973741 tn?1342342773

Diabetes prevention, when to start

So, when do you start worrying about diabetes prevention? Is there a certain age?  Do you wait until things show on blood work to indicate it's time to start thinking about it?  I guess a no brainer is to continually be aware of being a good weight and exercising regularly.  But we hear about pre-diabetes.  What exactly is that and when is it time for someone to make SURE they are doing what they need to do to prevent?
4 Responses
231441 tn?1333892766

We are talking about type 2 diabetes here.  I will give a very simplified description of what happens.

Obviously if you are at risk then the earlier you can adopt lifestyle measures the better your health will be.  If you have a family history, even if you don't appear to have a current problem, then it is time to take action.  Actually in America it is estimated that maybe 50% of the population are diabetic, prediabetic, or at risk of diabetes.... the pretty much means that nearly everyone should be concerned with prevention.

The process of developing diabetes will start long before symptoms are obvious.... it starts with diet which can result in build up of fat in the liver and the body.  In some people only the liver gets fatty, the body stays slim.   This then creates insulin resistance.  Doctors can test for insulin resistance by doing a glucose tolerance test and testing both glucose levels and insulin levels.  If insulin levels are high, even while glucose levels are normal, there is insulin resistance and risk of developing diabetes.

Insulin resistance means that the body doesn't respond well to insulin and so high levels of insulin are required.  While insulin is an essential hormone, too high levels are clearly implicated in inflammation, which then set an environment for other health conditions; obesity, cancer, heart disease, infertility....

In time, even these high levels of insulin will not be enough to maintain normal blood sugars and then there will be both high insulin levels and high glucose levels.  In time the situation gets even worse because the pancreas begins to fail (the high glucose levels can kill the cells of the pancreas).  Now there will be high glucose levels, but low insulin.  

It is best to address this entire situation from childhood; by developing eating habits (sticking to natural unprocessed foods and avoid sweets, sodas, processed foods) that support health, and by adopting regular vigorous physical activity to keep the body working optimally and optimally sensitive to insulin.  Weight should be kept to optimal level (helped by diet and exercise).

The old idea is that diabetes is progressive and irreversible.  This will be true if you don't remove the causative factors.  However, if you adopt a low carb natural diet, exercise, manage weight, and stay as happy as you can, then there is a very good chance that diabetes can be reversed and in many cases prevented.

Hope this helps.

If one has already started showing abnormalities, then adopting a low carb diet, normalizing weight, being physically active, and taking insulin sensitizing medications if the diet and lifestyle alone are not sufficient to get normal sugars, are all critical to long term health.
973741 tn?1342342773
All great information.  I know I get lab work each year at my physical and indicators are not warranting alterations, however, I have to wonder.  My girth has absolutely increased, I'm aging, and me like sugar.  I keep wondering if my next visit will result in the hammer from my doctor that I waited too long to be serious about it.  
231441 tn?1333892766
Hi Special Mom, nice to hear back from you. :)

If your girth has increased, then it is time to take action already.  I think  you already know that.  Don't wait to have problems, be proactive, and get with it already.  It is much easier to prevent problems than to deal with them once they have already occurred.

Start by cutting back severely on added sugars, and processed foods.  IF that alone will help you lose weight, then great.  IF that doesn't get you back to where you where you might want to look into being more strict with lower carb eating (you can research on paleo or mediteranean style diets - less strict, but may be enough for many.  Alternative isketogenic diet - more strict though i'd recommend that you adopt the approach focusing on adequate protein and low carb, rather than on high fat and low carb).

Make sure that you are getting plenty of protein, as that helps with feeling satisfied from food, and protein is the most important nutrient for our body (and particularly as we age).

20849790 tn?1535814964
A lot of my patients get their HbA1c checked once a year - way more accurate than blood glucose.
Hi Dr.  

Yes, agree with you.  A1c gives a better way of monitoring glucose trends than fasting glucose which can still be low / normal even in advanced diabetes.
Early detection of diabetes is very important for management and prevention of complications.
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