Preventing Diabetes. prevent or delay type 2 diabetes from

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1 Preventing Diabetes Introduction Diabetes is a common condition. If not controlled, diabetes can lead to serious complications such as blindness, amputations, and even death. Before people develop diabetes, they almost always develop pre-diabetes. The good news is that healthy people and people with pre-diabetes may be able to prevent or delay type 2 diabetes from developing. This reference summary will help you understand type 2 diabetes and your risks for developing the disease. It discusses pre-diabetes, how pre-diabetes and diabetes are diagnosed, and tips on preventing pre-diabetes from advancing to type 2 diabetes. Diabetes The body is made of millions of cells that need energy to work. The food we eat is turned into glucose, also called sugar. The bloodstream carries glucose to the cells. It is one of the most important substances the cells need to make energy. Diabetes is a disease that makes it hard for cells to get the glucose they need to make energy. When glucose cannot get into the cells, it collects in the blood. This leads to excess glucose in the blood, also called high blood sugar. Lab tests can measure the level of sugar in the blood. 1

2 There are two types of diabetes: 1. Type 1 diabetes results when the body does not make insulin. Insulin is a hormone the pancreas makes to help glucose enter the cells. 2. Type 2 diabetes occurs when the body makes insulin, but in spite of this, cells are unable to use glucose. This reference summary is about type 2 diabetes. Symptoms The symptoms of type 2 diabetes show up gradually, over a long period of time. Most people who develop diabetes pass through a phase where they are at increased risk for diabetes. At this stage they do not have diabetes but are at an increased risk of developing it. This stage is also known as pre-diabetes. In pre-diabetes, the level of sugar in the blood rises slightly. People with pre-diabetes may not have any symptoms. Research has shown that people with pre-diabetes may be able to prevent its advance to diabetes by eating healthy, losing excess weight, and being more physically active. People with diabetes have even higher levels of sugar in the blood. When diabetes starts to develop, its common symptoms include: Excessive thirst. Urinating often. Excessive hunger. Other symptoms of diabetes include: Weight loss. Fatigue. Changes in vision. Slow-healing cuts or infections. Itchy skin. 2

3 Complications If left untreated, sugar levels in the blood of diabetic patients can become very high, leading to coma and possibly death. People with diabetes can learn how to control their blood sugar level so it does not get too high or too low. Over time, high blood sugar leads to dangerous complications, which includes damage to the nerves and blood vessels of the body. It is unknown why diabetes causes nerve damage. Nerve damage is called diabetic neuropathy. It usually involves the nerves going to the lower legs and feet. The feet or legs could feel numb or unusually cold. Damage to blood vessels may lead to heart disease, heart attack, and stroke, which may lead to death. Fat in the blood is deposited on blood vessel walls. This causes the arteries to harden, called arteriosclerosis. It may lead to heart attack. Small vessels in the back of the eye can get thicker than normal and cause blood to leak into the inside of the eye, causing diabetic retinopathy. If not treated, it can lead to blindness. Complications of diabetes may lead to amputations, especially of numb feet that become infected. Thickening of the blood vessels of the kidney may lead to kidney disease that requires dialysis or a kidney transplant. This could lead to death if not treated. Complications of diabetes could lead to sexual dysfunction. In diabetic men, the most common problem is impotence from damaged nerves in the sex organs. In diabetic women, damage to nerves in the pelvic organs and genitals can lead to impaired sexual arousal and painful intercourse. Risk Factors Diabetes is NOT a contagious disease, and its exact causes are not well understood. However, we do have a good understanding of its risk factors. A diabetes risk factor is something that increases your chance of developing diabetes. You cannot change some diabetes risk factors, but you can control many others. 3

4 Diabetes tends to run in families. If your parents have diabetes, you are more likely to develop diabetes. You cannot control this risk factor. People over 40 are more likely to develop diabetes than people younger than 40. If you are African, Hispanic, Native American, or Asian, you are more likely to develop diabetes than other people. You cannot control your age or your ethnic background. If you are overweight and especially if you have excess belly fat, you are much more likely to develop diabetes. You can control this factor by watching your weight and reducing excess fat. It is also very important to watch your children s weight because type 2 diabetes now affects children as well as adults. An early sign of high blood sugar is excess belly fat. For unknown reasons, excess fat at the waist triggers insulin problems that may eventually lead to diabetes. The larger your waist, the more likely you are to develop diabetes. Excess belly fat increases your diabetes risk even if your weight is healthy for your height. Unfortunately, since more and more children are obese, type 2 diabetes is becoming more common among children and young adults. If you are inactive, you are more likely to develop diabetes. You can control this factor by exercising more. Exercising includes any physical activity such as walking to the store, cleaning the house, and washing the car. If you have high blood pressure, you are more likely to develop diabetes. This is a factor you may be able to control by losing excess weight, exercising regularly, eating healthy, and avoiding salty food. Some people may also need to take a prescription medication to lower their blood pressure. 4

