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BY JESSICA SEGOVIA-YAP, MD
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Saturday, October 21, 2017
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THE INCIDENCE of diabetes mellitus worldwide has reached epidemic proportions. This could be attributed to an unhealthy lifestyle; obesity arising from eating carbohydrate and cholesterol-laden fast food and addiction and dependence to technology which glues us to our beds and couches and forgetting to exercise or simply to move around, to name a few of the causative factors.
But before you become a diabetic we have this so-called in-between stage which we call prediabetes.
Prediabetes is a wakeup call that you are on the path to full blown diabetes. Its incidence is also staggering; it has been estimated that by 2030 there will be more than 470 million prediabetics worldwide. Fortunately, it is not yet too late to turn things around. Your blood sugar level could still be reverted back to normal.
So what is prediabetes?
Normally, your body makes a hormone called insulin to help control your blood sugar. When you have prediabetes, that system does not work as well as it should. The probable scenarios are: you might not be able to make enough insulin after eating, or your body might not respond to insulin properly or what we call insulin resistance.
So how do you know when you already have prediabetes? We have three tests available that your doctor may request for you. The simplest and most common, and also the cheapest, is the fasting plasma glucose test or fasting blood sugar (FBS). You will be instructed not to eat or drink 8-10 hours before blood extraction. The results for this are: NORMAL if your blood sugar is below 100; PREDIABETES if your blood sugar is 100-125; and DIABETES if your blood sugar is 126 or higher.
The next test is the Oral Glucose Tolerance Test. This is a bit cumbersome and time-consuming as you need to spend two hours at the laboratory but it is a reliable test. A fasting glucose test is done first then you will be asked to drink a sugary solution. Two hours after, your sugar level is then taken. The results are: NORMAL if your blood sugar is less than 140 after the second test; PREDIABETES if your sugar level is between 140-199; and DIABETES if it is 200 or higher after the second test.
The last one is Hemoglobin A1C which determines your average blood sugar for the past two to three months. It is a bit pricey but since it your sugar level for the past three months, that is how often you have it taken. It can be used to diagnose pre diabetes or diabetes or if you are already diabetic, this test will show whether your sugar level is under control. The results are as follows: NORMAL if it is 5.6 percent or less; PREDIABETES if it is between 5.7 percent to 6.4 percent; and DIABETES if it is 6.5 percent up.
So whatever your sugar status is, but more so if you are in the prediabetic or diabetic stage, you need to work on these three key lifestyle changes:
- Weight control – If you are overweight or obese, it is more likely that your prediabetes will lead to diabetes sooner than you expect. So better start losing those extra weight because even a five to 10 percent weight loss could spell a huge difference.
Exercise simply because it helps prevent and manage diabetes.
Aerobic or cardio exercise is ideal. But do try to get clearance from your doctor first, especially if you have not been active for quite some time.
- Nutrition – Limit calories, especially those sugary and starchy carbs. Go for meals that mix low-fat, proteins, vegetables and whole grains. Favor fiber-rich food as these will make you feel full so you will not eat too much. Plus, it helps clear out those bad oils and fats in your body.
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It is also important that you follow up with your doctor since medications might need to be started and your sugar level will be monitored regularly.
Jessica P. Segovia-Yap, M.D., FPAFP is a Diplomate and Fellow of the Philippine Academy of Family Physicians. She is a practicing Family Medicine Specialist and holds clinic at the Medical Arts Building of Iloilo Mission Hospital. For comments, questions and suggestions, you may email at drjec.is.in@ gmail.com./PN
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