For patients diagnosed with prediabetes, the thought of living with a chronic illness for the rest of their lives is understandably upsetting. However, it is possible to see the condition in a positive light, says Sally Brozek, a registered dietitian and certified diabetes educator at Piedmont’s Diabetes Resource Center. “Prediabetes is a wake-up call and a real opportunity to get healthy and prevent a chronic disease you have for the rest of your life,” she says. “It’s time to take action.”
Prediabetes is frequently diagnosed through a routine checkup with a primary care physician and typically has no symptoms. Prediabetes often develops from a combination of lifestyle factors, particularly in patients who are overweight and/or sedentary. “A doctor diagnoses prediabetes based on lab work,” Brozek explains. “A patient with prediabetes has fasting blood glucose between 100 and 125. A reading of 126 is diagnostic of diabetes.”
Exercise as Medicine
“Treatment is going to focus on helping the patient achieve a healthy lifestyle,” she says. “Hopefully the physician will send the patient to a registered dietitian to learn about eating healthy to promote weight loss. A dietitian would also focus on helping the patient become more active.”
According to the Physical Activity Guidelines for Americans, adults need 150 minutes of cardiovascular activity each week, such as walking, biking, swimming, running, dancing or aerobics. Patients are also encouraged to become more active in their daily activities as well. Brozek recommends:
- Taking the stairs instead of the elevator
- Taking a longer route when you have to walk somewhere
- Going upstairs to the second floor of your house more often
- Parking further away from the door at the supermarket or shopping center
- Wearing a pedometer to track your steps throughout the day (aim for 10,000 steps a day for optimal health)
“People often tell me they don’t have enough time,” she says. “I tell them there are 1,440 minutes in a day. I’m asking them to find 30 for exercise. Recent studies show that it’s equally beneficial to do three 10-minute workouts or two 15-minute workouts a day.” Brozek says walking is her favorite cardiovascular activity because it is appropriate for most fitness levels, convenient and affordable.
“You can do it anytime, anywhere. I recommend walking at the mall because it opens early, is safe and is climate controlled. There’s no need to join a fitness club if you’re new to exercise. Just walk out your front door,” she says.
“Exercise is an important aspect of diabetes prevention. I like for people to think of exercise as medicine,” Brozek says. “It’s like one big pill you take that lowers blood pressure, blood glucose and triglycerides. It also promotes weight loss. Exercise can do all of these things that no one medication can do. No one misses their blood pressure medication, so why miss your walk?”
Create a Healthy Plate
When Brozek meets with a patient recently diagnosed with prediabetes, she teaches them how to build a healthy plate. “This begins with portion control. Use smaller plates and bowls to serve your food,” she says. “Fill half of your plate with colorful veggies, then add lean protein the size of a deck of cards. Finally, add healthy carbohydrates, like whole wheat pasta, brown rice, sweet potatoes or corn.”
While many people believe carbohydrates make them gain weight, Brozek says this is not true. “A lot of people blame carbs for giving them diabetes or making them fat,” she says. “The problem isn’t with the carbohydrates, it’s that we eat too much of them. If we eat healthy servings, they fit nicely into a healthy meal plan. This is the same with fat. We emphasize eating less fat and choosing healthy varieties like monounsaturated and polyunsaturated fats, found in foods like avocados and olive oil.”
She cautions against following fad diets for quick weight loss. “Many people learn to eat in a way that is too extreme and that’s why fad diets don’t work,” she explains. “Dessert can be part of a healthy diet, but it needs to be considered a treat whether you have prediabetes, diabetes or no health conditions at all. We need to eat small portions and be happy with less. It’s all in moderation.”
Preventing Full-Blown Diabetes
The good news for those with prediabetes is that they have the opportunity to prevent diabetes, a chronic condition that can lead to serious complications. “The National Diabetes Prevention program has shown that you can prevent diabetes up to 58% by achieving a healthy lifestyle,” Brozek says. “There’s no question. You can get blood sugar levels back to the normal range through lifestyle modifications. “I see a lot of people making these changes and doing well,” she says.
“We do our eight-week healthy direction program and have people lose weight. Their blood glucose comes back into the normal range and they are able to come off insulin. Their body starts to use its own insulin better when they lose weight. It’s extremely rewarding because you can work hard and get things back to normal.”
Brozek emphasizes that prediabetes should serve as a wake-up call and is not a life sentence. “A lot of people who have diabetes wish they’d done more when they had prediabetes,” she says. “It’s an opportunity. We can make a real difference if we buckle down and make the necessary changes.” For more information about prediabetes, visit Piedmont’s Diabetes Resource Center.
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