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Diagnosis, Treatment, and Prevention

Before developing the serious health condition of type 2 diabetes, a person will almost always have pre-diabetes beforehand. But pre-diabetes is a condition without symptoms, meaning that many people can have it without even knowing it. Left unchecked, pre-diabetes can lead to full-blown type 2 diabetes, heart disease and stroke. Luckily, pre-diabetes can be diagnosed with a simple test, and treatment can prevent many health problems and complications. Here's what you need to know to control pre-diabetes before it gets control of you.

Diabetes Basics
Under normal circumstances, the glucose (sugar) levels in your blood rise after you eat a meal or snack. In response, your body produces a hormone called insulin, which is needed for the body to convert the glucose in your bloodstream into usable energy. But if insulin isn’t available, or if the body isn’t using it correctly, your blood glucose will remain elevated, and that can be harmful to your body. This is a condition known as diabetes. People who have higher-than-normal blood glucose levels that aren’t quite high enough to be diagnosed as type 2 diabetes have pre-diabetes. In the past, individuals with pre-diabetes would have been considered "borderline diabetic."

Who's at Risk?
Over 50 million Americans over the age of 20 have pre-diabetes, according to the American Diabetes Association. If you have any of the risk factors for type 2 diabetes, including uncontrollable factors like age and race, and/or controllable risk factors like obesity and physical inactivity, then you are also at risk for pre-diabetes.

Most of the time, pre-diabetes is asymptomatic (shows no symptoms), but some people will experience some general diabetes symptoms like extreme thirst, frequent urination, fatigue and/or blurred vision.

If you fall into any high-risk categories or experience any of the symptoms above, then visit your health care provider for a blood glucose test as soon as you can. Early diagnosis and treatment are crucial steps, as they can prevent the development of type 2 diabetes and its serious health consequences.

Testing & Diagnosis
There are two tests commonly used to diagnose diabetes and pre-diabetes: a fasting plasma glucose (FPG test) and an oral glucose tolerance test (OGTT).
  • The FPG test will measure your blood glucose level after an eight-hour (overnight) fast. A result less than 100 mg/dL is considered normal, but anything above that level is diagnosed as "impaired fasting glucose" (IFG). Between 100 mg/dL and 125 mg/dL is considered pre-diabetes, while 126 mg/dL or higher indicates diabetes.
  • The OGTT will measure your blood sugar after a fast and then again after drinking a glucose-rich beverage. Two hours after the beverage, a result less than 140 mg/dL is considered normal, but anything above that level is diagnosed as "impaired glucose tolerance (IGT). Between 140 mg/dL and 199 mg/dL is considered pre-diabetes, while 200 mg/dL or higher indicates diabetes.
  • Some people have both IFG and IGT.
Treatment & Prevention
While pre-diabetes in itself isn’t necessarily dangerous, the fact is that many people with pre-diabetes will develop type 2 diabetes within 10 years.

Read more: What is Pre-Diabetes?

Cues to Eating and How to Control Them

Balanced breakfast? Check
Mid-morning snack? Check
Healthy lunch with your co-workers? Check
Passing up your friend's homemade cookies? Check
Coming home in the evening and going on a feeding frenzy? CHECK!!

Does this sound like the bulk of your days? You're in control, everything is going fine - until you come home starving at night and eat a large dinner, say yes to dessert (and seconds) and finish off a bag of chips before bed. What gives?

From a metabolic standpoint, there is really no reason not to eat food in the evening. A calorie is a calorie regardless of when it is consumed. A morning calorie is metabolized in basically the same way as an evening calorie. However, eating in the evening is a problem for many, not because of the way food is metabolized, but because of the quantity of food that is often eaten.

Skipping meals and becoming overly hungry by evening can lead to nighttime binge eating. Recent studies revealed that when people ate three meals a day only 13% binged. When people skipped breakfast, 24% binged and when people skipped breakfast and lunch, 60% binged. In general, people who spread their meals throughout the day seem to be better able to control their eating. They are less likely to feel hungry and less likely to overeat. So by eating breakfast, lunch, and dinner and planning snacks in between, you can help yourself lose weight as well as maintain better control of your eating throughout the day and night.

For most people, the evening is "down-time," used to relax, watch television, and unwind from the stresses of the day. Others view this as a time to multi-task and catch up on household chores, bills, homework, and other responsibilities. Whether you're winding down or checking off your to-do list, unconscious eating can accompany your routine and result in a massive calorie intake. Devouring a bag of chips, a sleeve of cookies, or a pint of ice cream can occur when your mind is somewhere else.

