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PREDIABETES Sandra Byer-Lubin, RD, CDE University Medical Center at Princeton.

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Presentation on theme: "PREDIABETES Sandra Byer-Lubin, RD, CDE University Medical Center at Princeton."— Presentation transcript:

1 PREDIABETES Sandra Byer-Lubin, RD, CDE University Medical Center at Princeton

2 Blood sugar or glucose levels are higher than normal, but not high enough to be classified as diabetes.

3 Prevalence 41 million Americans have prediabetes All will develop type 2 diabetes within the next 10 years unless they do something about it. All have increased risk of heart disease and strokes.

4 Diagnosis (by fasting blood sugar) Less than or higher (Normal) (Pre-Diabetes) (Diabetes)

5 Diagnosis (by oral glucose tolerance test) Sometimes pre-diabetes is diagnosed by drinking a high sugar beverage. Blood sugar is then checked. –Pre-diabetes: A reading of (2 hours after drinking the beverage). –Diabetes: A reading of 200 or higher ( 2 hours after drinking the beverage).

6 Risk Factors of Pre-Diabetes 45 years of age or older and overweight. Under 45 with other risk factors for diabetes.

7 Other risk factors: Physically inactive. Family history of diabetes. Are African American, Native American, Asian American, Pacific Islander or Hispanic American.

8 Other risk factors, cont’d Have had a large baby weighing 9 lbs. or more or have had gestational diabetes. Have high blood pressure. Have low HDL cholesterol (35 or lower) or high triglycerides (250 mg/dl or higher).

9 How Food is Digested 1. Food enters stomach 5.Insulin unlocks receptors 4. Pancreas releases insulin 2. Food is converted into glucose 3. Glucose enters bloodstream 6. Glucose enters cell

10 Pre-Diabetes 1. Food enters stomach 5.Insulin does not fully unlock receptors 4. Pancreas releases insulin BUT 2. Food is converted into glucose 3. Glucose enters bloodstream 6. Glucose cannot enter cell and glucose builds up in the blood 7. Liver dumps more glucose in the blood because the cells are “hungry”.

11 Insulin resistance is the main problem!

12 How to help insulin work better: Increase physical activity. Eat a healthy balanced diet. Lose a little weight if needed. Take prescribed medication.

13 Healthy Eating: The first step

14 When should you eat? Eat regular meals about 4-5 hours apart. Skipping meals can cause weight gain and then more insulin resistance. Eating 3 smaller meals and a few snacks may also be helpful.

15 Increase fiber! Fiber helps you feel full and can help with weight loss. Fiber aids in regularity. Fiber helps to lower cholesterol.

16 You can get more fiber by eating: –Beans –Whole grains (5 g fiber/serving for cereal, 2 g fiber/slice of bread) –Whole fruits instead of fruit juice. –Vegetables.

17 Know your vegetables…… Starchy veggies are good for you, but limit the amount, if you are having other carbs with your meal ½ cup= 15 gm carb/1 carb choice or serving Non-starchy veggies eat all you want (no need to measure). ½ cup= 5 gm carb

18 Starchy Vegetables These are nutritious and high in fiber, and are counted as Carbohydrates, not vegetables: –Corn - Peas –Potatoes - Sweet potatoes

19 Eat more low starch vegetables !/2 of your plate should be these vegetables.

20 FOODS TO AVOID –Sweet tea –Regular sodas –Lemonade –Kool-Aid –Gatorade FREE FOODS (5 g or less carbohydrate and 20 calories or less) Sugar Substitutes –Equal –Splenda –Sweet N’ Low Diet Soda Unsweetened Tea Crystal Light Sugar Free Flavored Waters Sugar Free Jello Sugar Free Popsicles

21 Decrease amount of: Fruit juice to 4-6 oz a day Desserts and other sweets High fat foods Salty foods (if blood pressure is high) Alcohol (especially if overweight and/or elevated triglyceride level)


23 Carbohydrates give you energy. Starch Fruit Milk All carbohydrates turn to sugar (glucose). It’s a good idea to eat some healthy carbohydrates at each meal, even if you have pre- diabetes !

24 Try to eat: WOMEN 2-4 carbohydrate choices each meal or gm carbohydrate each meal 6 fists of carbs a day MEN 3-5 carbohydrate choices each meal or gm carbohydrate each meal 9 fists of carbs a day

25 Shredded Wheat

26 Bread

27 Potatoes

28 Beans

29 Peas and Corn

30 Light Yogurt

31 Milk

32 Apple

33 Treats 2-3 times a week Small portions Check carbohydrate content: gm = 1 carb choice or portion

34 Pudding

35 Moderation with Proteins 32 oz steak dinners are out Protein foods include Red meat Poultry Fish Cheese Eggs Nuts Tofu

36 How Much Protein Foods? Use palm of hands to estimate portions 2-3 palms or decks of card a day 1 protein food portion is about 3 oz


38 Go Easy on Fat Limit deep frying Choose lean meats Fat sources –Butter, margarine –Oil –Salad dressing –Sour cream –Bacon –Nuts

39 The Better Fats Canola oil Olive oil Peanut oil Tub Margarine Nuts and their butters Avocados

40 How Much Fat? Use thumb to estimate portions 3-4 portions a day grams of fat/day

41 Tub Margarine and Peanut Butter

42 Regular Salad Dressing

43 Almonds

44 What is a healthy meal? (amounts vary individually) 3-4 ounces of lean protein medium baked potato or 1-1/2 cups of pasta or rice(preferable whole grain) 1 cup vegetables salad with lite dressing/oil fresh fruit

45 Healthier snack suggestions: Lite yogurt Nuts (small handful) Graham crackers Fruit Low fat cottage cheese Low fat cheese stick Sugar-free pudding Raw veggies

46 Exercise is also important in managing your insulin resistance & pre-diabetes. Out of shape? Start slowly. –Maybe 10 to 15 to 20 minutes. –A little every day is good. In better shape? –30 to 45 to 60 minutes, 3 to 5 times a week.

47 Need motivation? Try using a pedometer. Wear for 7 days to determine your daily average. Increase steps gradually.

48 Irregular schedule? Take stairs instead of elevator. Park farther away. Take several 5 minute breaks during the day.

49 Time? –Set aside a time at lunch. –Walk or go to gym right after work (before you go home!).

50 Unable to walk? –Water exercise –Chair exercises

51 Lack of energy? –Start with just 5 minutes. –Walk in place during commercial breaks when watching TV.

52 Goal Setting New habits take some practice. You will have good days & bad days. Give yourself lots of credit for each new accomplishment. How realistic is it to try to change many things at the same time?

53 Setting some simple goals: Let’s set 1 nutrition and 1 exercise goal right now. Don’t make it too hard. Remember, be patient with yourself as you make changes.

54 Prescription Medications Metformin Much less effective than lifestyle changes in the prevention of DM2

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