What are Insulin Resistance, Metabolic Syndrome and Pre-Diabetes? Many people who develop type 2 diabetes are first diagnosed with one of its precursors: Insulin Resistance Metabolic Syndrome (Syndrome X) Pre-Diabetes Let’s go over each of them so you can understand how they affect the body and how they develop into full-blown diabetes. Insulin Resistance If you have insulin resistance, your body produces insulin but does not use it properly. Insulin is a hormone made by the pancreas that helps the body burn glucose for energy. Glucose is a simple sugar and a major source of fuel for cells. Most of the food we consume is converted into glucose. In the bloodstream, insulin helps glucose and other nutrients enter cells. However, if there is not enough insulin in the bloodstream to “unlock” the cells so that nutrients can get in, the cells literally starve to death. When you are insulin resistant, your body requires extra insulin in order for this “unlocking” process to work. The pancreas will try to keep up with this increased need by producing more insulin, but eventually it will fail to produce the amount your body needs. When this occurs, the extra glucose will begin building up in your blood, and type 2 diabetes will develop. Metabolic Syndrome (Syndrome X) In addition to being the driving force behind type 2 diabetes, insulin resistance is also part and parcel of a condition known as metabolic syndrome (formerly called syndrome X). Metabolic syndrome is a cluster of disorders that includes: Obesity (especially abdominal obesity: a waist measurement of 40 inches or more for men and 35 inches or more for women) High blood pressure (130/85 or higher) Elevated triglycerides (150 mg/dL or higher) Low HDL cholesterol (below 40 mg/dL for men and below 50 mg/dL for women) Increased risk of heart disease and type 2 diabetes The underlying constant among all of these characteristics is insulin resistance. Other risk factors associated with metabolic syndrome include: Age (the older you are, the higher your risk) Sedentary lifestyle Hormone imbalances Poor diet (particularly a diet high in saturated and trans fats and sugar) Pre-Diabetes Pre-diabetes is diagnosed when a person’s blood sugar is elevated, but not quite to diabetic levels. People with pre-diabetes have either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or both. To test for IFG, you must fast overnight and then have your blood sugar levels tested in a physician’s office. If your fasting blood sugar level is 100–125 mg/dL, you have IFG. To test for IGT, you will need to undergo a two-hour oral glucose tolerance test. If your blood sugar level is 140–199 mg/dL, then you have IGT. A diagnosis of pre-diabetes doesn’t necessarily mean you will develop type 2 diabetes. Studies have shown that people with pre-diabetes who lose weight and increase their level of physical activity can prevent or delay type 2 diabetes and get their blood sugar levels back to normal. While it makes sense to find out if you have pre-diabetes so you can take steps to prevent it from turning into full-blown type 2 diabetes, I only recommend taking these tests if you know you are at high risk for developing the disease. How do you know if you have diabetes? If you have type 1 diabetes, your symptoms are fairly clear cut. But for people with type 2 diabetes, the warning signs are less obvious—if noticeable at all. Here’s what to look for. Symptoms of Type 1 Diabetes Extreme hunger Rapid weight loss Extreme thirst Excessive urination The classic presentation of type 1 diabetes is extreme hunger, as the body tries to compensate for the inability of cells to use the glucose (blood sugar) created from food, and the rapid weight loss that occurs as a result. Patients experience excessive thirst and urination because their kidneys, in an attempt to keep glucose levels in balance, excrete as much excess glucose as possible in the urine. If you’re experiencing these symptoms, contact your doctor immediately. Symptoms of Type 2 Diabetes Unlike people with type 1 diabetes, those with type 2 don’t usually lose weight or become excessively hungry or thirsty. And because many people experience no symptoms, type 2 diabetes is often discovered only during routine blood tests. However, if symptoms of type 2 diabetes do exist, they usually include: Increased urination (sometimes as often as every hour) Fatigue Nausea Blurred vision Frequent vaginal or yeast infections Dry mouth Slow-healing sores or cuts If you have risk factors for type 2 diabetes or have been diagnosed with one of the conditions that often lead to diabetes, it’s essential that you begin taking steps to prevent development of the disease. In most cases, a few adjustments in how you go about daily life can lower your risk of developing type 2 diabetes. They include: Maintain a Healthy Weight Follow a Diabetic Diet Exercise Regularly Maintain a Healthy Weight One of the most important things you can do to prevent diabetes and many of its related complications is to maintain a healthy weight. This is best accomplished by following a nutritious diet and getting regular exercise. But how do you know what your ideal weight should be? One recommended guideline is waist circumference. To determine yours, measure your bare waist at its narrowest point. For men, this will be right at the navel, and for women, about an inch below the navel. Men should aim for a waist circumference of less than 37 inches and women less than 34.5 inches. Anything over that puts you in the danger zone. Another tool physicians and researchers use is the body mass index (BMI). Taking into account your height and weight, your BMI provides an estimation of your ratio of lean muscle mass to body fat. The healthy range is 18.5 to 24.9. If your BMI is above 25, you will benefit from weight loss, and a reduction may be all you need to get your glucose under control. One caveat: BMI not always accurate. If you’re exceptionally muscular, for example, you may have a high BMI even though you are not obese. Overall, however, it’s a useful guide for appropriate weight. Follow a Diabetic Diet Do: Eat plenty of vegetables and legumes (beans). Eat lean protein, such as fish, poultry, and tofu. Eat healthful fats, which can be found in cold-water fish, raw nuts and seeds, and extra-virgin olive oil. Eat modest amounts of fruit (one to two servings per day). Follow a mini-fast. Don’t: Eat too many processed foods. Eat a lot of red meat (limit to one serving per week). Eat carbohydrate-dense, starchy foods such as pasta, cereals, and other grain-based foods. Use sugar or artificial sweeteners to enhance the flavor of food, or consume products that contain these ingredients. Exercise Regularly Regular exercise is a must if you want to maintain a healthy weight and lower your risk of diabetes. Aerobic exercise lowers blood sugar and burns calories, and resistance training (weightlifting) builds muscle and improves long-term insulin sensitivity. You don’t have to run marathons—just get active. Brisk walking is one of the easiest exercises, and walking after meals in particular helps lower glucose levels by clearing glucose out of the bloodstream. Studies have also shown that regular exercise resets your body’s thermostat for hours after you stop exercising—which is precisely what you want. Exercise vigorously for at least 30–45 minutes four or more days per week. Dr. Whitaker
Posted on: Fri, 05 Jul 2013 12:50:06 +0000
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