Avoiding the Big D: Simple steps to prevent diabetes

Phyllis Class RN, Executive Director, Allied Health Continuing Education

Phyllis Class, RN

By Phyllis Class, RN
Executive Director, Allied Health CE

Recently, I was sitting on the edge of the chair at my nurse practitioner’s office awaiting the results of my semiannual hemoglobin A1c. Would I be diagnosed with diabetes? Would I have to stick my finger to check my glucose and take pills, or worse, insulin injections? With a family history of Type 2 diabetes, hypertension and heart disease, it was not an idle threat. But I dodged the bullet once more with an A1c within normal limits. Not everyone is that lucky, and this month those people will be spotlighted as November is American Diabetes Month and Nov. 14 is World Diabetes Day.

First, the bad news: Some 26 million Americans have diabetes, according to the 2011 National Diabetes Fact Sheet. And how’s this for scary? An estimated 79 million people have prediabetes, or glucose levels that are higher than they should be but not high enough for a diabetes diagnosis. The price tag for diagnosed diabetes in the U.S. in 2012? A whopping $245 billion, according to the American Diabetes Association. Healthcare costs for someone with diabetes are an estimated 2.3 times that of someone who doesn’t have the disease.

Now, the good news: studies show that physical exercise and weight loss can prevent or delay prediabetes from progressing to diabetes. Aerobic exercise has been shown to reduce insulin resistance by getting more blood to muscles, which improves glucose uptake. A good place to start is a daily walk. I just started using MapMyWalk, a free smartphone app that tracks your route, mileage and calories burned.

Needless to say, diet is crucial in preventing prediabetes. In addition to the common sense fruits and vegetables, whole grains, nuts and lean proteins, there is evidence that monounsaturated fats like olive oil help reduce insulin resistance. I just learned that sweet potatoes contain chromium, which also reduces insulin resistance.

Easier said than done? Avoiding the Big D has been a challenge for me. The last thing I feel like doing at the end of the day is putting on my sneakers and heading to the gym, but I do it anyway. I simply refuse to give in to genetics without a fight. Plus, I’ll admit it, I’m vain. I want to look good.

A little knowledge along the way has helped. Recently, I decided to take our newly minted obesity management course that offers 12 contact hours for nurses, dietitians, physicians, pharmacists, social workers and health educators. There’s just something about reading what obesity does to your body that is enough to make you run, not walk, to the gym.

What do you recommend to your patients to prevent diabetes? Let us know in the comments.

Continuing education resources:

Obesity management: A 911 call to American healthcare

A healthcare provider’s guide to diabetes care

New diabetes options: From lizards to laboratories

Exercise for health and fitness

The piece de resistance: Insulin resistance syndrome/metabolic syndrome

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7 Responses to Avoiding the Big D: Simple steps to prevent diabetes

  1. What do I tell my patients, my students. To know your family history and become very familiar with disease processes that have a genetic component. To make annual and semiannual well care visitts and have the laboratory work done and ask what the numbers mean. To eat healthy, exercise as often as you can and listen to your body. If diagnosed with type I or Type II DM consult a DM management specialist, see a nutritionist and ask for a consult with an endocrinologist. Above all take care of you and pay attention to your body and become educated about DM.
    Shirley

  2. Thanks for sharing your views. There are some simple steps to prevent diabetes such as :
    1. Control your weight : Excess weight is the important cause of type 2 diabetes.
    2. If you smoke, try to quit.
    3. Change your diet : Choose good fats instead of bad fats, choose whole grains, nuts, skip sugary drinks.
    4. Keep your blood pressure and cholesterol under control.
    5. Get more physical activities.

  3. This is becoming such a huge problem with our youth as our schools have cut back on the physical education requirements. What is being done in our schools? Are school nurses screening for juvenile diabetes? I believe that there should be a requirement for screening all children in our school systems for diabetes just as there is for scoliosis.

  4. hopeeg says:

    If you are sick with diabetes , and noted a rise in the domestic results of the examination , they should be looking for the reasons that led to it , the following are the most important factors that may raise blood sugar :
    – Disease or infection or injury : that fights disease may raise blood sugar , and those diseases colds, urinary tract infection and heart attack .
    – Tension or stress : Whether it is a positive tension , such as a wedding or a vacation or a negative member of the family .
    It should be mentioned that stress may cause a drop in blood sugar in some rare cases .
    – Not taking the proficiency of insulin either by injection or pills.
    – Eating or drinking more than usual amounts of carbohydrates .
    – Activity or Sport less than usual .
    – Wounds and surgical procedures .
    – Especially if the pain was due to inflammation in the body.
    – Any sudden change in your daily routine .
    – Some drugs used in the treatment of certain diseases , such as :
    • lung diseases such as asthma
    • rash
    • estrogen in the pill
    • antidepressants and anti psychotics and schizophrenia
    • Aspirin
    • Some types of antibiotics
    • diuretics for the treatment of blood pressure and fluid retention
    • Cholesterol
    • Hepatitis
    • thyroid disease , especially if the dose is incorrect .

  5. Margaret says:

    The point of your view Phyllis Class is very respectable to be spread awareness even overcome this chronic disease Thanks and I hope to communicate with you always. Dr magret

  6. Thank-you for discussing the significance of physical activity in primary prevention. At the turn of the twenty-first century, Barnett-Damewood and Carlson-Catalano (2000) proposed that physical activity deficit be added to the lexicon of NANDA approved nursing diagnoses. Defined as “a state in which an individual does not willfully expend any energy above what is required to sustain the body’s vital functions in the waking state that would produce health benefits,” major physiologic adverse health effects linked to physical activity deficit include:

    •Hypertension
    •Heart disease
    •Diabetes mellitus
    •Obesity
    •Osteoporosis
    •Muscular atrophy
    •Decreased blood volume
    •Decreased immune function
    (Barnett-Damewood & Carlson-Catalano, 2000, p. 26).

    More people are at risk for physical inactivity than any other single risk factor for chronic diseases. In addition, physical inactivity has been linked to depression in older adults with heart failure (Alosco et al, 2012) and adults with diabetes mellitus (Geulayov, Goral, Muhsen, Lipsitz, & Gross, 2012). According to the Harvard Medical School Family Health Guide (HMSFHG) (2005), the physiologic effects of physical activity may include a “blunting” effect on the disruption of the body’s inflammatory processes and energy metabolism (e.g. blood glucose regulation) associated with central obesity (HMSFHG, 2005). Thus, the potential of physical activity to lessen the severity of the adverse effects of obesity without the added benefit of weight loss is significant (HMSFHG, 2005).

    References
    Alosco, M. L., Spitznagel, M., Miller, L., Raz, N., Cohen, R., Sweet, L. H., & …Gunstad, J. (2012). Depression is associated with reduced physical activity in persons with heart failure. Health Psychology, 31(6), 754-762. doi:10.1037/a0028711
    Barnett-Damewood, M., & Carlson-Catalano, J. (2000). Physical activity deficit: A proposed nursing diagnosis. Nursing Diagnosis, 11(1), 24-3
    Geulayov, G., Goral, A., Muhsen, K., Lipsitz, J., & Gross, R. (2012). Physical inactivity among adults with diabetes mellitus and depressive symptoms: Results from two independent national health surveys. General Hospital Psychiatry, 32(6), 570-576.
    Harvard Medical School Family Health Guide. (2005). Is it okay to be fat if you’re fit? Retrieved from http://www.health.harvard.edu/newsweek/ Is_it_okay_to_be_fat_if_youre_fit.htm

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