With healthy habits, pre-diabetes can be reversible – 10/30/2020

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According to the Brazilian Diabetes Society, “pre-diabetes is a term used to indicate that the patient has the potential to develop the disease, as if it were an intermediate state between the healthy person and type 2 diabetes” – in which the The body becomes resistant to insulin and the cells stop responding normally to this hormone.

Many people believe that after the diagnosis of pre-diabetes the person will inevitably have diabetes and will carry the problem for a lifetime. But this is not the case, if you take care of yourself, of course.

Receiving a diagnosis of pre-diabetes means that your blood sugar level is above normal, but not high enough to be diagnosed with diabetes – what will happen if the problem is not treated.

O National Institutes of Health (NIH) points out that prediabetes is reversible, with changes in lifestyle, implementation of physical exercises, improvement in the food / nutritional pattern and, in some cases, administration of medications, all of which must be supervised and oriented by health professionals specialized in the theme, such as physical education professionals, nutritionists, doctors etc.

If you have pre-diabetes and don’t make lifestyle changes, you can develop type 2 diabetes in about 10 years. Mayo Clinic

The causes of insulin resistance are not clear, but they can be strongly linked to genetic and lifestyle factors, such as physical inactivity, poor diet and obesity. Speaking of health, we have to think that, as much as it is possible to be overweight and with “normalized” exams, body fat is a silent enemy. Sometimes everything is fine, everything is within all limits and suddenly, when we do annual exams again, everything is changed.

If you have had tests and your doctor said you have prediabetes, stay calm as there is a chance to return to normal patterns, but it will all depend on your lifestyle change. Here are some actions that are important to take.

Avoid processed and ultra-processed foods

This is no longer new here in my column, right? Whenever the label has an extensive amount of ingredients with difficult names, keep an eye out and, if you can, avoid it. Reduce your intake of simple carbohydrates and opt for complex ones, avoid food in sachets, prefer fresh foods, eat fruits in a portioned way and according to nutritional recommendations, vegetables, grains.

Escape from sedentary lifestyle

I know that for many people it is difficult to find motivation to train, but physical inactivity is one of the biggest factors for the development of pre-diabetes and the consequent evolution to type 2 diabetes. One of the great benefits of physical exercise for diabetes is that during contraction glucose is taken up by the muscle via the cell, regardless of the presence or action of insulin.

In other words, as the exercise is carried out, blood glucose contributes to the generation of energy in the musculature, its uptake remains high for hours after physical activity, which before (rest and post-feeding) was not possible. This results in a decrease in the hyperglycemic condition and, when associated with an adequate diet and controlled oral hypoglycemic agents, it forms an effective treatment for type 2 diabetes.

Although resistance exercise (weight training) and aerobic exercise result in the same benefits in relation to glycemic control, when performed in combination they promote additional benefits, being considered by the American College of Sports Medicine (ACSM, 2010) the best option for intervention overall in pre-diabetes and diabetes 2.

According to the American Diabetes Association (ADA), exercise can lower blood sugar for up to 24 hours after training. If you’re starting a new exercise routine, go slow. Practice light physical activities for 15 or 20 minutes and gradually increase the intensity and duration of your workouts after a few days. Ideally, you should have 30 to 60 minutes of moderate physical activity at least 5 days a week. Exercises can include walking, cycling, running or swimming combined with functional exercises or weight training. Learn more about how exercise helps control type 2 diabetes.

Focus on weight loss

When I say weight loss, it is always thinking about reducing body fat (mainly). Therefore, weight reduction should happen in a structured, programmed and conscious way, not abruptly – very restrictive diets and that make you lose weight quickly, can lead to the accordion effect.

The more normal your body fat composition is, the farther you are from pre-diabetes. Just as the lower your waist-to-hip ratio, the less likely you are to develop the problem.

Reduce the meal’s glycemic load

To do this, add a portion of oilseeds (nuts, chestnuts, almonds, pistachios, hazelnuts) or seeds (flaxseed, chia, pumpkin and sunflower) when consuming fruit. For lunch and dinner, use 1 spoon (dessert) of extra virgin olive oil to season the salad.

Avoid adding sugar to preparations and drinks. The tip is to reduce the amount of the substance little by little, so that the palate gets used, and add sweeter fruits or coconut water in juices, to sweeten naturally.

Opt for foods with a lower glycemic index. These foods have the ability to raise insulin secretion less than foods with a higher glycemic index.

Avoid consumption of trans fat

The nutrient, present mainly in industrialized foods, increases LDL-cholesterol and triglycerides, and reduces the fraction of HDL-cholesterol. The major contribution of these fatty acids to the diet stems from the consumption of hydrogenated oils and fats, hard margarines and shortenings (industrial fats present in ice creams, chocolates, bakery products, chips, salad dressings, mayonnaise, dessert creams and oils for industrial frying).

