How a non-diabetic person’s body functions:

They eat carbohydrates (sugars) and their blood sugar level rises. The pancreas secretes a hormone called insulin into the blood. This insulin is responsible for helping the body use the blood sugar for energy and fat storage. After the insulin has moved the blood sugar to the muscle and fat tissues, the person’s blood sugar level drops. If the person continues to fast for at least 8 hours, their blood sugar will slowly decline and reach a baseline level called the “fasting blood sugar” or FBS. In America, the FBS range for a diabetic person is anything over 125 mg/dL.  Anything close to that is called pre diabetes.  You can get your FBS level checked easily at the doctor’s office.

A diabetic person:

They eat carbohydrates and their blood sugar rises. They either don’t produce any or enough insulin (Type 1) or their body cells don’t respond well to the insulin they do produce (type 2). The result is similar for both types. The blood sugar remains high (hyperglycemia).  Diabetes essentially is “higher than normal blood sugar levels”.  If left unchecked, high blood sugar can lead to all kinds of problems including heart damage, kidney damage, stroke, blurred vision, and eventually coma and death.

Pre diabetes basically means you have too much sugar in your blood, but not enough to classify as diabetes. This number is somewhat arbitrary, and as silly as it sounds, it’s possible to have pre diabetes or diabetes in the USA but not in Canada. These countries use a different cut off point.

They also use different units to measure your blood sugar. We’ll use the American standard here. If your FBS (fasting blood sugar) levels are between 100 and 125 mg/dl (5.6 and 6.9 mmol/L) you are considered to have prediabetes. Anything over that is considered full blown diabetes. This means that your body isn’t responding to insulin as well as it should. Unchecked, this can easily lead to diabetes. A pre diabetic FBS reading is also called “Impaired fasting glucose” (IFG). We’ll discuss the other test in the next section.

Although it doesn’t sound like a big deal, it is. Over time, this high fasting blood sugar level can cause major health problems including damaging the heart and circulatory system. Diabetes can dramatically decrease a person’s life span.

How do I know if I have Pre diabetes?

There are two simple tests you can take to see if you have pre diabetes.

Test one:

Fasting blood sugar test. Here you don’t eat for at least 8 hours. Then you go to the doctor and give them a sample of your blood. They test to see the concentration of sugar. Since you haven’t eaten in a while, this measure is called your FBS (fasting blood sugar). The pre diabetic range is 100 to 125 mg/dL (5.6-6.9 mmol/L)

Test 2:

Oral glucose tolerance test. Here you are asked to drink a sweet drink containing a lot of glucose. Then you wait 2 hours and give your blood. If your glucose level here is between 140 and 199 mg/dL (7.8-11.1 mmol/L) you have pre diabetes.

Both tests are generally considered to be equally good at determining pre diabetes.

Who is typically at risk for pre diabetes?

Here are typically the high risk groups for pre diabetes:

• People with a family history of type 2 diabetes.
• Women who had gestational diabetes or have had a baby weighing more than 9 pounds.
• Women who have polycystic ovary syndrome.
• African Americans, Native Americans, Latinos, and Pacific Islanders, minority groups that are disproportionately affected by diabetes.
• People who are overweight or obese, especially in the mid section.
• People with high cholesterol, high triglycerides, low HDL/LDL ratio.
• People who are inactive.
• Older people. The ability to utilize insulin well gets worse as we age.

Should I get tested for pre diabetes?

Yes. Adults should be getting blood work done at least every couple of years anyway. Your fasting blood sugar (FBS) is one of the standard readings. The next time you get your blood work done, pay attention to that number and monitor it over your life. If it keeps creeping up, then you need to be extra careful. Don’t wait until a doctor tells you that you have pre diabetes or diabetes. Take matters into your own hands.

What should I do if I have pre diabetes?

You should get on an exercise program, reduce stress, lose weight (particularly body fat) and control your blood sugar through dietary changes.

Exercise and diabetes

What diet should I be on to prevent or control pre diabetes?

Diets to prevent diabetes or pre diabetes are the same. Read this article Diabetes prevention diet

Is there any oral medication I can take for pre diabetes if diet and exercise alone don’t work?

Yes. Oral medication for preventing diabetes

Type 1 diabetes:

In order to keep a lid on rising blood sugar, our bodies need insulin, a hormone which takes sugar out of the blood and directs it into mostly muscle and fat tissue. Insulin is produced by the beta cells in the pancreas. Type 1 diabetes is a disease where the pancreas is unable to produce any or enough insulin do to the loss of these beta cells. In this case the type 1 diabetic needs to take injections of insulin in order to stay alive. They must regularly monitor their blood sugar level during the day, and take the requisite amount of insulin. It is an annoying process but certainly worth the effort, since without insulin, diabetic ketoacidosis often develops, often resulting in coma or death. Now there are electronic devices called insulin pumps, which monitor blood sugar and supply the correct amount of insulin. These devices take less effort to use but still need to be attached outside the body. Unfortunately, we don’t know enough about how to prevent type 1 diabetes. The good news is that adult onset type 1 diabetes is much less common than adult onset type 2 diabetes, a disease much easier to reverse, especially during the early stages. Type 2 diabetes is so common now due to poor lifestyle habits with people in the developed world, that this disease is often just referred to as adult onset diabetes, even though that term isn’t really accurate.

