If you rounded up all the Americans with diabetes, they’d make up Texas’ entire 21 million population. Another 54 million—that’s Texas and California combined—have pre-diabetes, which means they are likely to develop diabetes within 10 years.
Are you at risk? Are you sure? What if there were simple, lifesaving steps that could put you on a path to prevention of this dangerous disease? Would you take them? Here’s a before-and-after look that might sway your thinking.
Step 1: Adopt a healthy diet
Before: Are you pre-HD? We’re not talking high-def television, we mean healthy diet. If you eat a diet high in fat and calories—and if you are genetically predisposed to diabetes—you may be at risk.
Here’s why. Long term, big portions or excess calories will lead to weight gain. “Obesity creates a burden on the pancreas that, over time, decreases its ability to make insulin,” says Carlos Arguello, M.D., a UAB attending physician.
This is important because insulin is needed to convert blood glucose to energy. In people with pre-diabetes, the pancreas is already overworking to produce enough insulin. “By the time people discover diabetes, they have lost 50 percent of the cells in the pancreas that make insulin,” says Cathy Crawford, R.D., CDE, supervisor of the diabetes and nutrition education department at UAB’s Kirklin Clinic®.
If the pancreas does not make enough insulin or if your body can’t use it effectively, you will develop diabetes. If left untreated, it can lead to complications such as eye, kidney and nerve damage and heart attack or stroke.
After: The after-effects of a healthy diet may ward off diabetes. Studies show that high-risk people can prevent or delay diabetes by losing just 5 to 7 percent of their body weight. This can come partly through portion control and healthy meals that include vegetables, whole grains, fruits, nonfat dairy, beans and lean meats, poultry and fish.
Meanwhile, the burden on the pancreas will be lessened and the fat you lose will help your body use insulin better. “We have receptors in our cells that let insulin do its job. Fat makes those receptors more resistant to insulin,” Crawford says.
Step 2: Exercise regularly
Before: Here’s a news flash to all couch potatoes: You’re not burning many calories and you may be overweight.
And, Dr. Arguello says, in patients who are predisposed to diabetes, such as those with a family history of the disease, a sedentary lifestyle may contribute to diabetes.That’s because a lack of exercise reduces the body’s ability to use insulin. It also contributes to weight gain and is linked to high cholesterol and high blood pressure, which are diseases that often occur in tandem with diabetes.
After: Here’s the good news. You don’t have to run a marathon or hire a personal trainer to exercise. In a major study, people at risk who lost weight did so—in addition to dietary changes—by being physically active for 30 minutes a day, five days a week.
Regular exercise tackles several risk factors. “It increases weight loss and increases insulin effectiveness. It changes hormones that allow our tissues to respond better to insulin,” Dr. Arguello says.
In the short term, exercise helps your muscle cells use blood glucose because they need it for energy. “In the long term, if you exercise regularly and continuously, you don’t just burn glucose, you burn fat,” Dr. Arguello says. Exercise also will help control cholesterol and blood pressure.
Step 3: Get your blood glucose checked
Before: Of the 21 million people who have diabetes, 7 million don’t know it. The risk of not getting a simple blood sugar check is that you could be one of them. “Half of patients diagnosed with diabetes already have a complication such as eye problems or neurological problems,” Dr. Arguello says. In fact, many diabetes patients are diagnosed when they come to the emergency department with a heart attack. “By then, you’ve probably had it for a long time,” he adds.
After: Meanwhile, if diabetes or pre-diabetes is uncovered through screening, patients can lower their risk for complications. UAB can help patients with above-normal blood sugar learn how to control it. “Most patients are a little shocked. But they want to do whatever it’s going to take to not get diabetes or develop complications from it,” Crawford says.
Step 4: Stop smoking
Before: There is no known direct cause between smoking and diabetes. However, the American Diabetes Association reports that smoking does raise your blood sugar level.
“Some studies suggest that smoking also makes insulin resistance worse,” Dr. Arguello says. Further, smokers with diabetes are more likely to get nerve damage and kidney disease and are three times more likely to die of heart disease than nonsmoking diabetes patients. Blood vessel damage resulting from smoking also may worsen foot ulcers or lead to leg and foot infections.
After: Again, although he’s careful not to say there is a definite link, Dr. Arguello says some studies suggest that quitting smoking will decrease your diabetes risk.
So, isn’t it about time to kick the habit? In fact, isn’t it about time to kick all the habits—poor diet, physical inactivity, putting off blood glucose screenings and smoking—that may up your risk for diabetes? You’ll be healthier, you’ll feel better, and you may prevent or delay diabetes. That’s sweet news indeed.
Dr. Josh Klapow’s Healthy Habit
Don’t Change Everything; Change One Thing
When you’re ready to commit to a healthy lifestyle, it can be discouraging to accept that it won’t happen overnight. But a quick fix just isn’t realistic, says Josh Klapow, Ph.D., a clinical psychologist in the UAB School of Public Health and author of Living SMART: Five Essential Skills to Change Your Health Habits Forever.
“For the best results, you should change just one behavior at a time,” he says. “if you’re exercising, don’t start with an hour at the gym. Start with a 10-minute walk around your neighborhood.”
To make changes to your diet, Dr. Klapow also suggests gradual shifts, such as adding a few more fruits and vegetables into your diet or drinking one fewer sodas.
“Developing healthy habits really happens one behavior at a time,” he says. “Before you know it, these small actions will lead to the big ones.” For more tips on healthy habits, including Web videos, visit uabhealth.org/tv/living.