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How About a Pedometer for Christmas?
(Prediabetes)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 32 in the December 8, 2010 issue of The Mississauga News
under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

There is a relatively new term floating around called"prediabetes", and it is linked to inactivity. Your doctor may have talked to you about it already. It is in no way an attempt to scare people, but one aimed at prevention. Diabetes is a disease that is still an expanding entity in Canada.

Many people believe that having diabetes simply means that they consume too much sugar. Diabetes refers to the sluggish nature of how our body cells get their fuel. Insulin is a natural peptide hormone produced in our pancreas. I try to think of it as a key that opens the gas tank into our cells. If it fits poorly, then the energy acquiring process slows down. This creates a backlog of sugar along the delivery highways of our blood.

Measuring this backlog of sugar in the blood provides one clue to a problem. Without proper energy to burn, your cells fatigue, and with all that sugar floating in your blood, more water is needed to prevent sludge, so you get thirsty. Your kidneys work overtime trying to get rid of the excess, and this produces more trips to the water closet. One thing leads to the next, and eventually, filtering all this excess will cause the kidneys to deteriorate.

To prevent diabetes, you need to recognize the early warning signals. If you fast for at least 6 to 8 hours, and your blood sugar is in the 6.1 to 6.9 mmole/L range, then it may indicate the first signs of a problem. If you suffer from obesity (Body Mass Index - BMI 30 or greater), have a family history of diabetes, suffer from high blood pressure or you smoke, then you are at risk for developing diabetes. Leading a sedentary life style increases this risk.

I often have a confounding conversation with people who feel that their eating habits have not changed much since they were 30 years old, but yet seemed to have put on that extra 30 or 60 pounds. It is a simple equation that has held true over the millennia. Obesity is not about gluttony or massive eating behavior. It is about failing to burn small amounts of excess calories on a regular basis. These very small seemingly negligible amounts add up in the long run. A pound every couple of months seems miniscule, but over ten years, it becomes a heavy burden.

In our society, we seem to love our carbohydrates because they give us quick energy and are found in foods that don't spoil easily. Prediabetes is one result. There are very few things in medicine that respond amazingly well to a tweak in our behavior, and unfortunately for the pharmaceutical giants, prediabetes is one of those entities. EXERCISE! You can almost use the "cure" word in the same sentence.

I have witnessed the prediabetes state disappear when people start to move more and eat a little differently. It is not easy. Years of sedentary behavior is often cemented behind walls of self-justification. Starting to move more hurts, at first. It aches and you need support from those around you, but the benefit is worth it. Start with a simple walk around the mall or block. If you didn't gain 10 pounds in a week, don't expect to lose it fast either.

Looking for a Christmas present? A pedometer measures your activity level, and 5000 steps a day will lead to better health and a new you.


Related resources:

Eye On Pre-Diabetes. YouTube video, 1:26 min.

Pre Diabetes - Metabolic Syndrome explained by John Close, Publisher of DiaTribe. Video from Videosurf.com, 4:18 min.

Health Files: Pre-Diabetes video from CNN. Managing pre-diabetes can help you avoid full-on diabetes. (Ad at beginning).

Do you have pre-diabetes? From Rant and Rave, YouTube video, 2:37 min.

Prediabetes from Wikipedia, the free encyclopedia. Classification: Impaired fasting glycaemia, Impaired Glucose Tolerance, Signs and symptoms, Cause: Genetics, Pathophysiology, Prevention, Screening, Diagnosis, Management, Prognosis, Epidemiology.

Diabetes Basics: Prediabetes from American Diabetes Association. "Before people develop type 2 diabetes, they almost always have 'prediabetes' - blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 57 million people in the United States who have prediabetes."

Put diabetes on hold by Elizabeth Rogers, from Healthy Living, 50plus.com. "Recognizing and treating pre-diabetes may delay or prevent type-2 diabetes -- and all the complications that go with it . . .

By 2010 three million Canadians will have diabetes, according to statistics from the Canadian Diabetes Association. It will cost our health care system $15.6 billion, and people with diabetes will pay between $1000 to $15,000 a year out of their own pockets for medications and medical supplies . . .

Catching pre-diabetes - That's where pre-diabetes (also known as 'impaired glucose tolerance' or 'impaired fasting glucose') fits in . . .

Catching the condition at this stage is important because doctors warn that the damage and complications associated with diabetes can actually start during the pre-diabetes stage."

Prediabetes: Symptoms by Mayo Clinic staff. "Often, prediabetes has no signs or symptoms. Darkened areas of skin . . .is one of the few signs of prediabetes. Classic red flags of type 2 diabetes to watch for include: Increased thirst, Frequent urination, Fatigue, and Blurred vision." Prediabetes: Causes, Risk factors, Complications, Tests and diagnosis, Treatments and drugs, Alternative medicine, Prevention.

Prediabetes: Risk factors by Mayo Clinic staff. Risk factors include: Weight, Inactivity, Age, Family history, Race, Gestational diabetes, Polycystic ovary syndrome, Inadequate sleep, High blood pressure, Low levels of HDL or 'good' cholesterol, High levels of triglycerides (fat in your blood).

Insulin Resistance and Pre-diabetes from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). Topics include: What causes insulin resistance? What is pre-diabetes? What are the symptoms of insulin resistance and pre-diabetes? Risk Factors for Pre-diabetes and Type 2 Diabetes, Body Mass Index (BMI), Can medicines help reverse insulin resistance or pre-diabetes?

Body Mass Index Table. BMI Chart in PDF from National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH). Check your BMI to see if you fall under the category of: Normal, Overweight, Obese, or Extreme Obesity, according to your Height (in inches) and your Body Weight (in pounds). You can print out this handy one-page chart to measure the BMI for adults from 91 lbs. to 443 lbs. in weight, and 4' 8" to 6' 3" in height.

Prediabetes Prevention by Ranlyn Oakes, eHow Contributor. "While it doesn't generally cause any symptoms, prediabetes can mean damage to your circulatory system and heart are already beginning . . . The best ways to stave off prediabetes involve diet, exercise and weight loss. Low-calorie, low-fat food choices are best."

How to Prevent Prediabetes from WebMD. "Your risk for prediabetes is higher if you are overweight and physically inactive. So: Watch your weight, Make healthy food choices, Be active, If you smoke, quit, Keep blood pressure and cholesterol under control."

Small Steps. Big Rewards. Your GAME PLAN to Prevent Type 2 Diabetes: Information for Patients from National Diabetes Education Program (NDEP), National Institutes of Health (NIH). Am I at Risk for type 2 Diabetes and Pre-diabetes? Small step for Eating Healthy Foods, Small Steps for Getting More Physical Activity, Food and Activity Tracker Copier-Ready Pages.

Diabetes & Me: Prevent Diabetes from Diabetes Public Health Resources, Centers for Disease Control and Prevention (CDC). What are the most important things to do to prevent diabetes? "Anyone aged 45 years or older should consider getting tested for diabetes, especially if you are overweight . . .

Being overweight can keep your body from making and using insulin properly, and can also cause high blood pressure . . .

If you have pre-diabetes, you have a higher risk of developing type 2 diabetes. Studies have shown that most people with pre-diabetes go on to develop type 2 diabetes within 10 years, unless they lose weight through modest changes in diet and physical activity.

People with pre-diabetes also have a higher risk of heart disease. Progression to diabetes among those with prediabetes is not inevitable. Studies suggest that weight loss and increased physical activity among people with prediabetes prevent or delay diabetes and may return blood glucose levels to normal."

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