What is Diabetes?
If you have diabetes, your body has difficulty converting the food you eat into energy you can use.
After you eat, your body breaks down some of the food (carbohydrate) in to glucose or sugar, which is the basic fuel for all the cells in your body. Insulin, a hormone produced in the pancreas, helps take the glucose from your blood to the cells. When you have prediabetes o type 2 diabetes, two things are going wrong with this process. First, your body is unable to keep up with the demand for large amounts of insulin. Very often, this is because you are carrying around excess weight. Second, because your body has become resistant to the insulin your pancreas does make, you are not able to efficiently use the insulin you make. You have both, insufficient insulin production and insulin resistance. The result is that glucose builds up in your blood, instead of getting into your cells via insulin to be used for energy.
Risks Factors for developing Pre-diabetes and type 2 diabetes
• Sedentary lifestyle.
• Have a family history of type 2 diabetes
• Have a history of gestational diabetes or have given birth to a baby who weighed more than 9 pounds (4.1 kilograms).
• Have a history of polycystic ovary syndrome.
• Have high blood pressure.
• Have abnormal cholesterol levels, including high-density lipoprotein (HDL) cholesterol levels below 35 mg/dL (0.9 mmol/L) or a triglyceride level above 250 mg/dL (2.83 mmol/L)
The American Diabetes Association recommends that blood glucose screening begin at age 45, or sooner if you have any of these risk factors for prediabetes or type 2 diabetes.
How do I know if I have prediabetes?
Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetes. It is diagnosed when you have one os the following:
• Fasting blood sugar test between 100 -125 mg/dl
• Oral glucose tolerance test between 140-199 mg/dl
• Glycated hemoglobin (A1c) between 5,7-6,5%
Pre-Diabetes. What you can do?
Key medical benefits from weight loss happen with the first 10-15 pounds you lose. There is no need to get down to an unrealistically low weight to enjoy thse benefits. The key is to keep these small amounts of weight off for good.
How does type 2 diabetes diagnosis is made?
If you have been diagnose with diabetes it is because you have had in 2 different occasions:
• Any time of the day plasma glucose >200 mg/dl, accompanied or not with excessive thirst, excessive urination, hunger and unexplained weight loss; or
• A fasting glucose level > 126 mg/dl; or
• A 2 hour plasma glucose >200 mg/dl, during an oral glucose tolerance test; or
• An HbA1c > 6,5%
Complications of having high glucose levels
The combination of high glucose, hypertension and abnormal lipid levels can cause complications of diabetes, including heart and blood vessels disease.
Persons with type 2 diabetes:
• Are at a 2-4 fold higher risk of cardiovascular events, especially heart attack and stroke. For every 10 persons with type 2 diabetes, 8 will develop cardiovascular disease.
• More than 60% have some degree of retinopathy 20 years after diagnosis. Up to 21% have retinopathy at diagnosis. Diabetic retinopathy, an eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina. People who have diabetic retinopathy often don’t notice changes in their vision, in the disease’s early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed.
• Diabetic nephropathy occurs in 20-40% of individuals with diabetes and is the leading cause of end stage renal disease which requires dialysis . Diabetes can damage the kidneys they begin to leak and protein passes into the urine. Often there are no symptoms as the kidney damage starts and slowly gets worse
• Diabetes can also damage the nerves in the body a condition known as diabetic neuropathy. As many as 6 to 7 diabetics for every 10, will develop some degree of neuropathy, and this condition is responsible for more than 60% of non traumatic lower limb amputations.
Many people need to take medications to manage blood glucose, blood pressure and abnormal lipids. Regardless of the medication you use, research shows that there are three other key features for a solid treatment plan for diabetes. These are:
• Healthy eating
• Achieving and maintaining a health weight
• Being physically active
Medical Nutrition Therapy is the cornerstone in diabetes treatment and management. Having diabetes under control is of high importance in the prevention of diabetic complications.
What do I have to do to prevent complications?
You with your healthcare provider must discuss treatment goals, which should be individualized. Usually these goals are:
1. Weight reduction of 5-10% of your body weight if you are overweight. This has demonstrated significant reductions in cardiovascular risks factors, and improvements in glycemic control.
2. Physical activity, not only enhance weight loss and helps weight maintenance, it also has benefits in glycemic control and cardiovascular system11, it is also good for your bone health and improve your mood. It is recommended to do 150 min/week of moderate physical activity and the more, the better. If you are a sedentary person you should start your routine of exercise step by step, until you reach the goal.
