Diabetes Prevention: Steps to Taking Control

diabetes Rx

diabetes Rx

By Amandeep Sandhu, RD, CDE

Millions of people have been diagnosed in Canada with Diabetes and billions of dollars are invested into the health care system each year for Diabetes care.

How Many and How Much?

The number of people diagnosed with Diabetes in Canada doubled between 2000 and 2010 — from 1.3 million people to more than 2.5 million people.  From 2010 to 2020, another 1.2 million people are expected to be diagnosed with Diabetes, bringing the total to about 3.7 million. In 2010, 7.3% of the population of Canada was diagnosed with Diabetes and it is expected that by 2020, 10% of the population will meet the criteria to be diagnosed as having Diabetes. That is a lot of people.

Diabetes is also places a huge economic burden on the country – doubling from 6.3 billion dollars per year in 2000 to $12.2 billion per year in 2010. The cost of Diabetes in Canada is expected to rise by another $4.7 billion by the year 2020; that is a total of 3.5% of public healthcare spending in Canada directly attributable to the Diabetes care. That is a lot of money.

But more than an economic burden on the country, there is the economic stress on the individual and their family. Clients frequently tell Dietitians that they would have taken action to prevent Diabetes, had they been better informed. The purpose of this article is to provide some of the information needed to lower your risk of getting Diabetes.

Lowering Your Risk of Diabetes

Although genetics play a role in Diabetes, there are several things that you can do to decrease your risk.  Here are a few;

  1. Get more physical – It is recommended that people be active for at least 30 minutes a day, 5 times a week in order to benefit from improved cardiovascular health, increased strength and to help maintain a healthy weight. Research has demonstrated that resistance activity not only helps achieve lean muscle mass but decreases insulin resistance. That means that resistance training makes the cells more sensitive to insulin’s action in taking up glucose from the blood.  In addition, muscle cells during exercise can decrease blood glucose levels by taking up the sugar directly from the blood into the muscle.

2. Lose extra weight – Obesity is a prominent risk factor for Diabetes. As of 2009, one in four Canadian adults were obese (BMI >30). A modest weight loss of 5-10% of initial body weight can reduce the risks of Diabetes by approximately 60%. For a 150 pound woman, a loss of just 8 -15 pounds can reduce the risk of developing Diabetes by 60%.  For a man weighing 190 pounds, it only takes a loss of  only10-20 pounds.


How Much Should We Weigh?

Canadian guidelines for body weight classification in adults uses Body Mass Index (BMI) which is calculated by taking a person’s weight in kilograms (kg) divided by his or her height in meters squared. The resulting BMI is then classified as underweight, normal weight, overweight and three classes of obesity.

Classification BMI (kg/m2) Risk for developing health problems
Underweight <18.5 Increased
Normal weight 18.5-24.9 Least
Overweight 25.0-29.9 Increased
Class I    

Class II    

Class III

 

⩾30.0

30.0-34.935.

0-39.9

⩾40.0

 

 

High

Very high

Extremely high

Where Weight is Distributed is Important

When extra weight is distributed in the abdominal area, insulin produced by the body can’t work as efficiently, leading to insulin resistance. That means, that despite there being enough insulin being produced by our bodies, it doesn’t work as well, leading to the body producing more and more insulin in order to clear the same amount of glucose from the blood.

Just as there are Canadian guidelines for body weight classification, there are Canadian guidelines for waist circumference and it is not “one size fits all”. These figures are based on population studies of different ethnic groups and the relationship of their waist circumference to the risk of becoming Diabetic.

To lower their risk of Diabetes, people of Asian (Chinese, Japanese, Korean), South East Asian and South and Central American ethnic background need to have smaller waist circumference than those of Middle Eastern, Sub-Saharan African, and Mediterranean descent – who in turn are recommended to have smaller waist circumferences than Caucasian (white) Canadians.

Ethnicity Men Women
Asian, South and Central American ⩽90 cm ⩽80 cm
Middle Eastern, Sub-Saharan African, Mediterranean ⩽94 cm ⩽80 cm
Caucasian (white) ⩽102 cm ⩽88 cm

Charts adapted from Canadian Diabetes Practice Guidelines, 2013

3.  Get Plenty of Fiber – Fiber has shown to:

    • reduce your risk of Diabetes by improving your blood sugar control
    • promote weight loss by helping you feel full

While not directly related to Diabetes prevention, fiber will also lower one’s risk of heart disease

It is recommended that the average adult aim for 25-35 gm of fiber a day. Fiber is listed on all food labels in Canada, so referring to the food label help you choose the product with the most fiber.

Foods high in fiber include fruits, vegetables, whole grains, beans, lentils, nuts and seeds and remember to choose non-starchy vegetables more than fruit or starchy vegetables (such as peas, corn, potatoes) as both fruit and starchy vegetables can raise blood sugar more than non-starchy vegetables.

To prevent abdominal discomfort, remember to gradually increase fiber and remember to increase fluids which is needed for your body to eliminate the fiber.

4. Get screened – While lifestyle plays a significant role in developing Diabetes, genetics can significantly increase one’s risks. Research has indicated that the offspring of parents where either father or mother had Type 2 Diabetes has a 12 -14% likelihood of becoming Diabetic themselves — which increases to 30% if both parents have Type 2 Diabetes. As a result, it is imperative to have your doctor screen you for Diabetes especially if you are over the age of 40 and have any risk factors for Diabetes.

Want to know more?

If you would like to learn about preventing or delaying Diabetes or how to manage your blood sugar better living with Diabetes, Nutrition to You’s Dietitian who specialize in Diabetes prevention and treatment can support you in learning to make healthier food choices to better manage your health.

Please give us a call or send us a note by clicking on the Contact Us tab, above.

References

2013 Canadian Diabetes Association Clinical Practice Guidelines (CPGs)

Rawlings, Kelly. Diabetes: What to Eat. New York: Houghton Mifflin Harcourt, 2011. Print

Canadian Diabetes Association. in: H. Jones (Ed.) Building Competency in Diabetes  Education: The Essentials. Canadian Diabetes Association, Toronto, ON; 2008

Canadian Diabetes Association, Economic Tsunami: The Cost of Diabetes in Canada, December 2009