Mary Hartley, RD, MPH, is the director of nutrition for Calorie Count, providing domain expertise on issues related to nutrition, weight loss and health. She creates original content for weekly blogs and newsletters, for the Calorie Count library, and for her popular daily Question-and-Answer section, Ask Mary. Ms. Hartley also furnishes direction for the site features and for product development.
If you are an American adult, there’s a one in three chance that you have pre-diabetes, and in five to ten years, pre-diabetes will progress to type 2 diabetes. Diabetes is a serious metabolic condition that ravages the circulatory system over time, but the long-term damage may begin during the early stages. The good news is that you can reverse pre-diabetes by natural means.
The difference between pre-diabetes and type 2 diabetes is a matter of degree. When the Fasting Blood Glucose (FBG) is 100 – 125 mg, it is called pre-diabetes; when the FBG crosses over 126 mg, the name changes to type 2 diabetes. Diabetes has to do with the way glucose travels from the bloodstream into the cells where it is burned for fuel. In pre-diabetes and most type 2, the pancreas still makes insulin, but that insulin cannot help the cells to uptake glucose. Glucose, called ‘sugar’, builds up in the blood and ruins the little capillaries in every part of the body. One quarter of all new type 2 diabetics already have eye damage at the time of diagnosis.
Diet and exercise can easily reverse pre-diabetes and new type 2 diabetes. A long running, landmark study, the Diabetes Prevention Program (DPP), conclusively showed that people with pre-diabetes could return their blood sugar levels to normal by eating the right food and moving more – and that diet and exercise was more effective than metformin, a leading medication for type 2 diabetes. In the study, diet and exercise reversed the risk by 34 percent, while metformin alone was more effective in only 18 percent of the patients.
Those life-saving diet and exercise changes are easy to do. The ‘diet’ is to eat 500 to 1,000 calories less than that typically eaten in one day, and to eat the right type and amount of carbohydrates. The right type is unprocessed and unrefined; vegetables and fruit, dried beans and lentils, oat bran and whole grain breads and cereals fill the bill. Those carbohydrates are high in fiber, which slows the release of sugar into the bloodstream. Research shows insulin sensitivity improves on 20 to 35 grams of fiber a day. Total carbohydrate intake should provide 45 to 55 percent of daily calories; that’s roughly 250 grams of carbohydrates on a 2,000 calorie diet.
Exercise opens up the cells to receive glucose. In the DPP, 30 minutes of moderate aerobic activity a day, when coupled with modest weight reduction, was enough to normalize blood glucose. A loss of only 5 to 10 percent of excess weight did the trick. The American Diabetes Association officially recommends 30 minutes or more of exercise a day, five days a week, for a total 150 minutes or more per week. Examples include brisk walking, swimming, biking, low impact aerobics classes, and some team sports. Exercise may start gradually and increase over time and may be broken into three 10-minute intervals a day.