Diabetes gets a lot of attention these days, as it should. More than 130 million US adults—half of the men and women in our country—have type 2 diabetes or an increased risk of developing it (prediabetes). Diabetes has become so common, in fact, that it almost seems normal in some families and communities.
Yet, despite its prevalence, there is nothing normal about diabetes. It’s a serious condition that can lead to amputation, blindness, heart disease, nerve damage, kidney failure, memory loss, and premature death. Plus, cases are skyrocketing—making it a “silent epidemic.”
The first step toward protecting yourself is knowing the signs and symptoms.
What Are the Signs of Prediabetes?
Signs and symptoms of prediabetes include:
- Frequent urination
- Excessive thirst and hunger
- Blurred vision
- Unexplained weight gain or loss
If you are noticing one or more of these symptoms, you want to see your physician and get your blood sugar levels tested. Knowledge is power and if your numbers are high, it’s important not to fret. It’s not your fault and it’s not your fate.
Instead, I want to empower you to be in control of your health, just as I empower the patients that I treat every day. Let’s start with the basics.
What Is Type 2 Diabetes?
After you eat, your body breaks down carbohydrates into glucose (sugar). As glucose levels rise in your bloodstream, your pancreas secretes insulin—a hormone that tells your cells to unlock and let the glucose in so it can be converted into ATP, your body’s energy.
If cells unlock to let glucose in, we call that “insulin sensitivity.” When they don’t, “insulin resistance” replaces sensitivity, and glucose builds up in your bloodstream. This triggers your pancreas to generate even more insulin. Eventually, your overworked pancreas cannot keep up, resulting in chronically high blood sugar.
Are You at Risk of Type 2 Diabetes?
One of the top risk factors for diabetes is weight. Even a small amount of weight loss can have a significant impact on blood sugar. Unfortunately, losing weight can seem like a huge, daunting task. So, I do my best to educate my patients on the importance of a healthy weight, while acknowledging that I understand it’s not simple and takes a bit of ownership, and reinforcing that a little effort goes a long, long way.
Other risk factors include:
- Family history: Diabetes has a strong genetic component, so knowing if it runs in your family is extremely important. But remember that genes are not necessarily your fate—nutrition is key here.
- Age: As we get older, our bodies can become more glucose intolerant. So, be sure to monitor it and talk to your doctor about checking it at least once a year. Although, I prefer two times per year.
- Race/ethnicity: Some segments of the population have higher rates of diabetes, including African Americans, Native Americans, Hispanics, and Asian-Americans—often because these are underserved populations when it comes to healthcare.
- Lifestyle: Inactivity and a diet heavy on excess calories, sugars, and other processed carbohydrates are associated with weight gain and a higher likelihood of developing diabetes. Other lifestyle factors that may contribute to diabetes include deficiencies in essential nutrients such as vitamin D and chromium, sleep problems, and chronic stress.
Type 2 diabetes and prediabetes can sneak up on you, and many people have no overt signs or symptoms. That’s why I emphasize periodic blood sugar testing. If any of the above risk factors pertain to you, ask your doctor to test your fasting glucose and hemoglobin A1C, which measures the average blood sugar level over the previous three months.
Even if you have no obvious risk factors, annual testing is a good idea. I used to suggest starting at age 50, but given the alarming rise in diabetes, I now recommend baseline testing by age 40—and earlier if you are at elevated risk.
Diabetes Prevention & Treatment
Although many patients take oral diabetes drugs and some end up on insulin, a solid body of research confirms the effectiveness of lifestyle changes, weight loss, and targeted nutrients for the prevention and treatment of type 2 diabetes and prediabetes.
- Supplement with Vitamin D: Did you know vitamin D is actually not a vitamin at all, but a hormone that is said to affect over 1,000 genes and is incredibly important for blood sugar balance? The reason is that vitamin D deficiency may impair insulin sensitivity. Therefore, a healthy Vitamin D level (40-60 ng/mL) should be the goal and a part of any regimen to maintain healthy blood sugar levels.
- Exercise: It’s important to get up and get moving. Ideally, you should include both aerobic and strengthening exercises and aim for some type of physical activity most days of the week. If you can’t find time to get to the gym, find 30 minutes a day to take a walk and try to reduce the amount of time you’re sitting. The best exercise to lower blood sugar is any activity that you will do. Decide on something—anything that gets your heart rate up and your muscles working—and just do it.
- Watch Your Weight: Nine in 10 people who have type 2 diabetes are overweight or obese. Losing as little as 5%–10% of your total weight can significantly improve your blood sugar levels. For weight management, I recommend a 60/40/20 plan: 60 grams of carbohydrates, 40 grams of protein, and 20 grams of fat. Eating this way can help you feel full and energized—so, try it, and see if it works for you.
- Adjust: All experts who claim to have the best diet to lower blood sugar agree on one thing: Cut out sugars and processed carbohydrates like bread, rice, and pasta, which are rapidly converted to glucose and drive up blood sugar. Replace them with whole, unprocessed foods, lots of vegetables, plenty of lean protein, and healthy fats. And be particularly mindful of portion sizes. Many people understand that too much added sugar in the diet is not good for you, but they minimize the impact of portion size, especially for foods that have more complex carbohydrates. It’s also important to increase your fiber and water.
- Take Supportive Nutrients: In addition to the basic vitamins and minerals (vitamin D, antioxidants, etc.), I recommend supplements such as berberine
for glucose control. By activating an essential enzyme called AMPK, berberine helps lower blood sugar, increase insulin sensitivity, and reduce cholesterol, which is often elevated in individuals with diabetes. Other suggested supplements for blood sugar control include cinnamon, banaba leaf, and chromium.
- Prioritize Self-Care: Do not forget the importance of what I like to call self-love. We lead busy lives and have so many responsibilities that we sometimes lose focus on what really matters. Whether this involves meditation, prayer, family time, etc., is up to you, but to maintain optimal health and balance in your life, you must prioritize taking care of yourself.
Finally, Remember It’s a Marathon, Not a Sprint
When it comes to blood sugar management, remember to be patient with yourself. I had a diabetic patient who struggled with his blood sugar for years because of difficulty managing his diet due to a lack of willpower. His A1C, which is an average measure of blood sugar over three months, remained high.
To take the pressure off him, I asked him to do just three things for me: avoid white rice, white bread, and white pasta—and anything that leaves "powder" on his fingers after eating it. (Ok, that is four things actually!)
While his numbers are not as perfect as I would have liked, he has had a marked weight loss and improvement in his baseline glucose levels, with a solid drop in his A1C levels. I told him it's more a marathon than a sprint, and you're closer to the finish line than you were previously. That’s something I encourage you to remember as well—celebrate your successes and please don’t ever give up!