Type 2 diabetes:

In order to take the sugar (glucose) in the blood to the surrounding tissues, we need not only insulin, but we need the insulin to work. People with type 2 diabetes can produce their own insulin, but their bodies aren’t able to use it, or at least not efficiently enough. Insulin is a hormone that attaches to receptor sites on the cells that need the glucose inside, mainly muscle and fat cells. When an insulin molecule is attached to the receptor site on the outside of the cell, it allows the cell to open up and allow glucose inside. Without insulin, glucose won’t be able to squeeze through the cell membrane. If the insulin receptor sites are damaged or not responding well to insulin, then insulin is essentially useless. In the early stages, type 2 diabetes is often characterized by reduced insulin sensitivity. Lifestyle changes alone are often enough to reverse this. Sometimes oral medications are needed. If the disease progresses far enough, insulin production becomes a problem, and these type 2 diabetics often need to start taking therapeutic insulin.

We can’t think in terms of, “this food is nutritious therefor it is healthy”. Preventing diabetes through diet really comes down to one major concept.

1. We need to eat in a way that stabilizes blood sugar. If we allow our blood sugar to go too high, we put too much strain on the pancreas to create insulin. The more insulin we use the more resistant we are to insulin. High blood sugar levels are a disaster for diabetes. We absolutely need to control our blood sugar levels.

How do we stabilize our blood sugar through diet?

1. Avoid eating foods with a high sugar content. Foods high in sugar cause our blood sugar levels to sky rocket.

2. Eat several small meals throughout the day. Large meals spike blood sugar and insulin production. Eating more but smaller meals allows our blood sugar levels to remain more stable.

3. Don’t eat carbohydrate-only meals. Healthy fats like monounsaturated fat (found in olive oil) and omega 3 polyunsaturated fat (found in salmon and flax seed oil) help to slow down the release of carbohydrates (sugars) into the blood stream. The slow release allows for lower steadier blood sugar levels. Proteins also help to slow down the release of carbohydrates into the blood stream. Eating a banana, drinking a glass of orange juice, or having a few crackers on an empty stomach is a major no-no. This type of eating will cause your blood sugar and insulin to spike.

4. Choose complex carbohydrates over simple carbohydrates. Complex carbohydrates break down much more slowly and have a higher nutritional value than simple carbohydrates. Complex carbohydrate sources are whole grains, most vegetables, brown rice, unprocessed oatmeal, and whole grain pasta. Simple carbohydrates include pop, junk food, white rice, bread, bananas, cereal…..

5. Eat a high fiber diet. Foods that are high in fiber help to slow down the release of sugars into the bloodstream.

6. Don’t eat too much. Overeating is a major problem especially in the developed world. These extra calories cause excess insulin production as well as increased insulin resistance.

Make sure you read this article before moving on.  Diabetes prevention diet

Good dietary choices:

1. Whole grains (brown rice, whole grain pasta, unprocessed oatmeal) , legumes, fruits (not so many bananas), vegetables,

2. Olive oil, Salmon, Tuna, Flax seed oil.

3. Lean chicken breast, tofu, whey protein powder

4. Green tea, cinnamon

5. Water

Poor dietary choices:

1. Junk food: Chips, crackers, cake, chocolate, candy, soda, cookies…

2. White flour or white rice: bread, pasta, pastry,

3. Saturated or hydrogenated fats: red meat, cheese, dairy, ice cream, pie, peanut butter (100% natural is ok)…

4. Fruit juice

You are human. If you make a poor food choice don’t panic. Just start fresh and try not to spiral out of control. Don’t use the reasoning, “Well, I’ve already ruined my perfect day by having a few cookies, I might as well go all out and pig out today”. Eating some sugar produces some insulin, eating more sugar produces more insulin. This is not an all or nothing thing. Remember that your life is at stake here.

• Both types of exercise help the body to burn fat. A high level of body fat, in particular abdominal body fat, decreases the body’s sensitivity to insulin. This decreased sensitivity to insulin is one of the major causes of type 2 diabetes. Cardiovascular exercise helps to burn the fat directly. The increased muscle mass from strength training also help to burn fat, since muscles need energy. You don’t need huge body builder type muscles to get this effect. A slight increase in muscle mass helps a lot.

