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The Prediabetes Wake-up Call

Diet and exercise can stop the progression toward diabetes.

If the results of your latest blood test show that you’re glucose levels are higher than normal, you aren’t alone. According to the Centers for Disease Control and Prevention, an estimated 79 million Americans have prediabetes, a condition where blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. A fasting blood glucose level in the 100- to 125-milligrams-per-deciliter range indicates that you have prediabetes.

People with prediabetes are likely to develop type 2 diabetes within 10 years—unless they take steps to prevent or delay the onset. The good news is that lifestyle changes can help stop the progression from prediabetes to diabetes. The American Diabetes Association says that people who lose 7 percent of their body weight and exercise for 30 minutes five days a week can reduce their risk of developing diabetes, a condition where the body doesn’t make enough of the hormone insulin or doesn’t use it properly. If there is an insulin problem, sugar builds in the blood, damaging nerves and blood vessels. Left untreated, diabetes can lead to heart disease, stroke, kidney failure, foot and leg amputations, and blindness.

Amy Griffith of Embrace Health and Nutrition in Oakland (www.embracehn.com) is a certified health coach and nutritionist who privately counsels clients on how to change their diet to achieve better health. She works with a number of clients who have been diagnosed with prediabetes.

“The best diet for prediabetes is one that is slightly higher in protein and lower in saturated fat,” Griffith says. “It should also include carbohydrates that have a low value on the glycemic index, which rates foods according to the degree to which they cause blood sugar to rise.”

Griffith says she tailors meal plans to each client’s individual preferences and lifestyle and even offers recipe makeovers to make favorite dishes healthier. “I have one client who loves German chocolate cake,” Griffith says. “So I redid the recipe and reduced the sugar content without sacrificing the taste.”

Griffith also recommends her clients aim for 30 minutes of exercise five days a week and notes that walking is a great way for prediabetics to begin an exercise routine.

“I also look at the timing of my clients meals,” Griffith says. “One client didn’t eat anything until 11 a.m.; another skipped meals. If you have prediabetes, it’s important to eat within an hour of waking up, and to have three meals and two snacks each day.”

One challenge is helping those with prediabetes is changing how their taste buds work. Griffith often recommends that her clients begin with a gentle seven- to 21-day cleanse to detoxify the body and eliminate highly processed and high-fat foods. Griffith then counsels clients on how to begin introducing healthy foods into their diet such as high-quality whole grains, fruits, and vegetables, and lean proteins such as fish, shellfish, and lean cuts of meat.

“I also recommend that people with prediabetes avoid saturated fats and trans fats and instead choose monounsaturated and polyunsaturated fats, found in olive oil and canola oil,” Griffith says. “It’s not about radical diet changes or feeling deprived, but rather making lifestyle changes they can live with.”

One Bay Area–based company, Omada Health, is making strides in addressing the prediabetes epidemic. The Omada Health program, Prevent, is an online version of a 2002 government-financed project sponsored by the National Institutes of Health called the Diabetes Prevention Program, which found that behavioral weight-loss programs can be more effective at combating diabetes than medication.

“Our 16-week online program helps people with prediabetes lose weight and adopt sustainable, healthy lifestyle changes,” says Sean Duffy, CEO of Omada Health. “In our program, we match people into groups of about 12 and bring them through the curriculum with a professionally trained health coach and all sorts of amazing digital tools, like a wireless-enabled scale, a Wi-Fi, or Bluetooth-enabled scale that wirelessly obtains your weight and measurements from your scale and syncs it, allowing you to visualize your weight loss online or on your smartphone. The goal is to create an environment where participants feel guided, supported, and put on a path toward better health.”

Duffy says that Prevent’s core model is to work with employers and insurers to cover the cost of the program, approximately $120 per month for the four-month course, since many employers and insurers are interested in new solutions to help their employees or members live healthier lives.

“But if someone knocks on the door at preventnow.com, they’re able to pay on their own,” Duffy says. We left that feature intact because we didn’t want to leave anyone out.”

Duffy says that Prevent participants, on average, tend to lose about 5 to 7 percent of their bodyweight over the course of the 16 weeks.

“Many of these individuals have tried a number of other diets before, but felt that the structure and accountability that the Prevent program gave them helped them really achieve success,” he says. “We tell people to think of this as a fresh start. Prevent isn’t a diet; it’s really about learning to eat a bit more healthy and making sustainable lifestyle change.”

In addition, the YMCA is also launching a similar program based on the Diabetes Prevention Program. The 16-week program kicked off in Silicon Valley in September, and at present, approximately 92 YMCA facilities in 36 states offer the program at 614 locations. The YMCA plans to expand the prediabetes program to more than 300 facilities, including Bay Area locations, by the year 2017. By merging diet and exercise with group behavior counseling, the YMCA hopes to give local families support in the fight against prediabetes. For those who are uninsured, the program is offered on a sliding scale.


Know the Signs of Prediabetes

More information on how to prevent developing diabetes can be obtained at the American Diabetes Association website, www.diabetes.org.

Prediabetes classes are held at medical facilities throughout the Bay Area. Visit www.diabetes.org/in-my-community/local-offices/san-francisco-california/recognized-education-programs.html to find a class near you.

In his book, The Blood Sugar Solution, Mark Hyman, M.D., outlines a do-it-yourself plan for readers to get their blood sugar under control and prevent diabetes.

Elizabeth Mwanga, who appeared on the TV show Chopped, lost 100 pounds and no longer needs diabetic medication. She shares her healthy recipes free on her site, www.winningdiabetics.com.

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