2500: Preventing Diabetes

[00:00:00] It's another Q&A edition of Optimal Health Daily, Episode 2500 and I'm Dr. Neal Malik.

[00:00:06] Hey there, happy Friday and welcome to another Q&A edition of Optimal Health Daily, where

[00:00:12] I answer your health questions related to fitness, diet and nutrition, and more.

[00:00:17] You send in the questions and I answer them for you.

[00:00:20] Oh, and if you're in the US and send a relevant question in, we'll visit the post office

[00:00:25] and personally mail you a physical copy of the Optimal Living Daily workbook as long

[00:00:30] as we have copies left.

[00:00:32] Or if you're outside the US, we'll email you a digital copy.

[00:00:36] And I'll remind you how to send in a question at the end of this show.

[00:00:41] So for now, let's hear today's question as we optimize your life.

[00:00:49] Today's question came via email.

[00:00:51] Brenda writes,

[00:00:52] Hello, I was recently diagnosed with pre-diabetes.

[00:00:56] I have a family history of diabetes and want to do everything I can to avoid that fate.

[00:01:01] I exercise fairly consistently and my weight is reasonable.

[00:01:05] However, I do struggle with sugar intake.

[00:01:08] My question is what are the most effective steps I can take to reverse this diagnosis

[00:01:13] and avoid full-blown diabetes?

[00:01:15] Also, if I follow these steps, how long would it take to see an improvement in my blood

[00:01:21] work?

[00:01:22] Thank you for taking the time to send in your question, Brenda.

[00:01:25] I'm very sorry to hear about your diagnosis, Brenda, but I love that you're being so proactive

[00:01:30] about it.

[00:01:32] Pre-diabetes doesn't mean diabetes has to happen.

[00:01:36] So as always, I want to reset the show to make sure we're all on the same page when

[00:01:41] it comes to these different terms and definitions.

[00:01:44] If someone's doctor tells them they have pre-diabetes, it means that they don't have diabetes

[00:01:49] yet.

[00:01:50] But, the person is much more likely to develop diabetes in the near future.

[00:01:55] Usually, doctors diagnose diabetes by running some blood tests.

[00:01:59] They usually look at a person's fasting blood sugar levels, for example.

[00:02:03] This means that the blood is drawn after not eating for 8-12 hours.

[00:02:09] Basically, the doctor wants to see how much sugar is floating around in the bloodstream

[00:02:13] when you have an eaten in a while.

[00:02:16] This is valuable information because it tells the doctor how the body is processing sugar.

[00:02:22] Too much sugar sitting in the bloodstream is not good.

[00:02:25] We really want the sugar to get to your muscles, your liver and your brain so that it can be

[00:02:30] used for energy.

[00:02:31] When we have too much sugar in the bloodstream, it can lead to all sorts of side effects

[00:02:36] in the long term like loss of feeling in one's fingers and toes, changes in vision and blindness,

[00:02:43] increased risk for heart disease and stroke and on and on.

[00:02:48] So how much sugar in the bloodstream is too much?

[00:02:51] The cutoff for a fasting blood test is 100 or higher.

[00:02:56] Doctors may also look at another blood test called hemoglobin A1c or HB-A1c, that's its

[00:03:03] abbreviation.

[00:03:04] This tells the doctor what your blood sugar levels have been like not just today but over

[00:03:09] the past three months on average.

[00:03:12] HB-A1c or again, hemoglobin A1c is expressed as a percentage and you want your number

[00:03:19] to be less than 5.6%.

[00:03:23] What happens if your blood sugar is high, meaning over 100 but not so high that you have diabetes?

[00:03:30] Well the good news is there's still time to bring that blood sugar level back down.

[00:03:35] Normally the first thing I suggest to folks with pre-diabetes is to consider losing weight.

[00:03:41] High is weight loss or maintaining a normal weight so important.

[00:03:45] We're finding that if you carry excess weight, your body can't get rid of the sugar in

[00:03:49] the bloodstream as well as it should.

[00:03:52] Now for you Brenda, it sounds like your body weight is just about right.

[00:03:57] So we'll move on.

[00:03:59] Next up exercise regularly.

[00:04:01] In your case Brenda, it sounds like again you've got this covered but I want to clarify

[00:04:05] a couple of things.

[00:04:07] Notice I didn't use the term physical activity but instead I said exercise.

