Pre-diabetes. Let's talk about your blood sugar...
Prediabetes is the condition in which your blood sugar is no longer normal, but it hasn’t risen to a level at which diabetes is diagnosed. In Canada, we use a measure that considers a fasting blood sugar of 6.0 or lower to be normal. If your blood sugar after fasting is over 7.0 on two occasions, you have diabetes (we can also use a test called A1C to monitor blood sugar, but I will leave that to another article). If you are reading this, your fasting blood sugar may be between 6 and 7 and I may have told you that you have pre-diabetes. Sorry for the cliche, but we have some good news and some bad news about this.
First, the good news. Not everyone who has pre-diabetes is going to develop diabetes. An elevated blood sugar may give you an opportunity to improve your diet and your fitness and avoid developing diabetes. There is a lot of research being done around the world in how to prevent diabetes and we can be pretty sure that improving your diet and increasing your exercise will help. Here’s a link to some great work being done at UBC on this topic through a program called Small Steps for Big Changes. There is also plenty of evidence that eating a healthy balanced diet and being physically active helps people to live longer and protects against lots of other diseases, so this might be a great time to make some healthy changes.
Changing our diets permanently is hard. I think that the best approach is to follow the Mediterranean diet, which is simple, flavourful and healthy. You might also want to learn about some of the less obvious kinds of foods that raise blood sugar. We all know that cakes and candies and ice cream push our blood sugar up, but foods with a high glycemic index can do the same, even though they may appear more healthy. I like the Mayo Clinic article about the pros and cons of glycemic diet planning. If you want to talk to a dietitian directly for advice about your diet, you might want to call 811. Registered dietitians are available to all residents of British Columbia Monday to Friday from 9am to 5pm Pacific time. Information about the service can be found here.
“You need to exercise more.” It is pretty rare that I don’t say this several times a day when I am at work, but I often think that it would be helpful for us to be more specific. Our provincial guidelines call for two and half hours of moderate to vigorous activity per week (of course it is important to talk to your family doctor before starting an exercise program to make sure that this intensity of exercise is safe for you.) I think that it is best to choose activities that you enjoy doing as these are more likely to be maintained. Walking, cycling, dancing, climbing stairs, swimming and cross country skiing are all great choices. To make it simple, I often suggest trying to get five shirts wet with sweat per week, outside of work hours, as a goal for a great level of fitness.
Now, a little bad news. Some people go on to develop diabetes despite their very best efforts and it appears that some damage to organs may start before diabetes is formally diagnosed. This is why we might want to see you a little more regularly. Visits once or twice per year will help us monitor your blood pressure, weight and blood sugar and we will work with you to monitor your blood sugar over time.