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The plan, if you are Pre-diabetic

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With all this talk in Sugar Matters during the past few weeks about pre-diabetes, some of you may be wanting some more specifics. I urged you to take a healthier approach, talk to your doctor, get more exercise and try to lose some weight. But you want SPECIFIC GOALS, right? Here we go, then!{{more}}

If your doctor tells you that you are pre-diabetic based on either a blood glucose result or a hemoglobin A1C result, you have two options, or a combination of both.

Option 1: LIFESTYLE CHANGES. This is, of course, the option most people choose because it involves no medication. Plus every person wants to believe that he/she can be disciplined enough to improve diet, exercise more and thus lose some weight. Those of you who HAVE been successful can testify that it is often NOT easy, and that is takes dedication and attention, and some days you seriously feel like giving up and eating a whole cake. But I encourage you to keep at it and persevere.

The dietary changes are too expansive to go through in detail in one article. We have discussed many of them in the past. The obvious one, of course, is to cut out/significantly reduce added sugar, concentrated sweets of any kind (icing, sodas, sweets), and fried foods. All of these add calories, sugar and often fat when you are aiming for the opposite towards weight loss. In addition, you should strive to drop the simple carbohydrates (white bread, white potatoes, white rice etc) from your diet and replace them with wheat/brown versions of the same.

What is your exercise goal? To maintain weight, but improve your heart health, the current recommendation is to achieve a total of 150 minutes of exercise per week. Again, this is not limin’ and strollin’ somewhere slowly – this needs to be exercise that gets your heart rate up. Now, if you are aiming for weight LOSS, you should shoot even higher, for more minutes per week.

Weight loss is often required for many people who have pre-diabetes, but not all. If you are in the group that should lose some weight, often our target is initially 7% of your current body weight. That is not very much at all for the majority of people!

Option 2: MEDICATION. Yes, there is a medication used for treating people with pre-diabetes. Most often we use it for those who are at very high risk of progressing very quickly to diabetes in future, for example someone who is very overweight, has a strong family history of diabetes, was diabetic during pregnancy, already has an A1C in the low 6% range etc. Metformin, a medication used by many of you for your diabetes treatment, is also used to treat pre-diabetes at lower doses. Most often a dose of 500mg, once or twice daily, is what is used in pre-diabetes.

Now of course, many of you probably should use a combination of both options. Which option, or the combination you choose will depend on the discussion between you and your doctor. There is a lot to consider, but the overall message is that you have options that work, and you should start soon, instead of wasting time thinking “well my pre-diabetes won’t get any worse.” Chances are that it will.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD [email protected]

Medical Director Endocrine Care Group

Tel: 843-798-4227