If your health care provider tells you that you have pre-diabetes, consider yourself lucky. Why? Because you likely have a provider who realises that the earlier you take action, the better chance you have at preventing type 2 diabetes or delaying its progression.
Changing the path to type 2
According to Diabetes Australia and the National Diabetes Services Scheme (NDSS), pre diabetes affects about 16 per cent of Australian adults. The Baker Heart and Diabetes Institute confirms that nearly 1 in 6 adults (more than 2 million individuals) over the age of 25 are living with pre-diabetes. However, evidence shows type 2 can be prevented in up to 58 per cent of the population living with pre-diabetes through exercising and eating well.
Are you or someone you love at risk of pre diabetes?
The good news is you can prevent or slow the progression of pre-diabetes to type 2. Numerous research studies conducted over the past 30 years show that early and aggressive management with continued vigilance over time is what prevents or delays type 2 diabetes. And the earlier you detect it and put your plan into action, the better. Here are eight ways to manage pre-diabetes.
- Get tested: Do you have family – parents or siblings – with pre-diabetes or type 2 diabetes? Are you carrying extra weight around your middle? Don’t get enough exercise? These are a few of the risk factors for pre-diabetes. A good first step to see if you are at high risk is to use the Diabetes Australia Risk Calculator. You can take the test by visiting diabetesaustralia.com.au/risk-calculator. If you’re at high risk, schedule an appointment with your health care provider to get a check of your blood glucose level – or, better yet, your HbA1c results (an average of your blood glucose over 2-3 months)
- Be more active: For starters, think about how you can fit more physical activity into your daily life. Can you take the stairs more often? Park farther from destinations? Get off the bus/train one stop earlier and walk the rest of the way? Even consider longer routes in your home, office, school, and other places you frequent to burn a few more calories. Make a list and try them out. Also, decrease the amount of time you sit, whether on a sofa or at a desk or table. Research is showing that minimising sedentary behaviour is good for your metabolic health.
- Max out insulin-making reserves: It’s well known that at the centre of the storm of the slow and steady onset ofpre-diabetes is insulin resistance – the body’s inability, due to excess weight and genetic risk factors, to effectively use the insulin the body makes. Along with insulin resistance, the body also has an ever-so-slowly dwindling supply of insulin. Research shows that both insulin resistance and decrease insulin-making capacity start well before the diagnosis of prediabetes and years before the onset of type 2. It seems that some people’s bodies can continue to make as much insulin as they need, while others cannot. A key to treating pre-diabetes is to put this insulin resistance in reverse and maximise your body’s insulin sensitivity by losing weight or maintaining a healthy weight and being physically active. Studies show that just 30 minutes of daily activity, such as walking, can really help.
- Trim the kilos and keep them off: Research shows that losing weight, even just 4-10 kilograms, can accomplish near-miraculous health benefits: lower blood glucose (also known as blood sugar) levels, reduced blood pressure, improved cholesterol, increased energy, improved sleep quality (and decrease in sleep apnoea), decreased pressure on joints, and even decreased risk of certain cancers, such as breast and colon cancer. To continue to enjoy these health benefits, it’s important to maintain as much of your weight loss as possible.
- Resistance training: When it comes to tapering your calorie count, the first place to look is the size of your food portions. To change long-term eating habits, it’s best to make small changes rather than trying to adopt a rigid eating plan that will be difficult to maintain. If you’re like most Aussies, you likely eat too much meat, starchy foods, breads and sweets, and on top of that you may sip too many high-calorie, low-nutrition sugary drinks. Be aware of how much you eat and try to cut down your portions. Thirty grams less of meat per serving, a quarter cup less potatoes per serving, a smaller sandwich – it adds up. And if you drink sugary beverages, swap them for zero-calorie beverages, such as water, sparkling water, tea, coffee and diet drinks.
- Practice portion control: Resistance training means contracting your muscles against an opposing force by generating resistance. The goal? To make your muscles stronger and fight muscle loss from ageing. The push for resistance training for people with pre-diabetes is to improve insulin sensitivity and, in turn, lower blood glucose levels. Couple resistance training two or three times a week with regular aerobic activity. It’s ideal to get about 30 minutes of aerobic activity nearly every day. This can decrease insulin resistance, lower blood pressure and improve cholesterol more so than resistance training alone.
- Fill up on high-fibre foods: To eat enough fibre – 25-30 grams per day – eat fibre-rich whole grains, beans, legumes, fruit and vegetables. Most Australians don’t get nearly enough fibre. Think about how you can include more fibre in your diet. Increase all types of dietary fibre: including fibre that offers bulk, such as wheat flour and psyllium, which improves regularity. Also fibre that adds a gel-like quality, such as the beta-glucan in oats and barley, which can help lower blood sugar; and fibre that causes fermentation, such as legumes (beans) and under-ripe bananas, that contains resistant starch, which has been shown to increase insulin sensitivity.
- Seek support: With 1 in 6 people with pre-diabetes, you are not alone. However, it can feel overwhelming and challenging to change your lifestyle. Get support from your family, friends, co-workers and others who might be going through similar challenges. Do any of these people need to take the same actions you do? Perhaps you can partner up for success. Is there a group of people striving to live a healthier lifestyle at your work? Whether you look online or join your state’s prevention program (below), there are plenty of places you can go to if you’re at high risk of diabetes.
- Victoria – Life! (lifeprogram.org.au)
- New South Wales – Beat It (diabetesnsw.com.au/beat-it)
- Queensland – My Health For Life (myhealthforlife.com.au)
- Western Australia – My Healthy Balance (myhealthybalance.com.au), or Get on Track (getontrack challenge.com.au)
- Tasmania – COACH (diabetestas.org.au/thecoachprogram)
By testing your BGLs. There are two blood tests that can be used: • A fasting blood glucose or a non-fasting random blood glucose Blood is taken from a vein in your arm. This test may be done fasting (nil by mouth for at least eight hours) or non-fasting. If your BGLS are above the normal range (but not high enough to be diagnosed as diabetes) you will need further testing. • An oral glucose tolerance test (OGTT) You’ll have a fasting blood glucose test first. You’ll then be given a sugary drink and have your blood checked again two hours later. The results from the OGTT will show whether your BGLs are in the normal, pre-diabetes or diabetes range. If you have pre-diabetes, you’ll have one or both of these conditions: • Impaired fasting glucose: When your fasting BGL is higher than normal, but not high enough to be diagnosed as diabetes. • Impaired glucose tolerance: When your BGL is higher than normal two hours after an OGTT, but not high enough to be diagnosed as diabetes. Your fasting BGL may still be in the normal range.
For more information, visit diabetesaustralia.com.au
WORDS HOPE WARSHAW PHOTOGRAPHY GETTY IMAGES ADDITIONAL INFORMATION THE NATIONAL DIABETES SERVICES SCHEME (NDSS) IS AN INITIATIVE OF THE AUSTRALIAN GOVERNMENT ADMINISTERED WITH THE ASSISTANCE OF DIABETES AUSTRALIA.
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