Diabetes mellitus is a global problem largely associated with diet and lifestyle, although genetic factors are just as important. With some 26 million American living with diabetes, it has become one of the major chronic diseases of today along with coronary artery disease and high blood cholesterol. The even more concerning factor is that there are some 79 million Americans with prediabetes, and it is not just the middle aged or elderly. Studies have revealed that approximately 35% of Americans older than 20 years of age (just over 1 out of 3 people) are suffering with prediabetes and many do not even know that they have the condition. Eventually these people will become diabetic without quick intervention.
Is Diabetes Curable?
Broadly, there is no cure for diabetes – neither type 1 nor type 2. Transplantation of the insulin-producing cells of the pancreas has offered short term relief for ‘sugar diabetes‘. The same immune mechanisms that appear to destroy the original cells tends to destroy the transplanted cells. However, it has been known that some patients with type 2 diabetes may go into remission. This is not a cure as such but can shift the balance towards normal blood glucose levels. Overall it is a rare phenomenon that is associated with stringent dietary and exercise measures, or in some cases after gastric bypass surgery.
Can Prediabetes Be Cured?
Prediabetes on the other hand is curable. It can be reversed and diabetes can therefore be prevented. Even when prediabetes cannot be reversed, by properly managing it your chances of developing diabetes mellitus is greatly reduced. Recent research has shown that there may be some damage to the heart and blood vessels with long-standing prediabetes but it is usually not as severe as with diabetes mellitus. Prediabetes is the condition where your blood glucose levels may rise higher than normal, but not as high as the levels that characterize diabetes mellitus.Therefore prediabetes is more correctly known as impaired glucose tolerance (IGT).
The common terms that is often used along with diabetes and prediabetes is insulin resistance. It is a phenomenon that characterizes type 2 diabetes – your body does not respond as it should to insulin, the pancreatic hormone that lowers blood glucose levels. Initially the pancreas produces more insulin than normal to “force” the cells to respond but eventually this is ineffective. Antidiabetic drugs makes the body more responsive to insulin. Over time the insulin-producing cells of the pancreas are destroyed and no more insulin is produced like in type 1 diabetes. At this point a person may need insulin injections in conjunction with antidiabetic drugs to get the body to respond to insulin.
The key is therefore curing prediabetes and avoiding the development of diabetes.
Losing 5% of Body Weight
Obesity is one of the major risk factors for developing insulin resistance. It is therefore required that people with prediabetes or diabetes reduce their body weight to within a normal BMI as soon as possible and sustain it at these levels. But what about a person with a fairly normal body weight? Research has shown that if you can reduce your body weight by 4% to 5% and maintain it at these levels for at least 3 years then you may be able to completely resolve prediabetes. There is no guarantee that it will not return but if you maintain your body weight and follow the other measures below, you chances of developing diabetes in the future is greatly reduced.
Eat The Right Foods
Healthy eating is often a confusing concept to mant people. Just what exactly constitutes healthy foods for diabetes prevention specifically? Here are two points that you need to be bare in mind. Firstly, the foods should be low in calories – exceeding your daily calorie intake is the main reason for being overweight or obese. Secondly the foods should be low glycemic index (GI) foods. As your body cannot regulate glucose as it should, by opting for low GI foods there is a sustained release of glucose rather than a sudden surge which cannot be properly controlled. Take a look at this list of glycemic index and glycemic load of over 100 foods from Harvard Medical School. Speaking to your doctor and consulting with a registered dietitian or nutritionist specializing in diabetic diets will ensure that you are eating the right foods.
Get Up And Be Active
Exercise is known for its host of health benefits. This is particularly true for conditions like prediabetes and diabetes where a sedentary lifestyle if a major risk factor. Not only does exercise help you lose weight which is beneficial own, but exercise also directly improves your glucose tolerance. Ideally you should be exercising at least 30 minutes a day for 5 days a week bringing your total weekly workout to 150 minutes. But it is not just about dedicated exercise programs. You should try to be as active as possible – even if it is a short walk from one room to the other in the house or waking up to change the TV channel rather than using the remote. Even standing still works out your body more than sitting and standing. A recent study has shown that you should stop sitting and move more to avoid diabetes.
Losing weight, eating the right foods and being more active are three main ways to cure prediabetes, prevent diabetes and even improve your diabetes if you already have it. Here are some other measures that are also important in avoiding diabetes.
Increase Dietary Fiber
Fiber in food is known to have many effects like bulking the stool and helping food move through the gut faster. It also assists with reducing cholesterol absorption from the gut. But for diabetes and prediabetes, fiber has another benefit. It can help slow down the absorption of carbohydrates from the gut into the bloodstream. This essentially means that it can alter the glycemic index of some foods. Rather than your bloodstream being flooded with glucose, small amounts are instead circulating which is sufficient to maintain the body’s needs without spiking the blood glucose levels. Read more on the benefits of eating fiber for diabetes and a list of high fiber foods that should be incorporated into your diet.
Have Regular Tests
Prediabetes may be asymptomatic. Even diabetes may not present with any symptoms in the early stages. This means that vital time is lost if you do not know whether you have prediabetes. By the time the most prominent symptoms arise, you are most likely diabetic and have been for a while. Reversing your condition will not be possible. At one time it was only high risk individuals that were advised to undergo screening on a regular basis. Now every person who is obese, has a family history or is over 30 years of age should look at going for a blood glucose test at least once every year. An oral glucose tolerance test (OGTT) is the best investigation but even a fasting or random glucose test may suffice.
Sleep and Stress
With greater research into sleep physiology, it is now becoming clear that adequate sleep is important for various aspects of your health. Insufficient sleep on a regular basis can cause weight gain, alter your dietary habits and leave you too tired to keep physically active. All of these factors may contribute to diabetes and impaired glucose intolerance (prediabetes). It can also increase your stress levels which is associated with certain stress hormones like cortisol. This in turn can affect your normal carbohydrate metabolism which in turn may affect insulin sensitivity.
Apart from sleep problems, managing your stress is therefore an important factor in diabetes prevention. Stress, be it physical or emotional, can increase your blood glucose levels. While it has not been conclusively proven that stress itself may cause diabetes, it is often noted that people who are genetically predisposed to diabetes are often diagnosed during or after very stressful events in life. This may just be due to abnormally high glucose levels due to stress which causes symptoms to become more noticeable and thereby prompting a person to be tested. But there is the possibility that stress may increase the risk of developing diabetes.
Nevertheless, there is a known link between stress and diabetes and stress management should be part of any diabetes prevention and management program.