Pre-diabetes prevention

Men's Fitness, April, 2003

My doctor recently informed me that I'm developing a "pre-diabetic condition." (I'm 35.) What exactly does that mean, and what should I do about it?

--P.M., WOODSTOCK, NY

Bonnie Modugno, M.S., R.D., explains that the condition of pre-diabetes may have a significant impact on how your body operates.

"The pathology of elevated blood sugar impacts cell function," she says, "With this diagnosis, you're being told that the way you're living your life is allowing your body to store fat instead of burning calories for energy. Your pancreas has been happy to help you with that by secreting excess insulin and creating the conditions we associate with diabetes as many as 20 to 30 years before diabetes is diagnosed. This 'pre-diabetes' diagnosis gives you and your clinicians an opportunity to address the condition at an earlier stage."

Not surprisingly, the best approach to dealing with pre-diabetes is to increase exercise and monitor your food intake.

* Exercise: "If you start exercising, your body will become more sensitive to insulin secretion and will metabolize energy more effectively," says Modugno. "You won't be as likely to store excessive fat, especially truncal fat. This will likely give your pancreas a rest, with a resultant lowering of blood-sugar levels. Do whatever physical activity you like: weight training, yoga, swimming, walking. Do it daily if you can, or, at the least, three to five days a week--and do it with purpose. All forms of movement work to enhance your insulin sensitivity so that you burn energy more efficiently."

* Nutrition: "Eat more whole foods and fewer processed foods so that you'll have a higher fiber content," Modugno recommends. She also stresses nutritional balance. "Include protein and produce at each meal--meat, dairy, fruits, vegetables, beans and legumes. Foods from these categories should provide the bulk of your daily calories. Keep your refined-starch consumption--pasta, bread, rice--modest."

DIABETES DEFINED

"Clinically, diabetes is diagnosed when fasting blood sugars are above 126 milligrams per deciliter on several occasions over a short period of time," says Bonnie Modugno, M.S., R.D. "Clinically, 'pre-diabetes' is diagnosed at 100 to 125 mg/dl for fasting blood sugar. We know that people's blood sugar can spike when they're ill, when they're injured, or when they're under stress. What we need to see to make this diagnosis is a consistent elevation that indicates a clear tendency toward diabetes."