it’s daily walking or brief, high-intensity interval training. Even with a doctor’s permission, sedentary individuals should start exercising slowly to avoid injuries and work gradually toward more fast-paced routines.
Supplements that Can Help
There are some excellent products aimed at blood sugar management on the market, often combining a number of different substances for maximum effect. These products can be especially helpful for treating prediabetes. Look for ingredients like vitamins, herbs such as fenugreek and bitter melon, minerals (especially chromium, vanadium, and selenium), and various enzymes. These combination products are popular among my patients, since they provide good blood sugar control without requiring you to take a dozen different pills every day.
In addition, I recommend checking out the mineral magnesium. It’s helpful for anyone with prediabetes, and it’s not likely to be included in a combination product. Magnesium is difficult to get in sufficient quantities in our modern diet, so supplements are a good idea for anyone with prediabetes or heart health issues, which magnesium also supports.
If you have been diagnosed with prediabetes or suspect you may be at risk, please don’t hesitate to make the necessary changes that can prevent full-blown diabetes. A lifestyle overhaul may sound daunting at first. But I’ve seen it work again and again with my patients, and I know you can do it, too. As for Jamie, at his last appointment, he weighed in 20 pounds lighter with blood pressure and blood sugar readings in the normal range.
“You know, I used to wonder if I’d live long enough to see my little girl get married,” Jamie told me. “Now I’m thinking I’ll be around for grandkids. It’s like having a whole new life!”