November is National Diabetes Awareness Month, which is traditionally celebrated by the color, blue. The theme this month is Today’s Diabetes Hits Different. As educators, we are constantly teaching our patients about diabetes and cardiovascular disease prevention and treatment plans. Designating a month to diabetes promotes more media attention, which in turn provides patients with resources for awareness, prevention, and testing modalities available to them. High blood sugar levels can cause serious health problems over time, and the best way to prevent or manage any harmful health condition is to be informed.
Chances are, you know someone with diabetes. The National Diabetes Statistics Report provides up-to-date information on the prevalence and incidence of diabetes and prediabetes. Here are the latest stats:
37.3 million Americans—about 1 in 10—have diabetes. In 2019, about 1.4 million new cases of diabetes were diagnosed. For adults with diagnosed diabetes:
69% had high blood pressure, and 44% had high cholesterol.
39% had chronic kidney disease, and 12% reported having vision impairment or blindness.
96 million American adults—more than 1 in 3—have prediabetes. That’s almost 35% of the population. Without intervention, 15% to 30% of people with this condition will develop Type 2 diabetes within 5 years.As always, I turn to science to explain what goes on inside your body. The food we eat turns into glucose (i.e blood sugar), which is our body’s main source of fuel. Your pancreas is the organ in the body that produces insulin— the hormone that controls your blood sugar. Insulin’s role is to enter the bloodstream to scoop up the sugar and deliver it to your muscle cells to be used for energy or to be stored for later use. In type 2 diabetes, your body doesn’t make enough insulin, or the cells become resistant to letting insulin in do its job. This is often referred to as insulin resistance.
The difference between prediabetes and diabetes is how high the blood sugar levels get. Prediabetes is diagnosed when your blood glucose level is higher than normal but not high enough to be diagnosed as type 2 diabetes. Similar to diabetes, your body may not be able to fully use the insulin you make; in other words, your body produces insulin but doesn’t use it effectively. Being overweight or having a genetic predisposition to diabetes can put one at risk for getting prediabetes. The good news is that prediabetes can be reversed—if people find out early that they have higher blood sugars, they may be able to delay progression to type 2 diabetes by making lifestyle changes. Diabetes, on the other hand, is considered a chronic, long-lasting health condition.
Below are some factors that put people in a higher risk category than others for developing prediabetes and type 2 diabetes:
You are overweight.
You are 45 years of age or older.
Your parent or sibling has type 2 diabetes.
You are physically active fewer than 3 times per week.
You ever gave birth to a baby that weighed more than 9 pounds.
You ever had diabetes while pregnant (gestational diabetes).
Race and and ethnicity also affect your risk. African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at a high risk for type 2 diabetes.
Diagnosing diabetes and prediabetes got easier with the advent of a hemoglobin AIC test, also referred to as an A1C reading. Hemoglobin is the protein in red blood cells and glucose attaches (or glycates) to it. This number gives the doctor insight into how well your body is metabolizing sugars throughout the day, and measures your average blood glucose for the past 2 to 3 months. The more glucose in your blood, the higher the percentage of A1C in the blood level as the hemoglobin gets glycated. The advantage of the A1C test is that you don't have to fast or drink anything for the test.
Here’s a handy table for comparison of lab results that health practitioners use to diagnose these two disease states:
(Note that diabetes is diagnosed at an A1C of greater than or equal to 6.5%, or two consecutive fasting blood sugar readings of 126 mg/dl, or a reading over 200 mg/dl.)
Lifestyle, Exercise and Diet:
A large research study called the Diabetes Prevention Program has demonstrated that lifestyle changes such as weight loss (7% of body weight) and moderate physical activity (150 minutes per week) can reduce the risk of diabetes by as much as 58%. Studies have shown that lifestyle interventions actually decrease the incidence of diabetes better than metformin.
Nutrition also plays a major role in the treatment plan for diabetes and prediabetes. Choosing the right mix of foods can improve blood sugars into normal levels. Cutting highly processed, refined carbohydrates (white flour, cakes/cookies, juice, sugary beverages) is the first step—use whole grains, fresh fruits and vegetables, and drink more water, instead of sugary drinks. Replace the “bad” saturated fats (butter, red meat, palm and coconut oil) with heart-healthy, unsaturated fats (olive oil, nuts, avocado, and fatty fish).
Promoting and supporting long-term healthy eating patterns, watching portions and eating a variety of nutrient-dense, high fiber foods will improve overall health and can delay/prevent diabetes complications.
The primary aim of lifestyle interventions is to prevent diabetes by managing prediabetes. Studies show that interventions, such as weight loss and exercise, play an integral role in managing prediabetes. Change is not easy but you are not alone. Meet with a registered dietitian (like me!) for a personalized treatment plan to discuss new strategies if your doctor has diagnosed you with prediabetes or diabetes.
If you want to learn more about diabetes, please visit www.diabetes.org
In Good Health,