Prediabetes ; Not the End of The World

Almost 90 million Americans have it, but even though the condition can carry long-term life-threatening consequences, they may have no idea of the dangers.

Prediabetes  which, in up to 30 percent of cases, can lead to full-blown Type 2 diabetes within five years, according to the Centers for Disease Control and Prevention .

“It’s not a doomsday message, and it doesn’t mean you have to turn your whole world upside down because you’re prediabetic,” says Renu Mansukhani, a doctor at the National Center for Weight and Wellness in Washington in a recent Wahington Post article.

“Even just small lifestyle changes can make a big difference,” Mansukhani says.

First, , if you get a blood test back that indicates you are prediabetic, talk to your doctor about what it means and whether you should retake the test, as false positives are common.

If a second test comes back positive, make small, incremental lifestyle changes that will improve the condition for most people — but not all.

Diet: The first piece of the puzzle


One thing you do have control over is what you eat on a daily basis.

Having prediabetes doesn’t mean you can never eat a doughnut again, but it needs to be a rare treat.

The idea is to replace  simple carbohydrates (such as processed foods, fruit and milk products) with complex ones (whole grains, beans and vegetables), says Rebecca Scritchfield, a registered dietitian in Washington.

“You want to get quality carbs with lots of fiber with each meal. Combine that with protein and fat, and you can avoid spikes in your blood sugar,” Scritchfield says.

Still, she doesn’t suggest that you cut out fruit because it’s relatively high in sugar.

Pick fruits with less sugar — like berries and kiwi,” she says.

Fruit juices, though, should be avoided. They lack fiber and are high in sugar, a combination that often creates blood sugar spikes.

So instead of a glass of orange juice, eat an orange and drink a glass of water.

Along with complex carbs such as vegetables (which should take up half your plate), your meal should have protein and fat, which will help you feel satiated and “stop you from overeating carbs.


Exercise-The Second Piece

weight lifting photo

But there is another way — along with food changes, or by itself — to reduce the amount of sugar getting stuck in your bloodstream: Exercise.

Because sugar is the No. 1 fuel that muscles use for movement, exercise helps lower blood sugar.

“The big, overarching thing about exercise is that it is one of the most efficient ways to reduce insulin resistance [and lower blood glucose levels],” says Kyle Stull, a master instructor for the National Academy of Sports Medicine.

Insulin is a hormone created in the pancreas that helps deliver sugar (from food) to the muscle cells (for movement).

When insulin is resistant, it is less effective in getting the sugar — the fuel — to the muscle cells.

But with exercise, insulin becomes more sensitive, Stull says, and some studies show that blood glucose levels fall by as much as 15 percent or more after aerobic exercise.

In fact, one study showed that just 20 minutes of moderate exercise could reduce diabetes risk by 46 percent.

It has also been shown that exercise even without weight loss can reduce the risk significantly but that weight loss combined with exercise is even more effective.

What kind of exercise is the most effective, and how much of it should you do?

The recommended amount of moderate aerobic training is 30 minutes per day, he says. You can also shorten the duration and up the intensity for similar improvements, he says.

Resistance training has also been shown to help control blood sugar, and a benefit of resistance training is the building of lean body mass, leading to improved resting metabolic rate and weight loss.

“The main thing is to do something,” Stull says. “Time is the biggest obstacle. But if you can just do 10 to 20 minutes, it will make a difference.”

What if you make all these positive changes and your blood glucose level still isn’t going down — and maybe it even goes up over time?

“It’s not your fault,” Mansukhani says. “We know there is a group that doesn’t respond. In their case, medication might be necessary.” Some patients even undergo weight-loss surgery to help deal with their increased risk,

Bear in mind that incremental lifestyle changes that encourage less stress, more sleep, healthier eating and more exercise have benefits beyond diabetes prevention.   Remember, baby steps.

“Don’t try to cut carbs completely — you’re setting yourself up. But maybe choose an apple instead of an apple crisp or doughnut,” Scritchfield says.

Change your diet and add some exercise and monitor and track your blood sugar and you will be headed in the right direction.



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Industry funded studies don’t find sweet drinks linked to obesity, diabete… – Reuters

(Reuters Health) – Do sugar-sweetened beverages like soda and fruit drinks cause obesity and diabetes? The answer may depend on who funds the research asking the question.

An analysis of 60 studies found 26 out of 26 papers that failed to find a link between sugar-sweetened beverages and obesity or diabetes were funded by industry sources, compared to one industry-funded study out of the 34 that did find a connection.

Regulations, taxes and nutrition guidance hinge on whether these drinks cause health problems, but opponents of those initiatives continue to question whether the drinks are to blame, the study team writes in the Annals of Internal Medicine.

“If it were truly controversial, you would expect some of the independently funded studies would not find associations,” said Dr. Dean Schillinger, lead author of the analysis, from the University of California, San Francisco.

For their analysis, the researchers looked for studies published from January 2001 through July 2016 that tested the health effects of sugar-sweetened beverages. Studies sponsored by competing industries like dairy and bottled water were excluded from the analysis.

Twenty six studies failed to find links between the drinks and obesity or diabetes, and all of them were industry-funded. Another 34 studies did find associations between the drinks and those health outcomes, but just one was industry-funded.

“This industry seems to be manipulating contemporary scientific processes to create controversy and advance their business interests at the expense of the public’s health,” the researchers write.

The American Beverage Association (ABA), which represents the non-alcoholic beverage industry in the U.S., argued in a statement to Reuters Health that Schillinger is biased. He is a paid expert for the City of San Francisco in a suit challenging a law that would require a warning label be placed on advertisements for sugar-sweetened beverages.

Schillinger told Reuters Health that he would not be serving as an expert in the suit if the ABA and other organizations did not challenge the law. “I can thank them for being paid,” he said.

The ABA statement continued that the industry has the right and responsibility to engage in scientific research.

“The research we fund adheres to the highest standards of integrity for scientific inquiry based on recognized standards by prominent research institutions,” the statement reads. “It contributes to the body of scientific knowledge, meets the needs of regulatory agencies and enables consumers to make informed decisions.”

The ABA also argued that the new analysis is an opinion piece meant to influence people in areas near San Francisco and Boulder, Colorado, where soda taxes will be up for a vote next week.

“I don’t care if there is a tax or not a tax,” Schillinger said. “I don’t benefit from that, but what I care about is that all my patients in clinic today had diabetes.”

Schillinger’s team writes that there may be many sources of bias in industry-funded studies, including how studies are designed and what other health and lifestyle factors researchers choose to consider when assessing the effects of sweetened drinks.

For the public, he said it’s important to know the source of the message and who paid the messenger.

“If an industry is paying for it or a food company is paying for it, it’s reason for skepticism,” Nestle said. Hopefully those results will be replicated by someone without a vested interest, she said.

SOURCE: Annals of Internal Medicine, online October 31, 2016.

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