November is American Diabetes Month
Diabetes is a chronic health condition that affects how your body turns food into energy. It occurs when the pancreas does not produce enough insulin or the body cannot effectively use its insulin. Insulin is a hormone that helps glucose from food get into your cells to be used for energy. When there isn't enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which can lead to serious health problems over time, such as heart disease, vision loss, and kidney disease. There are two main types of diabetes: Type 1, where the body does not produce insulin, and Type 2, where the body becomes resistant to insulin or doesn't produce enough.
One in 10 Americans have type 2 diabetes — that's more than 30 million people. Another 84 million adults in the United States are at high risk of developing type 2 diabetes (have pre-diabetes).
What does insulin do?
Insulin's job is to take blood sugar from our food and drive it into the cells of our muscles and liver as stored sugar (glycogen) and into fat cells to store it away. Our body's tissues and cells can get damaged from too much sugar in our bloodstream, so we need insulin to do its job! When our bodies aren't "listening" to insulin the way they should, our pancreas "speaks louder" by releasing more insulin.
Over time, we become more "resistant," and eventually, we can't release enough insulin to handle the foods we are eating; we have more and more fat stores (especially around our mid-section) and inflammation, and we become diabetic. This increases our risk for heart disease, stroke, liver disease, certain cancers, and the list goes on! This process doesn't happen overnight.
How do you know if you have problems with insulin resistance?
What tests or signs can clue you in to whether you are having signs of insulin resistance? (Hint: by the time your blood sugars are high on bloodwork, it's already been happening for a while!). These are some labs that could tell you if you are at risk.
Fasting insulin level- can tell you how "loud" insulin is having to speak.
Highly sensitive C reactive protein- can identify those who have inflammation.
Increased triglycerides (type of cholesterol)
Fasting blood sugar creeping up/Fasting glucose and hemoglobin A1C
Increasing waist size!
Abnormal liver tests
Body composition analysis with measurement of visceral fat
Lipoprotein particle analysis
This is not a comprehensive list.
Is it possible to reverse the course of diabetes? Is it possible to prevent it?
YES. How? Here are some ways:
Know your numbers: Ask for a hemoglobin A1c test.
Know your risk: If you are overweight, have obesity, have a history of gestational diabetes, polycystic ovarian syndrome, or have a strong family history of type 2 (adult-onset) diabetes, act proactively to decrease your risk.
Signs of increased risk: Increased waist size/abdominal fat (even with a normal BMI), increased BMI, elevated Hemoglobin A1c, fasting blood sugar, and increased insulin level.
Additional info: Ask for an insulin level to assess how your body handles glucose (sugar). Know your cholesterol numbers.
Changes in nutrition: Decrease processed sugar and processed flour intake in baked goods/breads/tortillas/cereal. Opt for reduced portions of "healthy carbohydrates" like whole grains, beans/legumes, and fruit, and eat lots of veggies!
Lifestyle changes: Make sure to get adequate sleep, live as actively as possible, and even look into meal timing (aka fasting) as a strategy to help - and manage stress!
Maintain a healthy weight and waist size: Get professional help to optimize your weight! Note: Often, medications for type 2 diabetes can be changed to help promote weight loss and improve the risk for progression and complications of diabetes.
If you have diabetes and are on medications, you need to be supervised by a physician when making lifestyle changes, as often, medication dosages need to be reduced or stopped.
In my practice, we have patients making changes daily to reduce their risk while coming off medications and improving their health. Changing one's lifestyle, diet, strategies like fasting, and some medications can help reverse the process and decrease the chances of developing type 2 diabetes.
Exercise and diabetes
Exercise plays a crucial role in diabetes prevention, management, and potential reversal by improving insulin sensitivity, aiding in weight management, and enhancing overall metabolic health. Regular physical activity helps muscles use glucose more effectively, reducing blood sugar levels and decreasing the risk of developing type 2 diabetes. For those already diagnosed, exercise can help manage blood glucose levels, reduce the need for medication, and lower the risk of complications. Additionally, combining exercise with a healthy diet can lead to weight loss, which is particularly beneficial for reversing insulin resistance and potentially putting type 2 diabetes into remission.
According to the US Dept of Health and Human Services guidelines, it is recommended that for general health benefits, you should be getting 150 min/week (about 30 mins 5x/wk) of aerobic exercise plus strength training (muscle resistance training) 2x/week. For the prevention of weight gain, individuals need 150-300 minutes per week, and for the prevention of weight regain 300-420 minutes. As you can see, exercise is IMPERATIVE in maintaining weight loss once you have lost weight.
Examples of aerobic exercise are:
Walking
Jogging
Elliptical
Biking
Swimming
Dancing
Kickboxing
And the list goes on.
Find something you enjoy and make time for it! Muscle resistance training is essential as well. Strong muscles burn more energy at rest and help maintain weight and fitness. Strong muscles also allow your body to respond better to insulin.