Pay attention to apnea pictures

Sleep apnea has been associated with insulin resistance. With this condition, breathing stops repeatedly during the night, due to the relaxation of the throat muscles. Signs of sleep apnea include snoring, breathing pauses during sleep, gagging, waking up with a headache, tiredness. Understand problems that sleep apnea can bring.

Drink more water

Drinking water is another excellent way to help reverse prediabetes and prevent type 2 diabetes. Water helps to control blood glucose levels and is also a healthy substitute for soft drinks and processed juices, which are typically high in sugar .

References:

– CDC. Centers for Disease Control and Prevent.

– WHO. World Health Organization.

– American Diabetes Association: Standards of Medical Care in Diabetes. Diabetes Care 39: Supplement 1: S1-S119, 2016.

– Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? www.thelancet.com/respiratory Published online March 11, 2020 https://doi.org/10.1016/S2213-2600(20)30116-8

– Li XC, Zhang J, Zhuo JL. The vasoprotective axes of the renin-angiotensin system: physiological relevance and therapeutic implications in cardiovascular, hypertensive and kidney diseases. Pharmacol Res 2017; 125: 21-38.

– Brazilian Diabetes Society.

– Sigal RJ, Kenny GP, Boule´ NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147:357-69.

– Morrison, S.; et al. Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes. Diabetes Care. 2010 Apr; 33(4): 748-750.

– Reaven GM. Banting lecture. Role of insulin resistance in human disease. Diabetes. 1988; 37:1595 e1607.

– World Health Organization. Obesity and overweight. 2015.

– World Health Organization. Global recommendations on physical activity for health. Geneva; 2010.

– Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., Smith, B. K., & American College of Sports, M. (2009). American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc, 41(2), 459-471. doi: 10.1249/MSS.0b013e3181949333

– Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., . . . American College of Sports, M. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 43(7), 1334-1359. doi: 10.1249/MSS.0b013e318213fefb

– Stoner, L., Rowlands, D., Morrison, A., Credeur, D., Hamlin, M., Gaffney, K., . . . Matheson, A. (2016). Efficacy of Exercise Intervention for Weight Loss in Overweight and Obese Adolescents: Meta-Analysis and Implications. Sports Med. doi: 10.1007/s40279-016-0537-6

– Tapsell, L. C., & Neale, E. P. (2016). The Effect of Interdisciplinary Interventions on Risk Factors for Lifestyle Disease: A Literature Review. Health Educ Behav, 43(3), 271-285. doi: 10.1177/1090198115601092

– Thorogood, A., Mottillo, S., Shimony, A., Filion, K. B., Joseph, L., Genest, J., Eisenberg, M. J. (2011). Isolated aerobic exercise and weight loss: a systematic review and meta-analysis of randomized controlled trials. Am J Med, 124(8), 747-755. doi: 10.1016/j.amjmed.2011.02.037

– de Toro-Martín J, Arsenault BJ, Després JP, Vohl MC. Precision Nutrition: A Review of Personalized Nutritional Approaches for the Prevention and Management of Metabolic Syndrome. Nutrients. 2017 Aug 22;9(8).

– MASQUIO, D. C. L.; NETTO, B. D. M. ; CORGOSINHO, F. C. ; DÂMASO, ANA R. . Dietary Therapies on Obesity and Metabolic Syndrome in Adolescents: The Role of Nutrigenetic, Nutrigenomic and Food Compounds. In: Cedric Freeman. (Org.). Mediterranean Diet and Dietary Therapies: Food Sources, Role in the Prevention of Cardiovascular Disease and Other Health Benefits. 1ed.N.Y.: Nova Publisher, 2014, v. , p. 33-90.

– Martínez-Fernández L, Laiglesia LM, Huerta AE, Martínez JA, Moreno-Aliaga MJ. Omega-3 fatty acids and adipose tissue function in obesity and metabolic syndrome. Prostaglandins Other Lipid Mediat. 2015 Sep;121(Pt A):24-41.

– Brazilian Diabetes Society. Available at: https://www.diabetes.org.br/publico/temas-atuais-sbd/1427-consideracoes-sobre-diabetes-e-pre-diabetes

– National Institute of Diabetes and Digestive and Kidney Diseases. Disponível em: https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp

– Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/prediabetes/diagnosis-treatment/drc-20355284

– Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278

– Blood Sugar and Exercise. American Diabetes Association. Available at: https://www.diabetes.org/fitness/get-and-stay-fit/getting-started-safely/blood-glucose-and-exercise

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