Symptoms of Type 2 Diabetes
Type 2 diabetes is an epidemic in the US; symptoms include
- Frequent urination
- Blurry or cloudy vision
- Erectile dysfunction (ED, impotence)
- Excessive thirst...
Prediabetes is the term used to describe elevated blood sugar (glucose) that has not yet reached the threshold of a type 2 diabetes diagnosis. Consider pre-diabetes a warning sign that it is time to take your health more seriously.
Without reversing prediabetes, blood sugar continues to rise and signs and symptoms of diabetes may develop. The most common symptoms and early signs are thirst and excess urination. Sometimes people will notice unexplained weight loss. Later signs of type 2 diabetes are
Pre-diabetes is a warning sign that metabolism is getting out of balance. Humans are designed to be physically active hunters and gatherers who move a lot and eat only occasionally. This isn't what most of us do. Essentially, the underlying cause of prediabetes is that there is more fuel (glucose) available than can be used up. This can be because of excess intake of dietary carbs and sugars, because of insulin resistance, or because the liver is making too much glucose. The easiest causes of prediabetes to manage are insulin resistance and excess dietary intake. For many people with prediabetes, it can be reversed with exercise in combination with a eating a low-carb diet (low-glycemic index diet).
Some of the risk factors for prediabetes include
Type 2 diabetes is an epidemic in the US; symptoms include
Unfortunately, there really are no symptoms or signs of prediabetes. It almost always is diagnosed by chance during a medical screening or routine bloodwork. This is why it is important to get screened, especially if you are overweight or have family members with diabetes or pre-diabetes. However, the most common sign associated with prediabetes is being overweight.
It is common for a person with prediabetes to only have slightly elevated blood sugar levels, but the body continues to require increased insulin to maintain it. Hyperinsulinemia or high insulin, has signs and symptoms of:
Occasionally, people may notice they are thirstier than normal or are urinating more frequently.
There are three blood tests that can diagnose prediabetes and type 2 diabetes.
Prediabetes glucose levels are shown here in a chart of normal, prediabetes, and diabetes lab test numbers so you can make comparisons.
|HbA1c||5.6% or less||5.7%-6.4%||6.5% or more|
|Fasting blood glucose||99mg/dl or less||100-125mg/dl||126mg/dl or more|
|Oral glucose tolerance||140mg/dl or less||140-199mg/dl||200mg/dl or more|
Prediabetes can be reversed with lifestyle changes. This includes being more physically active and following a healthy diet plan such as a low glycemic index diet, rich in quality, real foods. Quitting smoking, stress management, and keeping alcohol intake moderate all help too. If lifestyle is not changed, prediabetes usually progresses to diabetes.
When you are working to reverse prediabetes, your health-care professional will advise you on how often you should have your blood tests checked – usually every 3 months.
Having your own personal home glucose monitor (finger stick test) gets you involved in managing your prediabetes, and also can help you track your progress. Write down the numbers and what was consumed to learn how you respond to different meals. This is a great way to test different prediabetes meal plans to find out what foods cause your blood sugar levels to go up the least, and the most!
Do the following to track your meals and foods.
Prediabetes is best treated with a proactive, renewed commitment to getting healthier, and making healthier choices every day. It can, and usually is, treated with diet and exercise alone. However, some people with prediabetes are treated with a medication called metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet). Research published in the New England Journal of Medicine showed that lifestyle changes reduced diabetes incidence by 58% compared to metformin, which reduced the incidence by only 31%.1
If you have been diagnosed with prediabetes, discuss a treatment plan with your health-care professional.
The best foods for prediabetes are
The foods to eat for prediabetes are real foods in their natural or whole form. There needs to be a balance of fat, protein, and carbohydrate. Drinking lots of water or unsweetened tea also is important.
And easy way to identify the most important foods to avoid is to avoid any food that is white. This includes
Cauliflower is white, but it is a good food for prediabetes because it is a whole, real vegetable.
It also is best to avoid highly processed foods (like foods that come in boxes or packages already prepared). These foods are high in calories, carbs, chemicals, and low in nutrients and vitamins. Other foods to avoid include:
The take home message is to pay close attention to the quality of all foods - fats, proteins, and carbohydrates – and choose less processed ones.
A low-carb diet is a great option for prediabetes because it will improve blood sugar, help you lose weight, and help you feel more energetic. Carbohydrates are digested into glucose very easily. A person with prediabetes already has too much sugar in the blood so you don’t want to add any more.
To feel satisfied on a low carb diet you have to eat healthy amounts of protein and fat. Many people continue to try to follow a low-fat or fat-free diet while also trying to make low carb choices, and understandably, feel hungry and frustrated because there is nothing tasty to eat. Recent research published in the British Medical Journal debunked the low fat hypothesis (that people on a low fat diet have a lower risk of developing prediabetes).2 People actually are not at a lower risk of prediabetes.
The easiest way to choose quality carbohydrates by following a low glycemic index diet. With a low glycemic index diet you balance the carbohydrate/sugar content of a meal with enough fiber, fat, and protein so that the meal is digested and absorbed slowly. This gradually releases glucose into the bloodstream, and thus the body does not require a large amount of insulin. It also provides the body with good, steady energy over many hours.
