1. 1 Are You at Risk for Diabetes? Information on Prevention and Control This presentation is part of Get Fit Topeka! Challenge, a seven-week challenge to help you make fitness, nutrition and wellness a healthy habit in your life. A presentation by Mary Alice Scheer RD, LD, CDE ADA Coordinator/Diabetes Dietitian St. Francis Diabetes Center

2. 2 Disclaimer The content of this presentation is not intended to be a substitute for professional medical advice, diagnosis or treatment. You are encouraged to confer with your doctor with regard to information provided here and to review the information carefully with your professional health care provider.

3. How Does Diabetes Develop? After a meal, food, primarily carbohydrates, is converted to blood sugar called glucose. Glucose is our body’s choice of fuel and our cells need glucose to survive. Glucose is carried by the blood to cells by the hormone insulin, which is made by the pancreas. People develop Type 2 diabetes because the cells in the body do not use insulin properly or are resistant to the insulin the body produces. As a result, blood glucose levels are high. 3

4. What Happens in the Long-Term? Over time, high blood glucose levels can damage nerves and blood vessels which can lead to chronic complications such as: –Blindness –Heart disease –Kidney disease –Nerve damage –Stroke 4

5. Pre-diabetes 41 million Americans have pre-diabetes. 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. 5

6. Risk Factors for Developing Pre-diabetes and Type 2 Diabetes Being 45 years of age or older and overweight Under 45 with other risk factors for diabetes Physical inactivity Family history of diabetes Being African American, Native American, Asian American, Pacific Islander or Hispanic American Giving birth to baby weighing nine pounds or more Having had gestational diabetes High blood pressure at or above 130/80 Low HDL cholesterol (35 or lower) or high triglycerides (250 mg/dl or higher). 6

7. The First Step: Healthy Eating Eat regular meals about four to five hours apart. Skipping meals, especially breakfast, can cause weight gain and then more insulin resistance. Eating three smaller meals and a few snacks may also be helpful. 7

8. Increase the Fiber in Your Diet Fiber helps you feel full and can help with weight loss. Fiber aids in regularity. Fiber helps lower cholesterol. 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 8

9. Eat Less of These Foods Alcohol Desserts and other sweets High-fat foods Salty foods Limit intake of fruit juice to four to six ounces a day 9

10. Proteins 10 Proteins include beef, pork, poultry, fish, eggs, cheese, cottage cheese and peanut butter. Use palm of hands to estimate portions. Aim for three servings of protein a day. One serving of protein equals approximately three ounces. Three ounces of meat equals the size of a deck of cards or the palm of your hand. One ounce of cheese, ¼ cup of cottage cheese, one egg or one tablespoon of peanut butter equals about one ounce of meat.

11. Carbohydrates 11 Carbohydrates give you energy. Carbohydrates include starches, fruits and dairy (milk and yogurt). 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. Most men should aim for approximately 60 to 75 grams of carbohydrates per meal. Most women should aim for approximately 45 to 60 grams of carbohydrates per meal.

12. Know Your Vegetables Starchy vegetables are good for you, but limit the amount: –Corn, dried beans, peas and potatoes Eat lots of non-starchy vegetables (no need to measure). One-half of your plate should be non-starchy vegetables: –Broccoli, cauliflower, carrots, green beans, lettuce, spinach, onions, peppers and tomatoes 12

13. Limit the Fat in Your Diet Limit deep frying Choose lean meats Fat sources: –Butter and margarine (choose light margarine) –Oil (choose canola, olive and peanut oil) –Salad dressing (choose light or fat free) –Sour cream (choose light or fat free) –Bacon (limit) –Nuts (a healthy option but limit to a small handful). 13

14. Healthy Snack Options Fruit Light yogurt Low-fat cheese stick Low-fat cottage cheese Nuts (a small handful) Raw veggies Sugar-free pudding Whole grain crackers 14

15. The Second Step: Exercise Exercise is also important in managing your insulin resistance and pre-diabetes. Before starting an exercise program, consult your doctor. Your exercise routine should include both aerobic and strength training. Out of shape? Start slowly and do 10 to 20 minutes of exercise every day. In better shape? Do 30 to 60 minutes of exercise three to five times a week. 15

16. Set a Few Simple Goals Set one nutrition and one exercise goal right now. Don’t make it too hard. Remember to be patient with yourself as you make changes.

17. 17 If you would like to enroll in a pre-diabetes educational seminar or attend the Diabetes Self-Management classes or support groups, please contact the St. Francis Diabetes Center at 785-273-2731. Are You at Risk for Diabetes? Information on Prevention and Control Mary Alice Scheer RD, LD, CDE ADA Coordinator/Diabetes Dietitian St. Francis Diabetes Center 6730 SW 29th Street Topeka, KS 66614 (785) 273-2731 mscheer@sftks.net