More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
HuffPost Social Reading
Milt Bedingfield

GET UPDATES FROM Milt Bedingfield
 

Prevent Pre-Diabetes From Becoming Type 2 Diabetes

Posted: 10/ 2/2011 9:23 am

Depending on whose statistics you are looking at, there are almost three times as many people with pre-diabetes as those with Type 2 diabetes.

The general concensus is that there are about 26 million people with Type 2 diabetes, approximately 19 million that know it and another 6-7 million that do not. This means that there are a whopping 72 million with pre-diabetes, those with fasting blood sugar levels greater than 100mg/dl. but less than 126mg/dl. Normal blood sugar levels are less than 100mg/dl. first thing in the morning before eating.

What is so very unfortunate is that the vast majority of the 72 million people with pre-diabetes will end up developing Type 2 diabetes in the not-to-distant future. And although Type 2 diabetes is highly treatable, it is not curable, and these newly-diagnosed Type 2s will have it for the rest of their lives. In spite of what you may read or hear, Type 2 diabetes is not reversible or curable. Even with weight loss the best you can hope for is that it will be better managed.

You see, generally speaking, when you are a smaller person -- particularly if you are smaller because you carry less fat on your body -- you need less insulin than if you are a larger person. Someone that can lose a lot of excess fat and reduce their body weight can oftentimes get by with producing less than normal amounts of insulin. In these cases it may be that you can get by with the limited amount of insulin that you are still able to produce. If blood sugar levels return to normal, it is likely many people would think that the diabetes is cured, when in reality it is well-managed. It is this type of scenario that confuses people and leads them to believing that their diabetes went away (as I have heard often) or is cured.

As a certified diabetes educator for the last 18 years, what frustrates me the most is that in the majority of cases of pre-diabetes, particularly those with an early diagnosis, developing on to Type 2 diabetes is preventable. This is worth repeating. If those people with pre-diabetes make some serious lifestyle changes immediately, then the development of Type 2 diabetes may be prevented.

People with pre-diabetes need to be told at the time of their diagnosis, rather emphatically, what they need to do to lessen their chances of eventually developing Type 2 diabetes. Instructions need to be given. Referrals need to be made. The seriousness of the diagnosis needs to be conveyed to the newly-diagnosed patient. The patient needs to know that they may be able to avoid diabetes if they do this, this and this.

Newly-diagnosed pre-diabetes patients need to seek instruction on how much exercise to engage in, how to improve meal planning and how much weight needs to be lost. Taking this advice and acting on it quickly is likely to mean the difference in developing diabetes or not.

 

Follow Milt Bedingfield on Twitter: www.twitter.com/Iknosugar

Depending on whose statistics you are looking at, there are almost three times as many people with pre-diabetes as those with Type 2 diabetes. The general concensus is that there are about 26 million...
Depending on whose statistics you are looking at, there are almost three times as many people with pre-diabetes as those with Type 2 diabetes. The general concensus is that there are about 26 million...
 
 
  • Comments
  • 51
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
Page: 1 2  Next ›  Last »  (2 total)
07:44 PM on 10/10/2011
Thank you for your post. I have been advocating for Diabetes Education classes that are appropriate for those newly diagnosed. I do not feel like a diabetic or have to take medicine, so going to seminars with folks who have already undergone amputations makes me feel like I am in the wrong room. Reading the comments, I can see that I need to change my thinking about things. I am still holding onto my "pre-diabetes" diagnosis, and not accepting that my numbers do keep inching up. Having seen two parents suffer with untreated diabetes, I have tremendous fear of the disease. You are shaking my comfort zone, and I thank you. And I can see that I need to be more pro active with my health and become my own advocate.
http://bluestarmoon.wordpress.com/
09:05 PM on 10/04/2011
Read "Sugar Nation" by Jeff O'Connell. It's his personal story of trying to get his pre-diabetes under control. He shows how morally and intellectually bankrupt the current authorities are in recommending that people who have developed an intolerance to carbohydrates should continue to eat half their calories from the very foods they cannot tolerate. He concludes that a low-carb diet and exercise is the correct therapy. He is right.
04:32 PM on 10/09/2011
I second this recommendation. It's a great book, not just because it outlines "a cure" but because it also explains how/why the medical establishment so often gives pre-diabetics and type II diabetics exactly the wrong advice.
09:16 PM on 10/10/2011
I will check it out.
photo
HUFFPOST SUPER USER
William Anderson LMHC
Licensed Psychotherapist, Weight Control Expert
07:11 AM on 10/04/2011
Almost all of my patients are successful with weight loss, and almost all of them with pre-diabetes and Type 2 diabetes can eliminate the medications they had to take for those conditions. Their doctors tell them they have cured themselves, that the diabetes has been reversed. They have the same experience with high blood pressure. How do you explain this difference in opinion that you and their doctors have about the weight loss curing and reversing their diabetes?