5 There are other risk factors, such as: High triglycerides with low HDL, or good cholesterol. About one-fourth to onethird of total blood cholesterol is known as high-density lipoprotein (HDL). HDL cholesterol is known as good cholesterol, because in high levels it seems to protect against heart attack. A history of gestational diabetes or of giving birth to a baby weighing more than 9 pounds (4 Kilograms). Testing Diabetes is usually discovered when your doctor or nurse notices a high level of sugar in your blood or urine. If your test shows high blood sugar, you will need to be retested to confirm the results. Blood sugar can be checked using a blood or urine sample. The most reliable test involves testing a blood sample before breakfast. This is called a fasting blood sugar. A blood sugar level of 100 mg/dl to 125 mg/dl on more than one occasion means you have pre-diabetes and are at an increased risk for diabetes. If you ultimately develop diabetes, you will go through this stage first. A blood sugar level of 126 mg/dl or more on more than one occasion means you have diabetes. A hemoglobin A1C test at or above 6.5% also means that you have diabetes. The hemoglobin A1C is a blood test that averages your blood sugar level over several months. If you are overweight and age 45 or older, you should be checked for diabetes during your next routine doctor visit. If you are 45 or older but are a normal weight, ask your doctor or nurse to be tested for diabetes. If you are younger than 45 and overweight, your doctor may recommend testing for diabetes if you have one more risk factor. 5

6 Additional risk factors include: High blood pressure. High triglycerides with low HDL, or good cholesterol. A family history of diabetes. A history of diabetes during pregnancy or of giving birth to a baby weighing more than 9 pounds (4 Kilograms). You belong to an ethnic group at high risk of diabetes. Preventing Diabetes If you don t have diabetes, you may be able to prevent it. Even if you have prediabetes, you may be able to prevent or delay diabetes from developing through changes in your lifestyle. To prevent or delay diabetes you should: Eat healthy. Become more active. Lose excess weight. Reduce elevated blood pressure. Lower blood sugar levels if you have prediabetes. Just 30 minutes a day of moderate physical activity, coupled with a 5% -10% reduction in body weight, have been shown to produce more than a 50% reduction in diabetes. The following sections include a review of how to eat healthy and increase physical activity. Eating Healthy A healthy diet may help reduce two main risk factors of diabetes: excess weight and high blood cholesterol. A healthy diet includes not only how much you eat but also what you eat. Here are some tips. 6

7 Cut down on foods with saturated fat. Saturated fats are found in: Red meats. Dairy products. Coconut and palm oils. Cut down on foods with hydrogenated fats, or trans fats. Trans fats are found in: Packaged foods such as crackers, cookies. Fast foods such as French fries. Bakery goods such as cakes, and cookies, and doughnuts. Choose unsaturated, healthy fats instead of saturated and trans fats. Healthy fats are found in: Lean meats and poultry. Certain fish such as salmon, and albacore tuna. Beans, nuts, and seeds. Olive, peanut, and canola oils. Eat a lot of high-fiber foods such as whole grain bread, fruits, and vegetables. Each day, you need 6 to 8 servings of grains. For instance, the following count as 1 serving: 1 bread slice. 1 cup cereal. ½ cup cooked rice. Each day you need 2 1/2 cups of fruit. For instance, the following count as 1 cup: 1 cup of fresh fruit. 1 cup 100% fruit juice. ½ cup of dried fruit. 7

8 Each day you need 2 1/2 cups of vegetables and legumes such as lentils, beans, and peas. For instance, the following count as 1 cup: 1 cup of raw or cooked vegetable. 1 cup vegetable juice. 2 cups of leafy greens. The way to approach portion control is NOT the same way you plunge into a diet. Instead of suddenly and temporarily changing your eating habits, make small and easy changes that last forever. Physical Activity Exercising lowers glucose levels, helps with weight loss, keeps your heart healthy, and promotes healthy circulation. Also, exercising relieves stress, strengthens muscles, and helps you sleep better. To begin, add at least 30 minutes daily of a moderate exercise such as brisk walking. Moderate exercise increases your breathing and heartbeat. On busy days, break up your activity into three 10-minute chunks. As you start an exercise program, if you feel pain, shortness of breath, dizziness, or nausea, then take a break. Be sure to discuss starting any strenuous activity with your healthcare provider. If you are physically inactive, start by adding a little bit of activity to the things you normally do. Any physical activity burns calories and counts! Here are a few tips: Take the stairs instead of using the elevator or escalator. Walk to your destination instead of driving there. Walk to your co-worker s office instead of calling on the phone. Wash your car, mow the lawn, and do housework. 8

9 Conclusion If not controlled, pre-diabetes may advance to diabetes. Diabetes is a serious disease. The body loses its ability to control the level of sugar in the blood. Patients with diabetes can be taught how to control their diabetes by controlling what they eat, checking their blood sugar several times a day, and exercising. If not controlled, diabetes can lead to serious complications such as heart attack, kidney failure, blindness, amputations, and even death. It is easier to prevent diabetes than to treat it. You can prevent or delay diabetes by: Losing excess weight and belly fat, if you are overweight. Eating healthy. Becoming more active. Reducing your blood pressure if it is high. Lowering your blood sugar level if you have pre-diabetes. By adopting these lifestyle changes, you will lower your risk of developing diabetes and its serious complications. A prevention plan can help you reduce your risks for diabetes and heart disease while helping you enjoy a healthier lifestyle. 9