If you fall into the second camp, there is plenty you can do to minimize the risk of the prediabetes progressing to diabetes. What's needed is a ''lifestyle reset," says Jill Wiesenberger, MD, RDN, CDE, FAND, a certified health and wellness coach and certified diabetes educator in Newport News, Virginia, and author of Prediabetes: A Complete Guide.2 The new book is published in collaboration with the American Diabetes Association.
Choose fresh or frozen vegetables without added sauces, fats, or salt. Non-starchy vegetables include dark green and deep yellow vegetables, such as cucumber, spinach, broccoli, romaine lettuce, cabbage, chard, and bell peppers. Starchy vegetables include corn, green peas, lima beans, carrots, yams and taro. Note that potato should be considered a pure starch, like white bread or white rice, instead of a vegetable.
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The good news is your risk of developing type 2 diabetes may be lowered with lifestyle changes like diet, exercise, and weight loss. If you’ve tried and failed to make changes before, remember that persistence is key, and even small changes can have a powerful impact. According to a Diabetes Prevention Program study sponsored by the National Institutes of Health (NIH), people at a high risk for developing type 2 diabetes who lost just 5 to 7% of their weight with diet or exercise were able to prevent or delay onset of the condition.
5. Cut back on refined carbs and sugary drinks. White bread, white rice, white pasta and potatoes cause quick increases in blood sugar, as do sugary soft drinks, fruit punch, and fruit juice. Over time, eating lots of these refined carbohydrates and sugar may increase your risk of type 2 diabetes. To lower your risk, switch to whole grains and skip the sugar — especially the sugary drinks.
If you have found that your fasting blood glucose is rising over time, even if it is normal, and certainly if you "officially" have impaired glucose intolerance (pre-diabetes), strongly consider getting a home glucose meter and testing your own blood to see if you can determine which lifestyle changes help lower and stabilize your blood glucose. The only problem is that many insurance companies will not pay for this preventative step, and the test strips are admittedly expensive. Still, you might be able to afford to monitor yourself at least occasionally or find a diabetic friend who sometimes has extra strips. Tracking your blood glucose response to meals and over time can be a big help in preventing the progression of diabetes.
The first thing to understand when it comes to treating diabetes is your blood glucose level, which is just what it sounds like — the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat and also is formed and stored inside the body. It's the main source of energy for the cells of the body, and is carried to them through the blood. Glucose gets into the cells with the help of the hormone insulin.
If your mood, sleep, blood sugar, and energy are being affected, limiting intake may be advised. The most important thing when choosing coffee for people with diabetes or those managing their weight is to pay attention to the carbohydrate content from milk and added sweeteners. Cutting back or eliminating artificial sweeteners is advised as these have shown to disrupt gut bacteria, cause cravings and overeating, and negatively impact weight and blood sugar management.
The American Diabetes Association (ADA) advocates for a healthy diet with an emphasis on balancing energy intake with exercise. Historically, they have advocated for the majority of calories coming from complex carbohydrates from whole grains such as whole-grain bread and other whole-grain cereal products and a decreased intake of total fat with most of it coming from unsaturated fat.
To help you avoid or limit fast food, Chong recommends planning ahead by packing healthy meals or snacks. Diabetes-friendly snack ideas include a piece of fruit, a handful of nuts, and yogurt. Also, if you absolutely must stop at a fast-food restaurant, steer clear of anything that’s deep-fried — such as french fries, chicken nuggets, and breaded fish or chicken, Chong says.
Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, diabetics usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
Food can be powerful in preventing and reversing diabetes. However, dietary approaches have changed as we have learned more about the disease. The traditional approach to diabetes focuses on limiting refined sugars and foods that release sugars during digestion-starches, breads, fruits, etc. With carbohydrates reduced, the diet may contain an unhealthful amount of fat and protein. Therefore, diabetes experts have taken care to limit fats- especially saturated fats that can raise cholesterol levels, and to limit protein for people with impaired kidney function. The new approach focuses more attention on fat. Fat is a problem for people with diabetes. The more fat there is in the diet, the harder time insulin has in getting glucose into the cells. Conversely, minimizing fat intake and reducing body fat help insulin do its job much better. Newer treatment programs drastically reduce meats, high-fat dairy products, and oils.[46,47,48,49,50] At the same time, they increase grains, legumes, fruits, and vegetables. The study found that patients on oral medications and patients on insulin were able to get off of their medications after some days on a near-vegetarian diet and exercise program. During 2 and 3-year follow-ups, most people with diabetes treated with this regimen have retained their gains. The dietary changes are simple, but profound, and they work.[51,52,53]