Help Your Patients Understand Prediabetes
Research-backed tips from a dietitian to prevent this killer in its early stages
Help Your Patients Understand & Prevent Prediabetes
By Hillary Wright
Did you know about 8.3% of the population, or almost 26 million Americans, have diabetes? What’s more prevalent than diabetes? Prediabetes, estimated to be 3 times higher: 79 million Americans have this condition, where blood glucose levels are rising but are not high enough to classify as diabetes. Without attention to diet and lifestyle, possibly up to 70% will progress to diabetes.
Given that being overweight or obese increases one’s risk for prediabetes/diabetes, anyone with limited mobility due to an injury or disability – and who over time gains weight as a result – may be in a higher risk category for diabetes. If there were ever a condition to be on the lookout for in your patient populations, this is it!
In patients with mobility issues, activity needs to be personalized to their abilities, but any movement can help naturally encourage glucose clearance from the blood. Testing for prediabetes requires a simple blood test, such as a fasting glucose or hemoglobin A1C.
The good news is a sizable body of research suggests that most cases of prediabetes can be reversed through some very reasonable diet and lifestyle changes. The very large and well-respected Diabetes Prevention Program (DPP) study confirmed that intensive diet and lifestyle intervention is almost twice as effective at preventing diabetes when compared to diabetes medication. This ethnically diverse study group of more than 3,000 participants was treated with 850 mg of metformin twice daily, a placebo pill twice daily, or intensive training in diet, physical activity, and behavior modification, and monitored over a three-year period.
The results? The incidence of diabetes was 58% lower in the lifestyle intervention group, and 31% lower in the metformin group, compared to the placebo group. The intervention worked particularly well for the over-60 group, who reduced their risk of developing diabetes by 71%!
Diet and lifestyle intervention targets two simple goals:
- Aim to lose 7% of body weight through a healthy, low-calorie diet
- Exercise moderately for 2.5 hours each week
As health professionals we’re well aware of the challenges of losing weight, so a weight loss goal of 7% – for example, 14 pounds in a 200 pound person – seems much more attainable to many. For those with injury or disability, the 2.5 hours of activity may be daunting. But any amount of physical movement may help prevent diabetes, a positive message that carries numerous quality of life benefits for physical and emotional health.
As a registered dietitian with more than 20 years’ experience, I’ve found that simple modifications to what – and when – people eat can improve blood-glucose levels and trim calories from their diet. Trimming carbs and spreading them out throughout the day is crucial. The underlying cause of prediabetes/diabetes is insulin resistance, a condition that mandates paying attention to the quality and quantity or carbohydrate one eats at a meal or snack. Carbohydrates convert to glucose in the blood an hour after eating, so learning to trim back carbs can help mute the post-meal glucose rise – and improve overall blood glucose control.
Some simple recommendations:
- Trim as much as possible refined sugar (soda, sweets, added sugars,)
- Trade in white rice, white breads, crackers, and regular pastas for brown rice, whole grain breads/crackers, and whole-wheat (or alternative whole grain) pasta.
- Cover half your plate with vegetables. Most vegetables are mostly water, and are very low in carbohydrates and calories.
- Cover the remaining half of your plate with protein (lean meat, poultry, seafood, or plant protein) and a healthy starch choice, like brown rice, quinoa, or a starchy vegetable like sweet potatoes, squash or a small portion of white potato.
- Eat whole fruit – it’s good for you! Just spread it out over the day to help manage blood glucose.
Hillary Wright is a registered and licensed dietitian with more than 2 decades of experience counseling clients on diet and lifestyle change. She holds a bachelor’s in Human Nutrition from the University of Massachusetts at Amherst, and a Master of Education in Health Education from Boston University. Hillary is the Director of Nutrition Counseling for the Domar Center for Mind/Body Health at Boston IVF, one of the nation’s oldest and most successful fertility clinics, where she specializes in nutrition and women’s health issues. In addition to “The Prediabetes Diet Plan: How to Reverse Prediabetes and Prevent Diabetes Through Healthy Eating and Exercise", she authored “The PCOS Diet Plan: A Natural Approach to Health for Women With Polycystic Ovary Syndrome.” Hillary is also a nutrition writer, speaker and consultant to industry and health-related organizations, and has been quoted widely in national media.