Nutritionist and Thrive Expert Swati Maden looks at what causes the onset of pre-diabetes and what you can do to prevent it!
What is Insulin Resistance?
Carbohydrates once digested get broken down into sugars (glucose) which then enters the blood. As the blood glucose level rises, the pancreas produces insulin to clear this glucose from the blood and facilitate the uptake of glucose by the cells to be used as a source of energy or stored as glycogen in muscle and liver cells. However, with the excessive consumption of sugar and other refined carbohydrates, over a period of time the cells may become resistant to insulin. This eventually has an effect on the pancreas and it starts producing less and less insulin – your blood glucose levels will rise. This increases the risk of prediabetes, and host of other serious health problems including heart attack.
What is Pre-diabetes?
One in three adults in England has prediabetes, it is a state where your blood glucose levels are abnormally high, but lower than the threshold for diagnosing diabetes. Over a period of time, there is a high chance of developing type 2 diabetes. However, the onset of type 2 diabetes can be prevented or delayed. Risk factors for pre-diabetes include excess bodyweight, lack of physical activity, genetics, various health conditions, lack of sleep and certain medication.
One in three adults in England has prediabetes, it is a state where your blood glucose levels are abnormally high, but lower than the threshold for diagnosing diabetes.
What is type 2 diabetes?
The prevalence of type 2 diabetes has risen dramatically across the globe! It is a condition which develops when the pancreas does not produce enough insulin or insulin resistance occurs – which means that the cells starts to resist insulin resulting in high level of sugar (glucose) in the blood.
How can we prevent the risk of developing pre-diabetes?
Several diabetes prevention trials have shown promising results with lifestyle changes such as healthy eating, regular exercise, intermittent fasting and weight control can all help prevent the onset of prediabetes and type 2 Diabetes.
1. Healthy Eating
Focus on whole foods: research shows that a low-carb eating pattern should be based on whole foods – mostly plant-based. Whole foods to include; whole grains, nuts, seeds, legumes, fruits and vegetables. Include lots of fibre – it helps in meeting nutritional needs, promoting satiety, maintaining gut health, weight management and blood glucose control.
Understanding the Glycaemic Index (GI) of foods
The glycaemic index or GI is the rate at which carbohydrate foods release glucose in your blood. If a carbohydrate food releases glucose quickly, they are called high GI foods. The lower the GI, the slower the rise in blood glucose levels. The type and quantity of carbohydrates is really important for a person with pre-diabetes, to keep their insulin levels in control they should opt for low to moderate amounts of carbohydrate and include high fibre foods.
Low GI foods – GI< 55 – oats, barley, non-starchy vegetables Intermediate GI foods – GI between 55–70 – brown rice, couscous
High GI foods – GI> 70 – pizza, cookies, some breakfast cereals.
Some people may benefit from following a Mediterranean diet to reverse prediabetes, if they are consuming a very high amount of carbs. However, others may have to follow a slightly stricter low-carb approach. According to a research study in 2008, a low carb diet is categorised into the following brackets:
- Moderate carbohydrate: 130 to 225g of carbs
- Low carbohydrate: under 130g of carbs
- Very-low carbohydrate: under 50g of carbs
It is important to note that if you want to choose a low carb diet, it is best to consult a registered Nutritionist or Dietitian to ensure the optimal daily intake of nutrients. A healthy low carb diet should focus on whole foods, increased intake of vegetables and good quality fats and moderate protein intake.
Food labels – pay special attention to the nutrient values listed on food labels such as calories, fat, carbohydrates, and other nutrition information for a particular serving and not just per 100g.
Fat is an essential component of a balanced and healthy diet. However, balancing dietary fat intake is the key. It is essential to opt for good quality fats such as avocado, nuts, seeds, extra virgin olive oil and decrease the intake of saturated fats.
Protein is the building block of life which is necessary for muscle growth, bone health, cell repair and growth and tissue repair. Protein helps to keep blood sugar and insulin levels stable. Consider reducing the intake of red and processed meat and choose lean cuts and oily fish such as salmon, mackerel and sardines which are high in Omega 3 fatty acids. Good sources of protein include nuts, seeds, legumes, legs, lentils and oily fish.
2. Intermittent fasting
Intermittent fasting is an eating pattern that cycles between periods of fasting and eating. The main benefit of intermittent fasting is to improve regulation of insulin levels by balancing meal times and fasting. Fasting allows your insulin levels to drop, resulting in periods where cells use the body’s fat stores for energy.
3. Increasing physical activity
Engaging in physical activity regularly for people with prediabetes and diabetes is highly beneficial for maintaining blood sugar levels. Physical activity should combine endurance, strength training and flexibility training.
4. Managing Stress
Stress response is a normal phenomenon that prepares the body to confront or avoid danger. However, constant stress can lead to array of problems. Stress leads to release of hormone called cortisol from the adrenal glands to prepare you for “fight or flight”. Chronic stress produces excessive amounts of cortisol and too much cortisol can directly affect the beta cells in the pancreas that produces insulin, forcing the pancreas to produce more insulin to get a response.
Over a period of time, the cells tire out and become less sensitive to insulin and your body remains in a general insulin-resistant state, resulting in higher glucose levels in the blood leading to pre-diabetes or type 2 diabetes.