The Role of Sleep
Consuming a large amount of food before bedtime can also result in indigestion and sleep problems, which can trigger you to eat more during the proceeding days. A growing body of research suggests a connection between obesity and lack of adequate sleep. Statistics show that overweight individuals sleep about 1.8 hours less a week than people of normal weight. Since the 1960's sleep duration for American adults has dropped by as much as two hours a night, while obesity has drastically increased.

Sleep is a regulator of two hormones that effect appetite, leptin and ghrelin. Leptin helps suppress food intake and stimulate energy expenditure, while ghrelin stimulates appetite, fat production, and body growth. When one is sleep deprived, the level of leptin drops and the level of ghrelin increases. The result is a drastic increase in hunger. One study reported a 24% increase in hunger, with excessive, uncontrollable cravings for calorie and carbohydrate packed foods such as cookies, candy and cake. It can all add up to a vicious cycle of late night binges, lack of adequate sleep, uncontrolled snacking, late night binges, and so on.

Are You An Evening Eater? Try this exercise to find out.
Use the Nutrition Tracker to track 3-5 typical days of eating. Print each day's results and use your records to answer the following questions:

1. How many meals and snacks did you eat after 5:00 pm?
2. How many meals and snacks did you eat during the day?
3. How many total calories did you consume after 5:00 pm?
4. How many total calories did you consume for the day?
5. What activities occurred while you ate after 5:00 pm?

You may have a problem with evening eating if:

  • More than one-third of your meals & snacks are eaten after 5:00 pm.
  • More than one-third of your total calories are consumed after 5:00 pm
  • Evening eating constantly occurs with another activity.

    Put An End to the Evening Binge Cycle!
  • Read more: Is Evening Eating Destroying Your Weight Loss Efforts?

    You ate them in February, from half a continent away, and they were flat and bland—passable, but nothing to write home about. Now, you take a bite from one grown half a mile away, and it’s spectacular—sweet, juicy, and flavorful.

    We’re talking in this particular instance about tomatoes, but we could say the same thing about any of a dozen produce items you’ll find at your local farmer’s market now. 'Tis the season to eat fresh, as the tender new growth of spring ripens into the rich abundance of summer. So why settle for "so-so" when you can savor the sensational? Consider the benefits of eating foods at the peak of their season. Seasonal foods…
    • serve up the most flavor.
    • pack the biggest nutritional punch.
    • boost your budget.
    • are  tied to the special days and seasons of our lives: sweet, luscious watermelon paired with the memory of fireflies and fireworks; fragrant hearty soups that temper winter’s chill; sweet young vegetables that accompany spring’s first warm day.

    As consumers today, we’re very lucky in some respects. The crisscross networks of our global village provide things our ancestors could only dream about, such as oranges in December. On the other hand, as we shed our rural roots, we tend to lose sight of the seasonal rhythm of life, relying heavily on processed foods and a worldwide distribution system that makes our grocery shelves look pretty much the same year-round. The out-of-season produce we buy has often traversed 1,000 miles or more by the time it reaches our kitchens—with a corresponding loss of flavor and nutrition and an increase in wax coatings, chemical ripening agents, and other preservatives.

    But locally-grown seasonal foods often harmonize with our nutritional needs. For example, the beta carotene in the orange pigment of pumpkins and other squash will help bolster your immune system just in time to help ward off winter colds. And the oils of nuts—fats in their purest form—will provide nutrient-rich calories that help keep you warm as the temperature drops.

    Read more: Seasonal Foods Exceptional Flavor & Nutrition that Fits in Your Budget

    Nourishing your family's health and growing appetite are probably among your highest priorities. You can satisfy both priorities with kale, the super food that should be on everyone's grocery list. Kale is called a "super food" because it packs more nutrition per calorie than almost any other food. Unfortunately many people haven't a clue how to prepare the stuff usually seen only as garnish beside the onion rings.

    Follow these simple instructions for delicious, tender, steamed kale:
    1. Select dark green crisp leaves.
    2. Wash kale in cold water to remove sand or dirt.
    3. Fold the kale in half, lengthwise, hold the base of the stem and rip the leaves from the stem.
    4. Chop leaves and add to a steamer basket and place in a pan of boiling water, filled just to the base of the basket, and cover.
    5. Steam for about 4-5 minutes, then check for tenderness.
    6. Kale cools rapidly, so enjoy immediately.

    You can eat it plain, spritz it with soy sauce, sauté it with garlic and olive oil, or toss it into soups. Use it in place of cooked spinach in your favorite recipes.

    Even kids like kale--especially if you start them on it young. Prepare as directed, then mince very finely. Serve it plain or mix it with some whole wheat pasta and they'll gobble it right up. If that doesn't work, try tossing it into their favorite soup.

    READ MORE...

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