Diabetes or prediabetes? How to be proactive with diet, exercise


Mark Mahoney
 |  Guest columnist

According to a recent Nutrition Action newsletter 15 percent of adults in the United States have diabetes. Add another 38 percent who have prediabetes  (with 8 out of 10 not even knowing it). Adding these together means one in two adults with harmful blood sugar levels.

Fortunately many cases can be prevented and, in some individuals, even be reversed.

Diabetes basics

Understanding the basics of how diabetes progresses is important and the following description from December’s Nutrition Action newsletter provides a succinct summary

Insulin acts as a key that allows blood sugar (glucose) to enter the body’s cells, where it can be burned for fuel or stored.

But in some people the key can’t open the lock.

To compensate for that “insulin resistance,” the pancreas pumps out more and more insulin, but it’s not enough to keep blood sugar from creeping up to “prediabetes levels. After years of straining to keep up, the pancreas starts to fail and blood sugar reaches the “diabetes” range.

The above describes the most frequent type of diabetes (type 2).  In type 1 diabetes (accounting for about 5 percent of diabetes) the body’s immune system destroys the pancreas’ ability to make insulin

Important research

In 2002 a nationwide study (the Diabetes Prevention Program, DPP) published results from a three year study of 3,234 individuals who had been assigned to one of three groups.  One group received an intensive lifestyle intervention while the other groups received either a diabetes drug called metformin or a placebo.

It was noteworthy that “the lifestyle intervention group reduced their risk of type 2 diabetes by 58 percent and metformin reduced the risk by 31 percent compared to those who got a placebo,” according to Dana Dabelea, professor of epidemiology and pediatrics at the University of Colorado.

The two-part lifestyle intervention “…focused on reducing dietary fat intake and promoting at least 150 minutes of physical activity per week, with a weight loss target of about 7 percent,” says Dabelea.

The message of the DPP is that if you lose weight, you’re going to substantially reduce your risk of…



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