Choosing quality fats and proteins means choosing real food rather than processed versions. Believe it or not, a serving of organic full-fat Greek yogurt with real raspberries will be much more satisfying, and better for your blood sugar and weight, than the fat-free fruity version.
Good protein choices include:
Organic and grass fed choices are important because what an animal eats changes the nutrition of the meat. Non-organic and factory-fed animal meats increase inflammation. In prediabetes, this means increased risk for heart disease and complications.
Make at least some of your meals vegetarian because plant-based fats are associated with lower oxidized LDL and less inflammation. Good fat choices include
Check labels because hydrogenated fats are often are used in packaged bakery products.
All exercise helps reverse prediabetes by using up sugar in the bloodstream and improving insulin sensitivity. An exercise plan should focus on two things:
Increasing muscle strength makes the cells of the muscle "hungrier (more insulin sensitive), and that equals a healthier metabolism. You can build muscle by using weights, your own body weight, or resistance bands. If you choose weight training start slowly, and ask for help using the equipment safely and properly. Begin with low weights, and gradually work up to heavier weights. Lifting one round of heavy weights for only 6-8 repetitions has more benefit than one round of light weights for 10 or more repetitions. If you can do more than 10 repetitions, add more weight.
This plan also is great if you are in a hurry. You can complete a full workout in just 20 minutes twice a week. Work up to this gradually to avoid injury.
If you like cardiovascular exercise, focus on short bursts of high intensity activity. Research studies show that few people lose weight by spending an hour on a treadmill or elliptical machine. Lifting heavy weights, and short sprints that make you breathless helps you lose weight best. For most people, this is less than 90 seconds, after which, you should walk until you catch your breath and do it again! You'll be done in 20 minutes.
And, as always check with your health-care professional before starting any exercise program and get help using equipment properly to avoid injury.
Metformin is the only medication approved by the FDA to treat prediabetes. It works by stopping the liver from producing excess glucose. For some people, metformin also helps them lose weight. It can be an option for people who aren't ready or able to make lifestyle changes right away. Metformin also is a medication that can be discontinued as soon as blood sugar levels are at goal, and healthy lifestyle habits have become routine.
Some dietary supplements have good evidence of helping reverse prediabetes. For example, most people with prediabetes are deficient in vitamin D and magnesium. Both of these are necessary to keep cells properly sensitive to insulin. A health-care professional can order a blood test to check and see if your deficient in these and other nutrients, for example, chromium, biotin, and N-acetyl cysteine. These also are nutrients that have research supporting their role in improving insulin sensitivity.3 Check with a health-care professional before taking supplements. You may need to find one with this specialized knowledge such as a naturopathic doctor, nutritionist, or integrative medicine doctor.
Prediabetes is typically diagnosed and managed by your primary care practitioner, including internists and family medicine specialists, or pediatricians in the case of children or adolescents. Other specialists who may be consulted include physicians who specialize in endocrine glands and hormones including diabetes management (Endocrinologists). A nutritionist can be consulted to help you review your diet and suggest dietary and lifestyle changes. A personal trainer can be helpful if you are having a hard time putting together an exercise plan for yourself. There are a lot of self-care resources too. Eating healthier, exercising, and losing weight are ways to improve your health, and are key to prediabetes treatment.
Absolutely! The best way to prevent prediabetes are to
If you had gestational diabetes, you may want to pay special attention to adopting the habits discussed in this article.
Most importantly, for people with prediabetes, diabetes can be prevented by taking action now.
Unfortunately, most Americans with prediabetes don't make healthy changes or aren't empowered to take control of their health. Because of this, most people with prediabetes do progress to diabetes. But the good news is, and what research proves, is that with physical activity and healthier foods 58% of new cases of diabetes can be prevented.
1. Diabetes Prevention Program Research Group. "Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin." N Engl J Med 2002; 346:393-403.
2. Ramsden, C. E. et al., "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." BMJ 2016;353:i1246.
3. Mwiti, K. C., et al. "The Biochemical Role of Macro and Micro-Minerals in the Management of Diabetes Mellitus and its Associated Complications: A Review." Int J Vitam Nutr Res. 2015;85(1-2):88-103.
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Gestational diabetes is a condition that is first recognized during pregnancy and is characterized by high blood sugar. Approximately 4% of all pregnancies are diagnosed with gestational diabetes. Low blood sugar is prevented by hormones produced by the placenta during a woman's pregnancy. The actions of insulin are stopped by these hormones. Gestational diabetes is the result of the pancreas' inability to produce enough insulin to overcome the effect of the increase hormones during pregnancy. Risk factors for gestational diabetes include:
There typically are no signs and symptoms of gestational diabetes. Treatment includes diet modifications and if necessary, insulin.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include:
Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. There are no signs or symptoms of insulin resistance. Causes of insulin can include conditions such as
Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include:
Type 2 diabetes is diagnosed by a blood test. Treatment for type 2 diabetes are a healthy type 2 diabetes diet, exercise, stress reduction, and medication. Type 2 diabetes is a preventable disease. Incorporating healthy lifestyle changes (for example, eating a healthy diet, exercising more, and reducing stress) can prevent type 2 diabetes.