Let’s Explore : PREDIABETES

Time to Reverse Diabetes Progression

An intermediate stage in the development of the dreaded diabetes, prediabetes is a condition when blood glucose levels are higher than normal but not as high as in a diabetic condition. And yet, it is very scary!

As there are no clear signs and symptoms, prediabetes is very common and many people are not aware that they are living with it. If you talk about the prediabetic numbers of India…let’s just say, they aren’t very encouraging at the moment 👇

Here’s something to scare you even more 😈

A person with prediabetes has a higher risk of the development of type 2 diabetes, cardiovascular disease, and stroke (NCBI-Books). Such a person should get an annual blood glucose test and should be screened & treated for risk factors like hypertension and dyslipidemia (abnormal lipid profile)(read : NCDC.gov).

And to explain this horrible disease in technical terms 👇
‣ ꞵ-cells of pancreas secrete insulin, which causes your liver and muscles to take up excess glucose from blood.

‣In people with insulin resistance, insulin receptors on liver and muscle cells become less responsive to insulin and this in turn decreases uptake of glucose from blood and increases blood glucose levels.

‣ Your pancreas compensates by working hard and secreting higher insulin. As the disease progresses many ꞵ-cells of pancreas become dysfunctional and thus results in ever increasing secretion burden on remaining functional ꞵ-cells (PMC-Articles).

‣ If left untreated, this can progress to permanent damage to your body’s natural ability to control blood glucose levels (Diabetes-journals).

The Science behind Diabetes Reversal

We need not repeat it but it’s simple to understand that the earlier you act, the better are the outcomes. Here are 3 easy things for you to note :

“You better understand what I explain to you Sir!”

⦾ Blood tests can help in early diagnosis of prediabetes. As per NIDDK, the recommended tests are :

1. HbA1C
2. 12 hour fasting plasma glucose
3. Glucose tolerance test after 2-hour of oral consumption of 75g glucose

⦾ Increasing physical activity and making healthier food choices can control insulin resistance and increase glucose tolerance. Both the Centre for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program and American Diabetes Association (ADA) recommend losing weight, especially if you are overweight, to prevent or delay type-2 diabetes.

⦾ You may also refer to various personalized lifestyle intervention programs which aim at diabetes prevention. It is important that the diabetes reversal program you enroll in and sources from where you follow a diabetes prevention diet are reliable and are based on the principles of the national institute of health-sponsored diabetes prevention program (NIDDK-DPP).

A 2016 WHO global report on diabetes acknowledged that diabetes can be reversed by calorie restriction and weight loss. Regular physical activity causes changes in your body that leads to better glycemic control (NIDDK). As obesity is associated with insulin resistance, decreasing your excess body fat improves your glucose control. Healthier lifestyle decreases fat accumulation in the pancreas and liver and can help in recovery of insulin secreting capacity of pancreas and restoration of normal glucose metabolism in liver. An ideal diabetes reversal regime will take off excess burden from your pancreas and give it a chance to repair. Success rate of these diabetes reversal programs is higher for patients at early stages of diabetes progression.

In true sense, diabetes reversal is achieved when a previously diabetic person is able to maintain non-diabetic blood glucose control without taking any diabetic medicine.

Know your Risk

If you have the presence of one or more of the following factors, then you are at higher risk of developing prediabetes :

1. Obesity (BMI higher than 30 kg/m²) and large waist size (a waist measurement more than 40 inches for men and more than 35 inches for women is linked to insulin resistance)
2. Having a parent or sibling with diabetes
3. Age more than 45 years
4. Physical inactivity
5. History of gestational diabetes (diabetes during pregnancy)
6. Health conditions like high blood pressure and abnormally high cholesterol levels
7. PCOS (Polycystic Ovarian Syndrome)
8. Sleep problems, especially sleep apnea
9. Cushing syndrome (hormonal problem where body secretes excessive amounts of cortisol, also known as the stress hormone)

Some other factors such as your ethnicity and presence of chronic inflammation (NCBI) can also modify your risk of developing glucose intolerance. Don’t forget uncontrolled high blood glucose can silently damage your blood vessels, your eyes, your nerves and your kidney.

Reference: NIDDK

Nutritional Therapy for Diabetes

A registered dietician /nutritionist familiar with diabetes treatment should consider individual needs of patients. Every person is different and diet plans should be individualized. However many dietary principles are the same for patients with diabetes, prediabetes, metabolic syndrome, obesity and even for healthy non-diabetic individuals.

Following are some important takings from diet recommendation by the American Diabetes Association :

• A major part of the carbohydrate intake should come from nutrient-dense carbohydrate sources that are high in fiber, including vegetables, fruits, legumes and whole grains. Check the label of breads and pasta to make sure whole grain wheat or another whole grain is the first ingredient listed. Choose whole grain oats, brown rice, parboiled rice, millets, bulgur, quinoa, hulled barley, faro etc.
• Consuming low glycemic index (low glycemic load) foods can reduce sudden shooting up of blood glucose levels after meals.
• Avoid processed meat, red meat, refined flours and fast foods.
• People with diabetes or those at high risk should avoid food with added sugar and sugar sweetened beverages.
• You can refer to the American Heart Association’s “The facts on fats” which provide information about healthy fats and unhealthy fats. Maintaining a healthy lipid profile and controlling levels of bad cholesterol is very important for a diabetic patient as diabetes increases risk of developing cardiovascular diseases. Foods rich in polyunsaturated fatty acids and monounsaturated fatty acids (such as olives, nuts, fatty fish, peanuts etc.) are recommended over saturated and trans fats.

Reference: NCBI-Books

So what now?

Have patience! 🕒
When we know that a person has become diabetic gradually over time, then how can we expect sudden reversal of diabetes? If you are taking appropriate steps then your blood glucose levels should improve slowly. Besides lifestyle modification, there are other medical interventions which are sometimes recommended for prediabetic and diabetic patients. This includes taking metformin medicine and getting bariatric surgery. Your healthcare provider can help in management and treatment of your health condition. It’s important to keep track of your progress by getting regular blood tests.

There are a few labs which provide historical analysis through graphical representation of your lab results. We call them SMART LABS.

It is also advisable to keep a blood glucose monitor with you to keep a check on your sugar levels post meal. This will enable better monitoring of your diabetes treatment.
Timely intervention can halt or even reverse diabetes progression. Please stay diabetes-free!

Smart Health Reports are essential. We are sure you knew that before, and if not, COVID-19 or this article must have done that by now.

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