A change in diet and exercise are key when diagnosed with pre-diabetes. It could mean warding off the disease altogether
A physician’s diagnosis of pre-diabetes should inspire patients to take action.
Unfortunately the message is often ignored.
“Really, most people don’t care. It’s amazing to me,” says Dr. Leon Camilo Uribe, Palm Beach Gardens, Fla.
That’s a serious concern.
Half of U.S. adults age 65 or older and more than a third of adults ages 20 or older had pre-diabetes in the period 2005-2008, according to government statistics.
The standard advice to eat less, lose weight and get more exercise may not be enough, say healthcare experts.
Personalized diet strategies – even those that contradict conventional wisdom– along with education, goal setting and accountability can mean the difference between ignoring health warnings and taking action, according to physicians.
Motivation is a big factor in successful weight loss, says Dr. Todd Burstain, clinical associate professor of internal medicine at University of Iowa Hospital and Clinics.
However, it’s more effective if patients have their own goals and aren’t just responding to feedback from others. It’s also essential that patients believe they can achieve success, according to Dr. Burstain.
“It doesn’t matter if it’s superficial. It can be fitting into a size 10,” he says.
In counseling, Dr. Burstain asks patients, including Judy and her husband John Clark, to make a list of five things they want to do.
For Judy it was getting out of her chair.
“My wish list was that I be able to walk again,” says the recent retiree, who lost 94 pounds.
Her husband John had a similar desire. It was very hard for him to stand from a chair until he lost 74 pounds.
“I can get out easier; I can get around easier,” he says.
“I think it’s good for your self-esteem, but you also feel so much better. I can stand up. That’s the big thing,” says Judy, Clarinda, Iowa.
Neither has diabetes, though their weight put them at risk. They’ve cut that risk with their weight loss, according to Dr. Burstain.
Becoming informed also helps people lose weight.
Dr. Uribe often initiates a conversation with his patients.
“I’m the one to get people thinking about this,” he says.
Often his patients think it’s “no big deal” to have high blood glucose (sugar) levels.
He’s the one who explains that pre-diabetes could lead to the full-blown disease with complications that could include damage to their heart, kidneys and liver.
“Once you explain that it’s not that complicated to take care of it, they do,” says Dr. Uribe, who specializes in family and sports medicine, member of the American Medical Society for Sports Medicine.
This may be especially true now that he’s given up on telling patients to count calories. “I can put patients on a 1,000 calories a day but that doesn’t mean anything if it’s three doughnuts a day. There’s no nutrition in a doughnut,” says the Florida physician.
Instead he tells patients, “This is the core of meals: fruits, vegetables and legumes.”
He insists patients eat three meals a day.
“If you’re skipping a meal you’ll never control your [blood] sugar,” Dr. Uribe says.
His advice is designed for a lifetime of eating habits, not a short-term diet.
“Make small changes in your daily eating plan. You can eat the bad stuff, but not every day,” Dr. Uribe says.
By contrast, Dr. Burstain has his patients keep track of what they’re eating and gives them a caloric limit.
The Iowa physician also tells patients to eat three meals a day, not the smaller, more frequent meals some people prefer.
“When you eat six meals a day you’re never really hungry, but you’re never really full. You should get hungry,” Dr. Burstain says.
For the Clarks, eating only three meals a day made sense.
“We were snackers before Dr. Burstain explained why that was a problem. It’s easy to do three meals rather than five or six,” Judy Clark says.
Judy and John were each assigned 1,200 calories a day that Judy keeps track of using an online program.
“I write everything down every day. That way we’re very accountable,” says Judy.
Stress and lack of sleep can also trigger overeating.
Being a county auditor was a stressful job for Judy Clark.
“I looked to food for comfort,” she says.
That’s in the past.
“Now if I get stress feelings I say I don’t need food.”
To combat stress, do things that make you happy but don’t involve foods, Dr. Burstain says.
“It doesn’t take long. You can listen to music for five minutes and release dopamine, but you’ve got to like it,” Dr. Burstain says.
If you don’t get enough sleep you could also be harming your health.
You have to get eight hours of sleep a night, according to Dr. Burstain.
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