Making Changes for Diabetes Prevention
● By Jon Lewis
By Jon Lewis
THE NUMBERS ARE downright numbing: Half the adults in Shasta County are prediabetic and a third of those will contract Type 2 diabetes within five years. Diabetes affects more than 30 million people in the United States and another 84 million are prediabetic. A mere 10 percent of prediabetic people are even aware of it.
A grim assessment from Shasta County’s public health department, to be sure, but within those numbers is hope. “When we find out the train of their life is heading toward diabetes, we just shift the tracks bit by bit,” says Deannie Joseph, a registered nurse and diabetes instructor at Shasta Regional Medical Center. “Each lifestyle change can completely change the direction and get them back on the track to a healthy lifestyle and quality of life.”
Classified as a metabolic disease, diabetes occurs when the body’s cells fail to absorb enough glucose (sugar) in the bloodstream. In a healthy system, cells take up glucose using insulin, a hormone produce by the pancreas. In a person with diabetes, the pancreas fails to produce enough insulin or the cells become resistant to it. When glucose builds up in the bloodstream, known as hyperglycemia, it can lead to serious health issues, including heart attack, stroke, nerve damage, kidney dysfunction and blindness.
The exact cause of Type 2 diabetes is not fully understood, but researchers have identified obesity, a sedentary lifestyle and poor food choices as the chief risk factors. It is believed that some people have a genetic predisposition for diabetes, says Malinda Knowles, a nurse practitioner and board-certified diabetes instructor.
“Usually someone has a family member who has had it,” Knowles says. “The gene is the gun but what pulls the trigger is your diet and lifestyle. On the positive side, there is a lot of control over these risk factors. If you keep your blood pressure, cholesterol and glucose within recommended parameters, you can markedly keep your risk within control.
“The other good news is a little bit of exercise goes a long way with diabetes. Even a five-minute walk reduces glucose levels. A 10-minute walk a day is very beneficial to someone with diabetes. It’s definitely a self-management condition,” Knowles says.
Exercise is one of the key components of the new diabetes prevention program being offered at the Shasta Family YMCA, says Pauline Asbill, the program manager. The yearlong program starts with weekly sessions, then biweekly and then monthly. Participants focus on eating healthier, losing weight and getting more active.
“There’s a lot of group support and you’re working with a lifestyle coach. When you’re with people in a similar situation, you can share tips and things that work for you,” says Asbill, who notes that the YMCA program is curriculum-based and follows guidelines established by the Centers for Disease Control. The program is for people diagnosed as prediabetic.
“Over 12 months, you can make small changes with different goals each week. These are small changes that people can actually make and be successful at,” Asbill says. Limiting carbohydrates, focusing on vegetables and lean proteins and increasing activity are lifestyle changes, not the latest fad diet, she says.
At least two risk factors for diabetes, age and heredity, are not controllable, but the others – a sedentary lifestyle, being overweight and not eating sensibly – are controllable. “That’s the beauty of Type 2 diabetes. If you’re prediabetic, you can turn that train around; if you’re diagnosed, you can make good food choices,” Joseph says. “We work with people to help them make good food choices, maintain their carbs and give them tips and strategies to be more active. There are always things people can do.”
Diabetes educators like Knowles and Joseph recommend diets that emphasize vegetables like green beans, broccoli, celery, bell peppers, asparagus, Brussels sprouts, spinach, kale and cucumbers.
Knowles recommends limiting carbohydrates to 180 grams a day (45 to 60 per meal and 15 grams in snacks) and the fruits, vegetables, whole grains and lean proteins associated with the Mediterranean diet. Thirty minutes of activity, five times a week, should also be on the to-do list.
“It doesn’t have to be strenuous,” Knowles says. “A little goes a long way. Try to find something you love.”
Losing weight shouldn’t be a crash course, either, she says. “Don’t lose it too quickly. Hormones are a factor and they can kind of sabotage your efforts. Even if you lose 5 percent of your body weight, even five pounds when you weigh 300, will reduce your numbers.
“A lot of diabetics feel like failures, but they’re fighting an uphill battle. It’s not their fault they gain weight faster. You just have to do your best. Even a five-minute walk will really help. You may not lose a ton of weight, but it will help your glucose,” Knowles says.
It’s recommended to always consult your healthcare provider before starting a new diet or exercise program. •
YMCA diabetes prevention program • www.sfymca.com/dpp