Pre-Diabetes vs. Type 2 Diabetes

Here is a question I recently received from FOODPICKER.org:

What is the difference between Pre-Diabetes and Type 2 Diabetes?  Could you tell me the diagnostic criteria for both as well as the treatment?

Answer:  Type 2 diabetes is the most common form of diabetes and can develop at any age.  Essentially, the pancreas loses its ability to secrete enough insulin in response to meals.   Type 2 diabetes is diagnosed with one of the following tests:

• Fasting blood glucose level higher than 126mg/dL on two occasions
• Oral glucose tolerance test higher than 200mg/dL 2 hours after the test
• Random blood glucose level higher than 200mg/dL with some of the common symptoms (increased thirst, urination or fatigue)

Treatment options may include dietary changes, physical activity, weight loss, medications to help control blood sugar levels and self monitoring of blood sugar levels.

Pre-diabetes, meaning “before diabetes” essentially means blood glucose levels are higher than normal, but not yet high enough to be diagnosed as diabetes.  Pre-diabetes is diagnosed with one of the following tests:

• Fasting blood glucose level between 100-125mg/dL on two occasions
• Oral glucose tolerance test between 140-199mg/dL 2 hours after the test

Research shows those with pre-diabetes can prevent or delay the onset of type 2 diabetes by making lifestyle changes including a healthy diet, physical activity, and weight loss (if indicated).

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Pre-Diabetes & Weight Loss

Here is a questions I recently received from FOODPICKER.org:

I was recently diagnosed with pre-diabetes and was prescribed medication.  I have been following a diet to lose weight but unfortunately in the past few weeks, I have actually gained a few pounds.  When I was eating whatever I wanted without the medication, I stayed the same weight.  In the past, I have exercised at least 3 days a week but after a year of doing this I only lost about 10 pounds.  Do you have any suggestions?

Answer:  Some medications used to control blood sugar levels can result in weight gain.  At your next appointment with your physician, I would recommend discussing your blood sugar control, the weight gain and any other concerns you may have. Your physician may choose to change the dosage or medication prescribed.   Here are some other tips to help you achieve your weight loss goals:

• Physical activity – Try to engage in at least 30 minutes of physical activity 5 days a week. Remember that physical activity does not need to be ‘planned’ – the goal is to get active and stay active by doing things you enjoy such as swimming, walking, dancing, running, team sports, etc. 
• Meal frequency and portion size – Try to eat 5-6 small meals/day.  Make sure to watch the portion sizes and read labels.
• Try keeping a food diary with all foods and beverages you eat and drink throughout the day.  When you look back on your days intakes, ask yourself what you could have done differently to promote weight loss and better eating habits.  i.e. smaller portion sizes, fewer calorie dense beverages, less condiments, more fresh fruits, etc.
• Balance intake and expenditure – one pound is equivalent to 3500 calories.  To lose 1 lb in a week, you would need to either consume 500 fewer calories/day, burn an additional 500 calories/day or a combination of the two.
• Make dietary changes to incorporate more fresh fruits and vegetables, whole grains, low fat dairy products and limit fat.

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Diet and Weight Loss

Here is a question I recently received from FOODPICKER.org

My doctor has diagnosed me with diabetes and has told me to lose weight.  I have heard about high protein diets, low fat/high carb diets, and many others.  I want a sound diet instead of a fad.  What type of diet is best given my situation?

Answer:  It’s great that you are looking for a sound diet rather than a fad diet. Fad diets, or any other type of diet that promises quick or guaranteed results, are usually nutritionally unbalanced and unrealistic to maintain long term.  Rather than following one of these fad diets, make changes to your current diet to incorporate a variety of fresh fruits and vegetables, whole grains, lean meats, low fat dairy products and healthier fats.  Including these items in your diet will allow you to maintain the diet changes, lose weight at an appropriate rate, and keep the weight off.

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Uncontrollable Diabetes

Here is a question I recently received from FOODPICKER.org

I just been diagnosed with diabetes.  Doctors say I have uncontrollable diabetes any tips on how I can get my sugar level down?

Answer:  There are many different methods that can be used to manage your blood sugars.  Speak with your doctor to figure out what will work best for you.  Treatment for diabetes may include:

• Consuming a balanced diet containing fresh fruits and vegetables, whole grains, lean meats, low-fat dairy products and fish
• Engaging in 30-60 minutes of physical activity most days of the week
• Monitoring your blood sugars as recommended
• Taking insulin or oral medications as prescribed by your physician
• Modest weight loss of 5-10%
• Meeting with a Registered Dietitian (RD) or Certified Diabetes Educator (CDE) to develop a plan that works best for you

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Cravings

Here is a question I recently received from FOODPICKER.org

I am very new to the diabetes lifestyle.  I have started working out and so far have dropped 8 pounds (I have about 100 pounds still to lose).  I am excited about the weight loss so far, but I am scared that I won’t drop the weight and that I will slip somehow.  Can you offer any advice in regards to cravings (I have a big sweet tooth and enjoy greasy foods such as burgers and fries)?

Answer:  Congratulations on your weight loss thus far!  You will find that as you continue to loose more weight, you will feel better and your blood sugars will be under better control.

As for cravings, these can be difficult.  To control these, I would first recommend considering the portion size.  Rather than eating a whole slice of pie or bowl of ice cream, limit yourself to a bite or two and savor the flavor.  Another suggestion is to save these items for special occasions.  Remember that sweets contain a lot of calories and fat, and dont always offer the best nutrients.

In regards to fast food, it is important to watch your portion size and cooking method.  Here are some suggestions:

• Choose grilled chicken instead of fried
• Substitute the fries for a side salad or apple wedges
• Choose a single burger instead of a double or even triple
• Substitute regular soda with water or a diet variety
• Now days, most fast food restaurants have an online website and post nutrient information.  Take some time and explore these websites so you are aware of just how many calories and fat are in these products.

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Daily Fruit and Veggie Recommendation

Here is a question I recently received from FOODPICKER.org

I have pre-diabetes and am trying to lose weight.  How many servings of fruit and veggies should I have each day?

Answer: If you have pre-diabetes, you can and should do something about it. Studies from the American Diabetes Association have shown that a reduction in 5-10% of your body weight can prevent or delay the onset of type 2 diabetes by up to 58% .  In addition, participating in some type of modest physical activity for 30 minutes daily can reduce your risk of cardiovascular disease and some cancers, strengthen your bones and muscles, and improve your mental health and mood.

In terms of fruit and veggie consumption, I would recommend a minimum of 5 servings daily.  An easy way to incorporate these is a fruit for breakfast, a fruit and veggie for lunch, and a fruit and veggie for supper.  Eating 5 of these each day will not only help you lose weight, but will also provide your body with essential nutrients it needs.  Below are some additional tips related to fruit and veggies in your diet:

• Choose whole fruits rather than fruit juices.  Juices do not make us feel full, are full of calories, and rise blood sugars quickly.
• Fresh or frozen are generally better. If  choosing canned fruits such as pineapple or peaches, look for ones in light syrup.  If choosing canned veggies, drain the water and rinse to remove excess sodium.
• Limit starchy vegetables like peas, corn, and potatoes.  Choose non-starchy vegetables like broccoli, carrots, cauliflower, lettuce, etc. These non-starchy veggies are lower in calories and carbohydrates, meaning your blood sugars will remain lower.  In addition, they are a rich source of fiber keeping you full longer.

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