Nurse’s Notes: Diabetes can be prevented
By JENNIFER TROUPE | Posted: Tuesday, March 8, 2011 12:30 am
Our nation is evolving into a sedentary, supersized, quick-fix culture, playing a significant role in the epidemic of
type 2 diabetes.
Recent data from the Centers for Disease Control and Prevention indicate 8.3 percent of Americans have diabetes,
which equates to 26 million people. Seventy-nine million Americans ages 20 and older are at risk for type 2
diabetes. It is destructive and costly to both the people with the disease as well as to our society.
In type 2 diabetes, the cells in our body are unable to recognize and use insulin, a hormone produced from the
pancreas that converts food into energy. This is called insulin resistance. Insulin deficiency results and then
contributes to high blood sugars that damage the major organs of the body.
Before people develop type 2 diabetes, they almost always have "prediabetes." In prediabetes, the main culprit is
also insulin resistance. If we can make our cells more sensitive to insulin, we can prevent type 2 diabetes. People
with prediabetes have an increased risk of heart disease and stroke.
Prediabetes is diagnosed by a lab test. The test can be fasting or nonfasting. If the fasting glucose is between 100 and
125 mg/dl and nonfasting is between 140 and 199 mg/dl, this indicates prediabetes. The hemoglobin A1C lab test
was recently approved for diagnosing prediabetes. If your A1C is between 5.7 percent and 6.4 percent, you have
prediabetes.
Two main factors that contribute to prediabetes are being overweight (body mass index of 25 to 29.9) or obese (BMI
of 30 or greater) and being inactive. Other risk factors include:
• Family history, such as having a parent with type 2 diabetes.
• Ethnic background, such as being a Pacific Islander, Native American, African American or Hispanic.
• Delivering a baby weighing 9 pounds or greater, or having a history of gestational diabetes.
• High blood pressure, low HDL, high cholesterol or high triglycerides.
• Polycystic Ovarian Syndrome.
• History of cardiovascular disease.
• Waist measurement of 40 inches or more for men or 35 inches or more for women.
A recent landmark study called the "Diabetes Prevention Program" demonstrated that losing 7 percent of your body
weight and exercising 150 minutes a week in the form of a walking program prevented diabetes in at-risk people by
58 percent. In people 60 and older, it had a prevention rate of 71 percent. In 2009, a follow-up study was completed
called the "Diabetes Prevention Program Outcomes Study" that indicated prevention or delay of type 2 diabetes with
lifestyle was shown to persist for at least 10 years.
Can diabetes be prevented? Yes!
If you are at risk:
• Lose 7 percent of your body weight if your BMI is greater than 25.
• Exercise 150 minutes a week.
• Go to your doctor and ask for a lab test for diabetes by age 45.
• If your labwork is normal, get tested every three years; if it is abnormal, get tested every year.
• Contact your local hospital to see if it hosts a diabetes prevention program that can give you ongoing support and
education to prevent diabetes.
Remember, when it comes to diabetes, you can play a role in preventing this crippling disease.
Jennifer Troupe is a registered dietitian, certified diabetes educator and program coordinator for Diabetes Care
Services at St. Patrick Hospital.