Prediabetic? Do These 5 Things First

Originally published at The Diabetic Herbivore.

The other night, we went to Applebee’s for dinner and met Sam, the manager originally from Thailand, who revealed that his doctor recently told him to change his diet because he’s prediabetic. This was after we shared about my blog and handed him a card.

The conversation had originally been about asking him to send the word up the command chain that customers are asking for low carb or sugar free desserts. Then we explained that we’re trying to ask as often as possible so that upper management might finally realize there’s a demand for that type of offering and do something to make that happen.

He said he would pass that along to his superiors, but then he asked me several questions about what it means to be prediabetic, and how he needed to change his diet. He shared that he eats a lot of food traditional to his culture, because his wife is also originally from Thailand. They always have rice with their meals, so he eats rice several times a day. I told him that’s a big no-no, unfortunately, because rice is very high in carbs. His face fell. So I amended that statement: “Well, at least cut down on how much rice you eat at every meal. Take half the rice you would normally take, and start there.” He looked reflective a moment and then nodded.

I also strongly recommended that he go to Walmart and buy himself a cheap blood glucose test kit. Walmart’s brands are far less expensive than others and are just as accurate. We tested that against Steve’s endocrinologist’s device back in Missouri. I’d been using one for years and we decided to get him the same kind so that we can share supplies and save money. At first, she scoffed at the brand of tester we showed her. We compared results right there in her office and she was impressed that the Walmart kit gave the same result as her spiffier, more expensive, doctorly device.

So anyway, I told Sam to go get one of those Walmart devices and to start testing his own blood sugar levels every day. I told him to test when he first gets up in the morning and then two hours after every single thing he eats. This way he can begin to see what foods are affecting him badly and which ones are okay. I told him, “You’re shooting for blood sugars in the 80 to 120 range, so test often to see where you are and what foods affect your blood sugar.”

I explained how he might also experiment with brown rice instead of white, because white rice is more heavily processed and therefore breaks down more easily in our system. Foods that break down easily get transformed more quickly into glucose and therefore affect our blood sugar levels more dramatically.

However, it’s also true that all of our bodies are different and metabolize foods differently, so it’s really important to get a handle on what YOUR body likes and doesn’t like.

In response to this, Sam said that there are significant differences in how Asians metabolize foods from Americans and I agreed with him. But I also explained to him that ever since Asian diets started incorporating elements of Western diets, the rates of diabetes in Asian countries have skyrocketed. If he was still in Thailand, eating ONLY his culture’s traditional foods, in traditional amounts, he might not have prediabetes. But he shared that he’d been in this country for around 30 years.

I was amazed at how much this man didn’t know or understand about his new condition. His doctor obviously didn’t tell him much or encourage him to learn on his own. He probably didn’t have a clue how to go about educating himself, but was hungry for the knowledge I was sharing with him. He really does want to take care of himself; he just needs the information and tools with which to do so.

Hopefully, he has joined us here at the Diabetic Herbivore by now and is sharing the journey with us. Hi, Sam!

Diabetes Threatens So Many People

In 2012, the American Diabetes Association estimated over 29 million people in this country alone are living with diabetes. That includes an estimated almost 9 million who are diabetic but undiagnosed.

Another 86 million people are prediabetic, which means their blood glucose levels are already higher than normal but not yet high enough for a diabetes diagnosis. Prediabetics are at a higher risk of developing diabetes and its complications.

That’s a staggering 115 million people in the U.S. who have diabetes or prediabetes. That’s a significant percentage of our population. Current estimates of the total population in the U.S. is a little over 318 million, so that means nearly a third of people have diabetes of prediabetes! Many others are at risk of developing diabetes, due to their lifestyle, genetics, and other risk factors. That’s a LOT of people! And it’s true, almost all of us know at least one person with the condition.

What IS Prediabetes?

Prediabetes is the term doctors have invented to indicate that a person’s blood sugars have begun consistently testing slightly higher than normal. Another term for this diagnosis is “impaired glucose tolerance.” Yet another phrase you may have heard is “borderline diabetic.” These all mean the same thing.

People who have prediabetes usually aren’t experiencing any symptoms. If you’re at least 45 years old and carrying a bit of extra weight, your doctor will probably recommend you get screened for prediabetes.

If you have any of the risk factors for diabetes, or have symptoms consistent with diabetes, then you can ask for a screening anytime.

If There Are No Symptoms, How is Prediabetes Diagnosed?

