November is Diabetes Awareness Month. As we end this month dedicated to raising awareness of diabetes, here are some thoughts, facts and resources to share with you regarding an important topic and that affects so many people.
For almost 25 years, I have been honored to work with clients week in and week out who struggle with all types of diabetes (or pre-diabetes) and who work very hard to stay healthy. Even before I finished my schooling, I was interested in this area of nutrition and health. I volunteered at a summer camp for children with type 1 diabetes. We went cabin to cabin checking blood sugars at 3 am. This was way before continuous glucose monitors and insulin pumps. These advances in technology have helped those with type 1 diabetes, and their families, live a better life but managing type 1 diabetes is a 24/7 job. I salute you all.
In the days after Thanksgiving, I am thankful for the people and families I have met and continue to meet, hearing their stories and helping them better their health. There is a steep learning curve when someone is diagnosed with diabetes (whether it is type 1, type 2 or gestational diabetes) and I am passionate about helping people navigate this curve!
Diabetes by the numbers
Of those diagnosed with diabetes 90-95% have type 2 diabetes and approximately 5% are estimated to have type 1 diabetes. (1)
Type 1 diabetes is an autoimmune disease where the body attacks the insulin producing cells of the pancreas. Once the cells stop producing insulin, injections or infusion of insulin through a pump is essential for people with type 1 diabetes. (2)
Type 2 diabetes is when your body doesn't use it's insulin properly, generally result of insulin resistance and over time less insulin being produced by the body. Type 2 diabetes is managed with diet and lifestyle changes, oral medication, insulin or other injectable medications.
Gestational diabetes, occurs in 2-9% of all pregnancies and this type of diabetes is thought to be related to hormones in pregnancy that block the action of insulin and often goes away after pregnancy. (1) It is important to have follow up care to test for diabetes after pregnancy.
The National Diabetes Statistics Report (click here to read more) from the Center for Disease Control gives the most recent numbers about Diabetes. 30.3 million people in the US or 9.4% of the US population had diabetes in 2015. Unfortunately out of those 30.3 million people, 7.2 million of those people did not know they had diabetes. That is almost 25% of those with diabetes that don't even know they have it! (3)
Lifestyle as prevention for Type 2 Diabetes
When we talk about prevention of diabetes, we are referring to type 2 diabetes. There is no prevention associated with Type 1 diabetes.
An estimated 33.9% of the adult US population has pre-diabetes but only 11.6% of this population had been told by a health professional about their pre-diabetes! (3) This is also unfortunate since those at risk for developing diabetes can significantly reduce their risk by engaging in regular physical activity (150 minutes per week) and losing a modest amount of weight, (approximately 5-7% of current body weight). A large study called the Diabetes Prevention Program (DPP) looked at reducing the risk of developing diabetes with lifestyle and also with medication (metformin). Those assigned to the lifestyle group showed a 58% reduction in risk of developing diabetes throughout the study. Those in the medication group also reduced their risk but not as significantly as those in the lifestyle intervention. Since that original study, a 10 year follow up study showed continued benefit and risk reduction. Read more here about the follow up study, The Diabetes Prevention Program Outcomes Study (DPPOS).
What are some simple things you can do to either achieve better blood sugar control if you already have diabetes or if you are in the pre diabetes range?
The first thing is to stay on top of regular doctor appointments so you know what your numbers are. Here is a quick test from the American Diabetes Association to assess your risk of type 2 diabetes and to start a conversation with your doctor. If you have diabetes it is important to know your HgbA1c, cholesterol and blood pressure numbers as well.
Secondly, working on improving the quality of your diet, is key in better blood sugar control. Meeting with a registered dietitian to come up with a realistic plan to help you achieve your individual goals is a great place to start. Changing your diet does not require you to avoid all carbohydrate but to be mindful of sources and portions of carbohydrate. Choosing those carbohydrates which may provide a benefit (such as whole grains, beans, and vegetables) and allow for better blood sugar control. Testing blood sugar before a meal and then again 2 hours after eating can help one learn about the effect of a particular meal on their blood sugar.
Lastly, moving more helps as we learned from the Diabetes Prevention Program. Exercise is important but so is activity and movement throughout our day. Going to the gym and getting on the treadmill is great but we miss out on opportunities to increase activity throughout the day if we never make it to the gym. Parking further away, taking the stairs, walking to do errands when possible, or walking to lunch are great ways to log steps through the day. No amount of exercise or activity is too small! One of my clients aims for walking at least 250 steps every 30 minutes while at work and then walks 1 mile in the morning and 1 mile in the evening. People with type 1 diabetes or those with type 2 diabetes on insulin (or some other medications) have to consider other things when adding exercise to their routine but it can be done.
Below are some resources to find out much more about diabetes, preventing diabetes or living a better life with diabetes.
Resources, click on the red area
American Diabetes Association diabetes.org
Juvenille Diabetes Research Foundation: jdrf.org
Center for Disease Control/Diabetes www.cdc.gov
Diatribe.org Online publication
Joslin Diabetes Center joslin.org
National institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
1. American Diabetes Association
2. Juvenile diabetes research foundation jdrf
3. Center for Disease Control, National Diabetes Statistics Report