From novanthealth.org
By Patrick Flanary
A nurse practitioner breaks down ways to turn the condition around
One of the scariest things about prediabetes? The serious health condition has no obvious symptoms, which means that most affected people don’t even know they have it.
And without intervention, prediabetes can develop into Type 2 diabetes, which occurs when the pancreas fails to make enough insulin to control elevated blood sugar. Type 2 diabetes affects more than 38 million individuals in the U.S. and heightens their risk of developing cardiovascular disease, cancer, stroke and kidney disease.
While genetics play a role in developing prediabetes, it is most often linked to excess weight and lack of physical activity. Men with high blood pressure and a family history of diabetes are at the greatest risk of going undiagnosed. (Find out your own risk level by taking this short test.)
The good news is that with the right steps, prediabetes can be reversed before it turns into a Type 2 diabetes diagnosis. Linda Wooley, a nurse practitioner and certified diabetes care and education specialist at Novant Health Internal Medicine Wilmington, has daily conversations with her adult patients about the most important component of reversing prediabetes: relearning how to eat well.
“The biggest things people don’t know? Milk turns into sugar, and peas and corn are carbohydrates,” she said.
Here, Wooley discusses actionable tips and resources to help manage and reverse a prediabetes diagnosis.
What makes prediabetes a health threat, and when is it too late to reverse it?
You can definitely turn it around. I usually describe prediabetes to patients as a fork in the road. It’s a little red-flag warning to either make a U-turn or head down the path to Type 2 diabetes.
We use a haemoglobin A1C test (a blood draw either from a vein in your arm or a simple finger prick) to measure blood sugar. A prediabetes diagnosis falls within the range between 5.7% and 6.4%. If your blood sugar tests at 6.5% or higher, you’ve crossed the threshold into diabetes, but that doesn’t mean you can’t bring the number down.
What steps can I take right now to reverse a prediabetes diagnosis?
1. Kick the soda and juice.
I start every conversation with patients by asking, “What are you drinking?” If you cut out all sugary drinks, like soda and juice, you may not necessarily have to revamp what you eat, though this depends on the individual patient and their habits.
2. Manage your stress.
3. Address excess weight.
Losing 10% of extra body weight (20 pounds for a 200-pound person) will make a huge impact on reversing prediabetes and preventing Type 2 diabetes progression. That loss also helps reduce blood sugar, blood pressure and cholesterol. Drink plenty of water and incorporate healthy snacks throughout the day so you’re not starving by dinnertime. Adults can get into a rut with eating habits. While the Mediterranean diet is a great one to follow, a registered dietitian is a perfect resource for helping come up with the right meal plan for you.
4. Portion your plate.
- One-fourth should be lean protein: chicken, turkey, fish or soy.
- Two-fourths (half the plate) is reserved for non-starchy vegetables like leafy greens, zucchini, bell peppers, broccoli, cauliflower, green beans, asparagus or cucumbers.
- The remaining one-fourth should be carbohydrates, like rice, pasta or bread. Too many carbs in a meal elevate blood sugar, so limit to no more than 45 grams per meal (a cup and a half).
5. Strive for an ideal meal.
The combination of foods you eat matters. Let’s think of what a typical Southern meal looks like: fried chicken, macaroni and cheese, biscuits, baked beans, peas and corn. If you put all those together, it's way too much.
A good alternative: grilled chicken breast with a salad. Or try broccoli, carrots, asparagus or green beans with a small portion of mashed potatoes or mac and cheese. A small slice of dessert is OK; it’s all about moderation. After you eat, go for a family walk to help digest your meal and burn off extra sugar.
What can parents do to ensure their kids avoid becoming prediabetic?
One in five kids in the U.S. lives with obesity, which puts them at risk of developing prediabetes. It’s important to monitor sugary drinks and to replace sweets and processed foods with fruits and lean protein. But the most important factor is getting physical activity, although that’s easier said than done for families with two working parents. Kids often come home after school to an empty house, and inevitably they’re playing video games rather than getting exercise. Be sure to make time for physical activity as a family, whether that’s going for a bike ride or shooting hoops together.
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