Transcript Preventing Type 2 Diabetes

Preventing Type 2 Diabetes
Presented by:
Cindy Sass, RD, CDE
Registered Dietitian, Certified Diabetes Educator
Nov. 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 prediabetes.
 How?
Lifestyle changes

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
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 PreDiabetic range:
Cut food portions by 1/3
 Move at least 30 minutes a day
 If you are overweight, lose 5 - 10 lbs

Being aggressive makes a difference!