[00:04:14] Exercise is different because we're talking about increasing the activity intensity.

[00:04:19] So if you haven't done this already and your doctor says it's safe to do so, I recommend

[00:04:23] increasing the intensity of your activity and considering incorporating high intensity

[00:04:29] interval training or hit.

[00:04:31] This is because a number of studies have found this is really effective at lowering blood

[00:04:35] sugar levels.

[00:04:37] I would also recommend being sure you're adequately hydrated most of the time.

[00:04:42] Now why should we care about this?

[00:04:44] This is because staying hydrated especially by using just regular water helps the body flush

[00:04:50] out some of the excess sugar in your bloodstream.

[00:04:54] Now you don't need to over hydrate.

[00:04:56] How do you know if you're adequately hydrated but not over hydrated?

[00:05:00] I know it sounds disgusting but the best way to make sure is to look at your urine color.

[00:05:05] If your urine is a light yellow lemonade color that's perfect.

[00:05:10] If it's clear all the time you're consuming too much water meaning you're over hydrating.

[00:05:15] Darker yellow and you're dehydrated.

[00:05:18] I should also mention that plain coffee and tea are also great to help keep you hydrated.

[00:05:23] In fact, consuming regular coffee without cream and sugar has actually been shown to help

[00:05:28] prevent type 2 diabetes.

[00:05:30] As far as food goes be sure to watch how much carbohydrate you're getting.

[00:05:35] Now without knowing the specifics of your diet all I will say here is that you may need

[00:05:40] to consider cutting back on your carbohydrates a bit instead of having let's say three

[00:05:45] servings of fruit each day aim for two.

[00:05:48] This is still adequate to promote health and prevent any nutrient deficiencies.

[00:05:54] Instead of having two pieces of toast for breakfast have one.

[00:05:57] Instead of having a sandwich for lunch have a salad with all the same sandwich toppings.

[00:06:02] I think you get the idea.

[00:06:04] It's also important to be sure you're consuming enough fiber.

[00:06:08] We found that fiber can help our bodies use blood sugar more effectively.

[00:06:12] We often think of carbohydrate rich foods as the best sources of fiber but that's not necessarily

[00:06:17] true.

[00:06:18] Vegetables can also be good sources especially beans, nuts and seeds.

[00:06:23] These foods are important additions to your diet if they're not in there already.

[00:06:27] Now lastly, be sure you're managing the stress in your life.

[00:06:32] Folks often look at me strangely when I suggest this.

[00:06:35] What does managing my stress have to do with preventing diabetes?

[00:06:39] Think about your body's response to stress.

[00:06:41] Your muscles tense so you can prepare your body to run or fight.

[00:06:45] Your heart races.

[00:06:47] Your blood pressure rises to be sure there's enough blood flowing to your brain and muscles.

[00:06:52] Your pupils dilate so you can see better.

[00:06:55] All of these responses require energy.

[00:06:58] To be sure these organs have enough energy to perform these actions the body will actually

[00:07:03] pump sugar into the bloodstream.

[00:07:06] So there's the connection.

[00:07:08] More stress leads to more sugar in the bloodstream.

[00:07:11] More sugar in the bloodstream means the risk for diabetes goes up.

[00:07:16] Now, if you were to start incorporating some of these changes how long would it take

[00:07:20] for your blood work to reflect this?

[00:07:23] It's hard to say for sure, but I would say give your body three to six months to know

[00:07:27] whether it's helping.

[00:07:29] And before I end, I will also say that some of these suggestions may seem overwhelming because

[00:07:35] I listed so many of them.

[00:07:36] If that's the case please know I understand.

[00:07:40] I would recommend trying just one of my suggestions, the one that really jumped out at you or

[00:07:45] the one you feel is most important for you right now.

[00:07:48] And maybe it's the one that you feel would be easiest to start with either way.

[00:07:53] If you begin making any of these changes start with just one or two maximum and just know

[00:08:00] that by starting with even just one or two, you're already on the right track.

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[00:09:19] Thank you again for taking the time to send in your question Brenda.

[00:09:22] Now if you want to send in a question to be answered right here on the show plus get a copy

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[00:10:13] Alright that's another Q&A edition of Optimal Health Daily.

[00:10:16] Thank you so much for listening every day and all the way through.

[00:10:19] I hope you have a great start to your weekend and of course we'll see you back here tomorrow

[00:10:23] where your optimal life awaits.