• Exercise increases the body’s sensitivity to insulin, thus helping you prevent the onset of diabetes. Muscle cells help keep blood sugar levels in check because they pull the sugar out of the blood with the help of insulin. The better trained your muscles are, the better they are at doing this job. This is one reason that sedentary people are in the high risk group for diabetes.

• Exercise helps to lower stress levels, control anxiety, and relieve depression. People with low stress levels and who have a positive outlook on life are less likely to get diabetes. The stress hormones trigger the body’s “fight or flight” response. These hormones cause the liver to release sugar into the blood for the anticipated need for energy.

• An exercise program helps to keep your good to bad cholesterol high. This helps not only with diabetes but also with pretty much every other disease.

Talk to your doctor before you start an exercise program, especially if you have been sedentary for years and/or have heart problems.

Green tea appears to help stabilize blood sugar, which is absolutely key in preventing diabetes. Obesity is also highly correlated with type 2 diabetes and green tea helps to suppress appetite. Eating less not only makes obesity less likely, but it also puts less strain on the insulin producing pancreas. Less insulin production leads to greater insulin sensitivity.

Cinnamon is another natural herb that is well known to help stabilize blood sugar.

Try drinking a few glasses of green tea a day and also including some cinnamon in your diet. See what effect this has on your Fasting blood sugar level. Keep in mind that controlling your diet, weight, and exercising are the most important things you can do to prevent diabetes. Green tea and cinnamon may very well help, but don’t use these supplements in place of the other changes you need to make.

1. They don’t produce enough

2. The insulin they do produce isn’t as effective as it should be “reduced insulin sensitivity”

They often take oral medication to help counteract these problems.

People who have pre diabetes are starting to develop those two problems. Lifestyle changes such as diet and exercise are highly successful in preventing the transition from pre diabetes to type 2 diabetes. Quite often, these lifestyle changes alone are sufficient in the prevention of diabetes, and can even get patients into the normal range from the pre diabetic range. Sometimes however, these lifestyle changes alone aren’t enough and oral medication is used. There are several types of oral medication that can be used for the prevention of diabetes. Here are a few:

• Sulfonylureas. These diabetes pills lower blood glucose by stimulating the pancreas to release more insulin.

• Biguanides. These diabetes pills improve insulin’s ability to move glucose into cells especially into the muscle cells. They also prevent the liver from releasing stored glucose. Metaformin is one example which is often used to help prevent diabetes.

• Thiazolidinediones. These diabetes pills improve insulin’s effectiveness (improving insulin resistance) in muscle and in fat tissue. They lower the amount of glucose released by the liver and make fat cells more sensitive to the effects of insulin.

• Alpha-glucosidase inhibitors. These drugs block enzymes that help digest starches, slowing the rise in blood glucose. Precose is one example of this type.

• Combination therapy. There are several combination diabetes pills that combine two medications into one tablet.

Both Precose and Metaformin, along with dietary improvements and exercise, have been shown to delay or prevent the onset of type 2 diabetes.
See if you can lower your blood sugar on your own, through diet and exercise, without having to rely on medication. No medication is without side effects.

Diabetes prevention diet

Exercise and diabetes

If you are truly unsuccessful, talk to your doctor about taking oral medication to prevent type 2 diabetes.

It won’t do it on it’s own, but drinking too much water can make you fatter indirectly. We all know that drinking enough water is essential for health for several reasons. Unfortunately, that makes many people wrongly conclude that “more is better” when it comes to drinking water. Drinking water lowers our blood concentration of salt and sugar. That is often a good thing, especially when those levels are too high. Let’s not forget however, that some salt and some sugar in our blood is a good thing. We need a balance and there exists an optimal concentration of blood sugar, sodium, vitamins, and minerals. The optimum blood concentration for these things certainly is not zero. 

When our blood sugar, sodium, and vitamin levels drop too low, our appetite increases. This is so we can restore these levels. We know that if we eat a lot of salty peanuts, we get thirsty, but what is less talked about is, if we drink too much water, our appetite for salty peanuts (and other things) increases.

There are many factors that regulate appetite. It’s true that an empty stomach can make us feel hungry. Drinking water may help with that factor, but let’s not forget the other factors that increase appetite. Low blood sugar is one of the biggest ones. This causes huge cravings for food, which lead to over indulging, followed by a rapid increase in blood sugar, followed by a huge insulin spike. This overeating leads to rapid weight gain as well. A nightmare situation for diabetics. If you don’t want your blood sugar levels to get too high, don’t let them get too low either. Don’t just drink tons and tons of water thinking that it’s the healthiest thing you can do.

So remember that drinking water is good, but don’t overdo it, or your cravings caused by the subsequent drop in blood sugar, sodium, and vitamins, could very well lead to over indulging, obesity, and diabetes.