3. Glycemic Control: In fasting and before meals your glycemia must be between 70-130 mg/dl (3,9-7,2 mmol/l); 2 hours after the initiation of the meal it should be < 180 mg/dl(<10,0 mmol/l) and the HbA1c, that is a lab test that shows the average amount of glucose in your blood over a 3 month period, this can tell how well you are controlling your diabetes, it should be < 7.0%.
4. Blood Pressure, < 130/80 mmHg
5. Lipids, bad cholesterol (LDL-c) < 100 mg/dl (<2,6 mmol/l); good cholesterol (HDL-C)>40 mg/dl (>1,1 mmol/l) and triglycerides
Health Benefits of losing weight
• If you lose weight, you can reduce your risk of getting diabetes, heart disease, high blood pressure, gall bladder disease, breast and colon cancer.
• If you already have any of these problems, losing weight improves them.
• When you lose weight you buy health, and you’ll spend less time and money on doctor’s visits and health problems.
• People who lose even small amounts of weight, between 5-7% of their starting weight, improves their health by reducing high blood pressure, high blood sugar, high cholesterol, sleep apnea, arthritis, and depression.
• Self-steem grows
• Even without weight loss, you start getting health benefits just as soon you change your diet pattern in conjunction with physical activity
What is a Reasonable body weight?
A reasonable body weight is defined as the weight that you and your health care team agree that you can probably achieve and maintain for the rest of your life. This weight can turn out to be different from the ideal body weight, but it does reduce your health risks.
The ideal body weight is personal and depends on individual characteristics.
Difference between overweight and obesity
Overweight refers to an excess amount of body weight for the height that includes all tissues, such as fat, bone, muscle and water. Obesity refers to an excess of body fat.
When the excess of body fat is stored in the abdominal area, the risk of developing chronic disease, such as: heart disease, high blood pressure, diabetes, and some types of cancer is higher.
Health risks seem to come with having a waist meassurmet of greater than 35 inches in women and greater than 40 inches in men. Abdominal fat is worse than fat on your buttocks or thighs. When you have fat is this area, your body can’t use the insulin produced by your pancreas very well. This is called insulin resistance, and it cause high blood sugar levels. High blood sugar levels put your organs at risk.
If you lose weight, the amount of fat stored around your waist and important oergans will decrease, and they will all work better.
Is one method of loosing weight better than the other?
What you need to understand is that you don’t follow a diet for 8 days, 8 weeks, or 8 months. Your new eating habits are the basis of your everyday food choices for the rest of your life. Healthy meal plan are high in vegetables, fruits, and other carbohydrates such as whole grains and low fat dairy products.
There is no magic pill, or any magic diet plan to help you reduce weight.
So Skip the diet, just eat healthy!
What can I eat?
Having pre diabetes or diabetes doesn`t mean you can´t eat carbohydrates. It´s true that all carbohydrates becomes glucose, the body´s preferred and primary source of energy. Restricting carbohydrates would limit food like fruits, vegetables and whole grains, which are essential for good nutrition. And your body still needs carbohydrates for energy.
Food groups whose calories come mainly from carbohydrates are:
• Starches: bread, cereal, crackers, rice and pasta
• Starchy vegetables: peas, beans, lentils, potatoes and corn.
• Fruit and fruit juice
• Nonstarchy vegetables: tomato, cauliflower and carrots.
• Dairy foods: milk, yoghurt
• Sweets: candies, cakes, cookies and pies.
Your daily total calorie intake should have between 45-65% of healthy source carbohydrates, like fruits, vegetables, whole grain, and nonfat dairy food.
What are the Health Benefits of physical activity for people with prediabetes and diabetes?
Better blood glucose control. Physical activity burns calorie, and lowers your blood glucose. It promotes weight loss, which lowers your blood glucose.
Physical activity helps you keep muscle while you lose fat, and muscle burns calories, even at rest. Which lowers tour blood glucose.
Exercise improves the health of your heart by keeping it strong and reducing your abdominal fat. Exercise also lowers your triglycerides levels and raises your HDL levels.
Physical activity also has powerful psychological benefits, such as improved mood, enhanced self-esteem, and a true sense of wellbeing. This lowers your blood glucose levels, too.