Doctors have a few different tests they can do to determine your blood sugar levels. This is just what it sounds like: the amount of sugar (glucose) in your bloodstream. All of the cells in your body need glucose to function properly, but if you have a high level of glucose floating around in your bloodstream, it means that your cells either can’t absorb it (indicating insulin resistance) or have absorbed all they can and the excess isn’t being dealt with properly (indicating insufficient insulin).

You will probably first have your finger pricked so the doctor can see what your blood sugar levels are reading right in that moment. If you’re higher than 126, your doctor may express concern and will likely have you do another test. This one will require you to be fasting and will require a blood draw (where they insert a needle in your arm and fill a vial with your blood).

This is then analyzed in a lab and the results of this HbA1C (or Hemoglobin A1C, commonly referred to as “A1C”) test will show the average level of glucose in your blood over the last three months. If this number is between 5.7 and 6.4, you will be told you’re pre-diabetic. If it’s higher than 6.5, you’ll be given a diagnosis of diabetes.

A Prediabetes Diagnosis is a Warning…and a Gift

Prediabetes is a warning and is indicative of the probability that you WILL develop the full-scale disease if you don’t change some things. Prediabetes is also associated with a higher risk of having a heart attack or a stroke.

People who develop prediabetes likely have a range of risk factors, some of which are genetic, while others are lifestyle-related.

You have the power to change the lifestyle habits that are putting you at risk of developing diabetes. Even if your genetics are strongly in favor of the development of the disease, by changing some lifestyle habits, you can delay and possibly even prevent the diabetes genes from activating.

This is the gift of prediabetes: You have time to change things to prevent diabetes and all the damage that high blood sugars can cause to your body.

The First 5 Things To Do If You’ve Been Diagnosed Prediabetic

1. Buy a glucose monitoring kit. Like I said, you can get a cheap one from Walmart. Mine is the ReliOn Prime, which also has the cheapest supplies.

2. Start testing & logging your blood sugars regularly. I suggest every morning when you first wake up, and then again, two hours after you eat anything. This way, you can start to detect patterns and begin learning what foods are bad for you and which ones you can eat safely.

You’re shooting for numbers under 100, but definitely no higher than 125, for your morning fasting test. Two hours after you eat, your “postprandial” sugars should be under 140.

Be sure to record your test results in some sort of a log. The best way to learn about your body’s reactions to foods is to note the food you ate, the time you ate it, and the blood sugar test result two hours later. For convenience, most glucose monitors also record the time, date, and results of each test.

3. Eliminate or reduce your intake of “white” foods and simple sugars. I no longer keep in the house the following white foods:

– White flour

– White bread

– White rice

– White potatoes

– White sugar

I also include noodles in the above list of contraband items, if they’re made from wheat flour. Of course, not all white foods are suspect. Cauliflower is white and can be a great low-carb substitute for a lot of things.

You also need to limit or eliminate simple sugars from your diet, which includes cakes, candies, cookies, or anything else which contains white sugar or high fructose corn syrup. (High fructose corn syrup is an evil all its own and I plan to do a blog post about that one in the not-too-distant future.)

4. Learn to read nutritional labels and how to determine net carbs. I’ve got a whole blog post about this, so go give that a read when you’re done here. Experiment with your number of carbs per meal or per day to find what works best for your body to stay within a normal blood sugar range.

5. Start getting some physical activity into your daily schedule. It needs to be more than your normal routine and it needs to get your heart rate up. For instance, if you’re a restaurant manager, like our friend Sam, then you’re probably getting in a few miles a day of walking around the restaurant. This does not count. Your body has adjusted to that level of activity and has plateaued, plus your heart rate is not elevated for most of those steps. So add something, even if it’s just 15–20 minutes a day, to start.

Weight Loss is Not the Goal, But May Be a Side Effect

Notice I’m not suggesting that you lose weight. That might be an important part of the equation for some people, but not for everyone. I was only 115 pounds when I was still having blood sugars in the “OMG, you should be in the hospital” range.

For some people, changing their diets and routines in the ways I’ve outlined here will result in some natural weight loss. But that’s not the most important factor, in my view. We are all different. The most important thing is to become more aware of what works for YOU.

Mindfulness Leads to Health

Becoming mindful of what you put in your body, in what amounts, and how those things affect you will start automatically helping you to be healthier. Following these simple guidelines, while not guaranteed to help you avoid diabetes, will give you a much greater chance at doing so. Plus the whole family will benefit from these dietary and activity changes!

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