William Anderson, LMHC
Author of 'The Anderson Method - Secrets of Permanent Weight Loss'
www.TheAndersonMethod.com
02:59 AM on 10/05/2011
When people start metformin (or other oral hypoglycemics) when they first develop type II diabetes, I think it's a shame... It just gives them a false sense of security, and a reason not to change their lifestyle (which in most cases will completely cure them). Why would people completely overhaul their diet and start exercising when quickly taking a pill can keep their glucose temporarily at safe levels? I say temporarily because eventually many progress to insulin-dependence simply because they didn't change their lifestyle. I think giving these patients metformin is like putting a band-aid on a festering wound and hoping it will get better without antibiotics...
photo
HUFFPOST SUPER USER
William Anderson LMHC
Licensed Psychotherapist, Weight Control Expert
08:48 AM on 10/05/2011
I agree. But is irrational, dishonest and unhealthy to think that ingesting an unnatural chemical (to compensate for the damage due to a disease) is the same as a cure. It is always a problem when people allow themselves to believe things that are not true.

The truth is that taking a pill to keep glucose levels safe does not reverse the disease process. If the unhealthy behaviors continue, the disease process continues. To think otherwise is dishonest and irrational. People overhaul their lifestyle even when a pill would keep their glucose level safe because they know a pill is not a cure, and they want to get better and get off the pills. People who choose otherwise are playing the fool, a poor decision, yet one that they are free to make, with dire consequences.

Why change diet and exercise when a pill will keep them safe at the moment? Because that is what is required to treat the illness properly. The pill won't do it, and if you don't treat the illness properly, you are choosing to get worse when you could be choosing to get better.
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:23 AM on 10/10/2011
I wholeheartedly agree. Very well said. Why is it so hard for peopkle to understand this?
photo
HUFFPOST SUPER USER
stonemann
02:34 AM on 10/04/2011
Milt, you’re beating around the bush. The bottom line is at the turn of the 20th century, Americans on average consumed 5 lbs of sugar per person per year and diabetes was practically unheard of. Today, the average American consumes 120 lbs of sugar per person per year and syndrome X along with diabetes is an epidemic. See a pattern here?
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:35 AM on 10/10/2011
I agree with you. The tremendous increase in sugar consumption since the turn of the century has definitely increased the number of people with type 2 diabetes. With better technology as well as other reasons, we are also a far less physically active country than we were years ago, also contributing to type 2 diabetes. Thanks for the comment.
ThatsTheTheWayItIs
religion, ideology, partisanship are delusional
03:27 PM on 10/03/2011
"The Zone" is about controlling insulin levels. The book was written by Barry Sears PhD, a biologist and diet researcher. It's not the fad diet people think, you don't just eat bacon. It's basically the Mediterranean diet, "white protein", he doesn't like fatty red meat or eggs.

