Preventing Type 2 Diabetes

Presented by:Cindy Sass, RD, CDERegistered Dietitian, Certified Diabetes EducatorNov. 12, 2013

The Blood Sugar Blues

In 2009 2.4 million Canadians had type 2 diabetes.

Numbers are predicted to climb to 3.7 million by 2019 .

Porrly controlled Diabetes can lead to heart attack, stroke, kidney failure, blindness, nerve damage, and amputations.

Over 40% of people with diabetes don’t know they have it.

The Gathering Storm

What worries experts the most are the estimated 4 million people who have “pre-diabetes”.

Pre-diabetes is the term that is used to describe people who’s blood sugar is higher than normal, but not high enough to be called diabetes.

Most of them don’t know they have it.

The Gathering storm cont’d

Between a third and a half of people with pre-diabetes will develop diabetes.

Pre-diabetes in itself is a risk factor for heart disease (1 ½ times increased risk).

Do You Have Pre-diabetes?

Fasting blood sugar (12 hour fast) of

6.1 – 6.9 mmol/L.

Previously called Impaired glucose tolerance or Impaired fasting glucose.

Diabetes

7.0 mmol/L or higher

Pre-Diabetes

6.1 mmol/L or higher

Normal

Below 6.1 mmol/L

What’s Your Risk ?

Your risk is higher if you: Are age 40 or over. Are overweight. Have a parent, brother or sister with diabetes. Are of Aboriginal, Hispanic, Asian, South Asian, or

African descent. Have high blood pressure (above 140/90). Have low HDL cholesterol (< 1.0 mmol/L for men, <

1.30 mmol/L for women). Have had diabetes when pregnant or gave birth to a

large baby (over 9 lbs). Are active fewer than 3 times a week.

Diabetes can be delayed or prevented!

Research studies done over the past decade have demonstrated that you can prevent or delay diabetes even if you have pre-diabetes.

How?

Food intake: lower calorie, low fat low saturated fat high fibre (25-50 grams)

150 minutes of moderate intensity physical activity per week

Resulted in a 5% reduction in body weight

Lifestyle changes

Diabetes Prevention Program Results

Diet and exercise lowered the risk of diabetes by 58%.

The results showed:Small changes work.A modest amount of weight loss (5%) and

exercise (30 min/day) was enough.

Don’t Weight

Weight loss is key. 4 out of 5 Canadians with type 2 diabetes are

overweight. In type 2 diabetes the body’s cells become

resistant to the hormone insulin. The consequences of insulin resistance are

not healthy: It may cause high blood pressure High triglycerides Inflammation in the blood vessels.

Don’t Weight cont’d

When insulin is not doing its job, blood glucose levels start to climb.

The pancreas secretes more insulin to keep up, gradually the pancreas tires out.

This is when blood sugar levels rise into the diabetic range.

Losing weight and exercising helps insulin work better.

How to lose weight?

Build your diet around vegetables, whole grains, lean meat, fish, legumes and low fat dairy.

Eat regular meals. Be aware of

portions. Move more.

Beyond Weight Loss

Weight loss is a slam dunk in keeping diabetes at bay.

Even without weight loss, overweight people can reduce their risk if they eat healthy, stay active and don’t smoke.

Beyond Weight Loss - smoking

Smokers have a higher risk of developing diabetes

Beyond Weight Loss - Exercise

Half an hour of brisk walking or similar aerobic activity lowers the risk.

Beyond Weight Loss – Good Fats

Using polyunsaturated oils (vegetable oils, nuts, salad dressing) and less saturated fats (meat, cheese, butter) and less Trans fat (muffins, donuts) lowered the risk.

Beyond Weight Loss- Good Carbs

Risk is lower in people who consume more whole grains - rich in fibre and magnesium.

People with diabetes who have a high fibre diet have better outcomes.

Aim for 25-50 grams of fibre a day. (CDA handout)

Beyond weight loss -Glycemic Index

Replace food high on the glycemic index with foods low on the glycemic index. ( see CDA handout)

Sweet potato instead of regular potato

Pumpernickel bread instead of white bread

Oatmeal instead of rice krispies

Beyond Weight Loss – Alcohol

Women who had as little as ½ drink a day had a lower risk of diabetes than non-drinkers.

Men who had one or two drinks a day have a lower risk than men who drink less often.

Heavy drinking may increase diabetes risk.

Beyond Weight Loss - Coffee

Women or Men who drank 4 – 5 cups of regular coffee a day had a 30% lower risk than those who almost never drank coffee.

Don’t add cream or sugar, use milk and try cinnamon vs. sugar.

Beyond Weight Loss – Processed Meats

Women or Men who ate bacon, hot dogs or sausage at least 5 times a week had a 90% higher risk (women), 40% higher risk (men) of developing diabetes.

Beyond Weight Loss – Dietary Advanced Glycation Endpoints

Thermal food processing at very high temperatures, such as frying, broiling and grilling, results in formation of dietary advanced glycation endproducts.

These endproducts can affect how your body uses insulin.

Cook food at low temperatures, preferably in liquid to avoid dAGE’s.

Sugary drinks

Drinking one sugary drink a day increased diabetes risk by 15%.

Drinking 2 per day, increased risk by 26%.

Sugar

Reduce your intake of added sugars

Women should limit their intake to 5 tsp./day (25 grams of sugar)

Look at labels

Don’t worry about the sugar in whole fruits

In nature, sugar almost always comes packaged with fibre which slows its absorption and gives you a sense of satiety before you have consumed too much.

That’s why you are better off eating the fruit than drinking the juice.

Get Tested

Most people with pre-diabetes don’t know they have it.

The only way to figure out is to get your blood sugar tested.

Everyone 40 years or older should have their blood sugar tested at least every three years.

Get Tested

If your results come back in the Pre-Diabetic range:Cut food portions by 1/3Move at least 30 minutes a day If you are overweight, lose 5 - 10 lbs

Being aggressive makes a difference!