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How Sweet it Isn’t

Preventing Prediabetes and Type 2 Diabetes

The World Health Organization predicts that by 2030 (a scant 13 years from today) diabetes will be the seventh leading cause of death. Closer to home - by next year, diabetes will affect over 3.7 million Canadians.

 

As in the case of many chronic diseases, the phrase “diabetes” does not refer to only one disease, but actually a family of diseases that all affect the handling of blood sugar (glucose) in the body. Most people know that chronic diabetic conditions include type 1 diabetes (formerly called juvenile diabetes), type 2 diabetes (formerly called adult onset diabetes). Lesser known are the two potentially reversible conditions, pre-diabetes (when blood sugar levels are slightly higher than normal, but still not as high as in diabetes) and gestational diabetes (occurs during pregnancy and in some cases self resolves after delivery).

 

Diabetes is a leading contributing factor in a variety of diseases and health conditions including heart disease, heart attack, stroke, nerve damage (neuropathy), kidney failure, blindness, impotence and lower limb amputation. Additionally, diabetes may significantly increase mortality in patients with cancer. Diabetes is too large a topic to adequately address in this article. For this article we will concentrate on the lifestyle decisions that can help you prevent pre-diabetes and its progression to type 2 diabetes.

 

The risk factors for prediabetes are well documented. These risk factors include:

 

  • Being overweight (Body Mass Index or BMI 25 or more) especially if a significant amount of the weight is carried in your abdomen (muffin top, spare tire, beer belly). This is the case in most men and many women, especially in women after menopause.

    • The key to losing weight seems easy enough “burn more calories than you consume” but in reality it’s really hard. We should all aim for a BMI between 18.5 and 24.9. There's no shortcut to weight loss “no miracle cure” but you can make the process easier with a few simple lifestyle modifications that are sustainable.

 

  • Being 45 years or older (sadly the older you get the higher the risk).

 

  • Genetic makeup (pre-diabetes has a stronger link to family history and lineage than type 1 diabetes).

 

  • Sedentary lifestyle (inactivity)

    • Don’t panic! You don't need to kill yourself in the gym; you only need to set up an exercise routine that you can follow each week. Start slow with easily achievable goals. If you see results early on, you are far more likely to stick with it long-term. As time goes on, try gradually increasing time and intensity; this way, you will continue to see results. Choosing activities that you enjoy can help keep you motivated. Ask a friend or a family member to be your “exercise buddy.” It will hold you accountable and keep you motivated. Making it social gives another motivating factor and it could be fun. Try to aim for a minimum of 30 minutes daily.

 

  • Other health conditions: High blood pressure (hypertension), low levels of high-density lipoprotein (HDL), cholesterol (the "good" cholesterol) and high triglycerides.

 

  • History of gestational diabetes

 

  • Race/ Ethnicity (African-Americans, Hispanic Americans, Native Americans, and Asian Americans are more at risk).

 

  • Polycystic ovary syndrome (irregular menstrual periods, excess hair growth and obesity) increases women's risk of prediabetes.

 

Pre-diabetes is a classification of related conditions based on how it is diagnosed: (1) Impaired fasting glucose (IFG) which means that your blood sugar is elevated even if you haven't eaten for a long period of time; (2) Impaired glucose tolerance (IGT) when your blood sugar levels reach a surprisingly high level after you eat foods or drinks containing sugars or insulin resistance. Some people can have both IFG and IGT. But in all pre-diabetes conditions your body needs to make extra insulin to keep your blood sugar levels near to normal.

 

Nearly 50% of people with pre-diabetes will develop type 2 diabetes. This is why pre-diabetes is considered an “early alert system” warning for type 2 diabetes. Pre-diabetes should serve as a BIG wake-up call telling you to smarten up and change to protect your future. Pre-diabetes is called a "silent" condition because it usually has no overt symptoms (some people develop darkened skin on certain parts of their body (neck, armpits, elbows, knees and knuckles) but often it is already too late by this time. Pre-diabetes should always be treated to prevent diabetes from setting in. If you are over 45 and have any of the above risk factors it is best to have annual glucose tests (A1C test) to detect blood sugar tolerance.

 

There are simple lifestyle modifications that can help you keep your blood sugar in check

 

  • Lose weight (even a small percentage will make a huge difference)

  • Improve the health of your diet

    • eliminate all refined sugars and starches (a good rule of thumb is to avoid foods containing white carbohydrates; sugar, flour, rice, etc)

    • eat a plentiful “rainbow” of high-fibre (both soluble and insoluble), colourful vegetables and fruits

    • restrict red meats to free-range or grass-fed animals

    • Reduce the amount of net carbohydrates in your diet, which will reduce the stress on your body, reduce inflammation and reduce the amount of insulin required to use the energy from the food you eat. A good way to do this is to look at the GI diet program, which is based on this principle.

  • Drink lots of water (your liver will secrete a hormone that increases your blood sugar if you are dehydrated) while avoiding sugar-containing drinks (soda, juice, store bought smoothies and shakes)

  • Relax (When you are stressed your body secretes cortisol and glucagon, both of which affect your blood sugar levels). Take a meditation or Yoga class to help center yourself.

  • Exercise at least 30 minutes a day. It does not have to be all at once.

  • Improve your sleep (Poor sleeping patterns may reduce insulin sensitivity and promote weight gain).

 

Also, look for symptoms that can suggest the development of diabetes, such as:

 

  • Excessive urination, thirst and hunger

  • Sudden, unexpected weight change

  • Increased susceptibility to infections, especially yeast or fungal infections due to higher glucose.

  • Sores taking longer to heal

  • Blurry vision

  • Tiredness

 

There are some supplements that look promising for lowering blood sugar; many require more research before they can be recommended by most doctors.

 

- Soluble Fibre (improves blood glucose tolerance)

- Touchi extracts may help decrease blood sugar levels in people with prediabetes or mild type-2 diabetes

- Marine collagen peptides (MCPs) may improve glucose metabolism and insulin sensitivity

- Milk Thistle Extract contains silymarin (an antioxidant complex) that showed a significant decrease in total cholesterol and LDL ("bad") cholesterol and may help regulate blood sugar levels.

- Cinnamon may help control blood sugar by lowering insulin resistance but the dose is high (g not mg per day) and study results are mixed.

- Coccinia indica (Cucurbitaceae family) is an herb that that grows abundantly in India that has demonstrated hypoglycemic activity with significant improvement in glucose tolerance.

- Ganoderma lucidum (known as the lingzi mushroom) may help maintain pancreatic function. 

 

Talking with your healthcare provider about pre-diabetes should be part of your annual physical. This way, your provider will be sure to order the appropriate blood tests (A1C) and monitor the results to see the early signs and work with you to prevent the onset of diabetes. This, combined with healthy lifestyle choices and proper supplementation, gives you an extremely low risk plan to keep your sugar in check and you healthy for a long time to come.

 

Joel Thuna, MH, is a master herbalist with over 30 years of experience. Dr. Claude Gallant holds a PhD in Microbiology.