The Zone is 40% carbs (unprocessed, from vegetables), 30% fat (mainly unsaturated, olive oil, avocados) and 30% lean protein. He claims average American diet is 60% carbs. He also thinks vegans can follow The Zone with some effort, has recipes. It's interesting stuff, worth reading.
HUFFPOST SUPER USER
DrP
11:31 PM on 10/03/2011
Still too high in carbohydrates for people with insulin-resistance, the underlying condition that causes "type II diabetes." The Zone may be better than the SAD, but for those with glucose-intolerance, it is necessary to restrict carbohydrates to under 50 grams a day, even lower for many. A ketogenic diet is logical, because fat is the nutrient class that does not require insulin to metabolize. There is nothing wrong with eating "fatty red meat or eggs" because there is not one shred of scientific evidence that those foods cause any health problems. (Real science, not observational studies which are not science).
05:24 PM on 10/04/2011
There are multiple types and underlying conditions that present as what we presently call "Type 2 diabetes". Only one of them responds specifically to total restriction of carbohydrates. The others that respond to dietary changes respond to overall caloric restriction, or to restriction of processed or refined carbohydrates, or to restriction of simple sugars, or to restriction of grains (particularly wheat).

Please do not paint all types of persistent non-autoimmune hyperglycemia with the same brush. You are only doing those of us who live with one or more of those conditions a disservice.
ThatsTheTheWayItIs
religion, ideology, partisanship are delusional
03:15 PM on 10/03/2011
Thanks for noting that only a change of lifestyle can prevent diabetes. Drugs can't.
HUFFPOST SUPER USER
mkthinker
11:54 AM on 10/03/2011
My grandfather had Type 2 diabetes. He was always a little guy so I doubt it was excess fat in his case (little as in 5'4 maybe 130 pounds tops, probably less). He controlled it completely with diet, he would read his blood sugar several times a day - NEVER ate refined sugar (or alcohol) in any form and never needed insulin to control his blood sugar. He did eat balanced meals and completely followed the American Diabetes Association's recommendations and that worked for him. I remember he had this unsalted unsweetened rice cake that tasted like cardboard and those where his snacks. He ate rice, bread- but it always had to be with something. The thing is, lots of people misunderstand the Glycemic Index, and that is a shame because 1- it's an average of all types of people and different diabetics have different reactions to certain things. In reality YOU may spike from eating rice with chicken but someone else won't. YOU NEED TO DO YOUR OWN READINGS. and 2 - eating fat with carbs deadens the glucose spike for almost everyone. This is a somewhat complicated science that a bunch of people are trying to jump to conclusions without fully understanding it. Please don't encourage others to not listen to the American Diabetes Association though. Because those people really have helped a lot of diabetics live without needed injected insulin and they know more about this topic then almost everyone.
ThatsTheTheWayItIs
religion, ideology, partisanship are delusional
03:29 PM on 10/03/2011
The food with the highest measured glycine index is - rice cakes, I kid you not. I've been reading The Zone. It's a technical book, not a diet book.
HUFFPOST SUPER USER
DrP
11:46 PM on 10/03/2011
Read the list of the ADA corporate sponsors and then decide if your trust their advice. They are all big pharma and processed food manufacturers.
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:40 AM on 10/10/2011
Information diseminated by the the ADA has probably helped far more people with diabetes than were ever harmed by the organization. I find it unfortunate that in some of these comments they are spoken of so poorly.
This user has chosen to opt out of the Badges program
11:17 AM on 10/03/2011
Prevention through lifestyle changes is a wonderful idea. It's been on the table as long as the diabetes crises has been identified. And it works!

Unfortunately, changing ones diet, exercise, and ultimately lifestyle; isn't very popular. Most people have chosen to continue until they actually develop diabetes and then enter the medical industries preferred treatment path. Of course, the author is frustrated. He's offering a proven pathway to better health, and most a rejecting it.

If look at this in isolation, it seems insanely odd. If we accept it within the broader context of today's American lifestyle, it fits perfectly. Our lives are filled with similar incidents of insanity. Just look at how much of our lives are built around fantasy. Cigarettes are back in fashion. So, is the punative approaches toward poverty. And as a country, we are still addicted to imported oil, and it's getting worse. Here in the southwest, we've got more than 100% of the average rainfall in the entire Colorado River basin allocatted. So, we've shut off the water to Mexico, which is their riparian right. And the lakes are all only partially full.

Americans should be electing Christie for president, because he is most representative of our lifestyle. He's killing himself by eating himself to death. Why should your patients by any different?
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:41 AM on 10/10/2011
Thanks for your comments.
08:10 AM on 10/03/2011
What's the differance? For a pre-diabetic to avoid type II diabetes, you basically have to follow the same rules as if you had type II diabetes.
08:22 AM on 10/03/2011
Oops. "difference"
photo
HUFFPOST SUPER USER
Pat Bateman2000
How did the Cat get so fat?
08:30 AM on 10/03/2011
I agree. Exercise, Eat more protein and fruits and veggies, cut the carbs. Avoid things that will spike your sugars like juices. There are Glycemic Indexes out on the web that are good tools to use to see what works and what doesn't.
HUFFPOST SUPER USER
DrP
11:33 PM on 10/03/2011
Fruit? High in fructose in other sugars? Not a good choice.
06:49 AM on 10/03/2011
I've been told glucose of 100 is normal. no?
photo
HUFFPOST SUPER USER
Pat Bateman2000
How did the Cat get so fat?
08:28 AM on 10/03/2011
Fasting or not? The ADA and the AACE have different guidelines as to what is normal and what is not and the ways to test.
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:45 AM on 10/10/2011
A fasting blood sugar between 101mg/dl and 125mg/dl is considered prediabetes. Two fasting blood sugars above 126mg/dl is considered type 2 diabetes.
photo
HUFFPOST SUPER USER
katmeyster
Proud practical progressive atheist
01:32 AM on 10/03/2011
Stop eating carbs, processed food, frankenfoods, and of course sugar in all its forms. Whatever you do, DO NOT follow the American Diabetes Association recommendations for diet -- they'll turn you from pre-diabetic to diabetic soon enough. Recommend Richard Bernstein's Diabetes Solution. So does our enlightened, well-researched, endocrinologist.

Some lower blood glucose levels by losing weight, but its really the carbs that are key for many people.
10:04 AM on 10/03/2011
Thanks for the caution about the American Diabetes Association. I'm hypoglycemic and have Type II in the family, so I know that cutting out sugar/carbs is the only way to control both. Imagine my surprise when an acquaintance was diagnosed with pre-diabetes and was told (by a nutritionist following ADA guidelines) to eat "balanced meals," including complex carbohydrates! I do agree that very limited servings of whole grains and fruits may be reintroduced cautiously after blood sugar and weight are under control, but that "complex carbs at every meal" nonsense is a road leading straight to diabetes.
photo
HUFFPOST SUPER USER
SamH
Writer of stuff.
10:51 AM on 10/03/2011
Complex carbohydrates process differently than something like raw sugar. The latter causes a huge spike in blood sugar and can, over time, damage the pancreas. The former allows for a more normal increase in blood sugar over time and a far less stressed pancreas.

We need carbohydrates in order to live and not all are bad news.
photo
HUFFPOST BLOGGER
Milt Bedingfield
10:50 AM on 10/10/2011
I think everyone agrees with reducing the carbs. How about also increasing the physical activity to increase insulin sensitivity and glucose uptake in the cells? It is not totally, 100% about diet. And unfortunately it seems popular to put down the ADA in these comments. I seriously doubt following an ADA diet has ever been responsible for causing a prediabetic to become a type 2.
photo
HUFFPOST SUPER USER
sacmom3
Watch out! They're wearing Hoodies!
12:48 AM on 10/03/2011
Great article.
HUFFPOST SUPER USER
DrP
10:29 PM on 10/02/2011
Cut the carbs - that's the simple, and most effective answer. I did it 12 years ago and have never had a high fasting blood sugar in spite of a major family history of "diabetes" and prior years of symptoms of insulin-resistance that I didn't recognize. Any physician that does not prescribe carbohydrate restriction to "pre-diabetics" should be considered guilty of malpractice.
HUFFPOST SUPER USER
tomofsnj
08:37 PM on 10/02/2011
I just got my blood test back on last thursday. The results were excellent and I hope others will understand following rules do make a difference. In one year without any medicine i was able to have no change in statues. Read the pages and if you trust the people follow their instructions.
HUFFPOST SUPER USER
Chas53
08:33 PM on 10/02/2011
Antiquated information. Type II Diabetes is a food borne illness and it is definitely curable by diet.
http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107
This user has chosen to opt out of the Badges program
photo
12:30 AM on 10/03/2011
Bunk!