Lifestyle Changes Can Reduce Diabetes Risk
by Marnie Blount-Gowan - Wednesday, November 13th, 2013
November is American Diabetes Month

It’s very likely that you know someone who has diabetes or is at risk for the disease.

“Type 2 diabetes is increasing throughout New York state and the world. This is linked to the rise in obesity and sedentary lifestyle,” explains Dr. Ruth S. Weinstock, medical director of the Clinical Research Unit and Joslin Diabetes Center at Upstate.

Nearly 26 million children and adults in the United States have diabetes, with type 2 being the most common form; 79 million Americans have pre-diabetes and are at risk of developing type 2 diabetes. The American Diabetes Association estimates that the cost of diagnosed diabetes in the United States is $245 billion per year.

What happens when you have type 2 diabetes?

If you have type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. Either the body does not produce enough insulin, or the cells ignore the insulin.

Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells.

Diabetes increases the risk for many serious health problems, including nerve damage, foot, eye and skin problems, hypertension, hearing loss and kidney disease. It is a serious chronic condition, but with correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.

How can I care for my diabetes?

•    Choosing what, how much, and when to eat.
•    Getting physically active.
•    Taking medicine (if your doctor prescribes it).
•    Checking your blood glucose (if your doctor prescribes it).
•    Going to your appointments.

Small Steps for Your Health

Making just a few small changes can make a big impact on your weight and health.

Build a healthier plate. Use a grocery list when shopping to help you choose more fresh vegetables, fruits and whole grains. Buy leaner meats–such as chicken, turkey and lean cuts of pork or beef such as sirloin or chuck roast–and lower-fat dairy products, like low-fat or skim milk and yogurt. Buy whole grain breads and cereals.

Eat smart. To cut down on the sodium in canned vegetables, drain and rinse them before heating in fresh water. You can do the same to reduce added sugar in canned fruits or buy them packed in juice, not syrup. Try starting meals with a salad or soup with lots of vegetables. Make healthy snack foods easy to find in your kitchen. In restaurants, ask if meats can be grilled rather than fried and request sauces and dressings on the side. Choose fruit, salad or other vegetables as side items. Order a salad or soup to start and then share an entrée. Skip dessert.
Be physically active. Physical activity, including exercise, household chores, walking, using the stairs, sports, dance and other types of movement, helps keep your blood glucose, blood pressure, HDL cholesterol and triglycerides on target. Physical activity lowers your risk for pre-diabetes, type 2 diabetes, heart disease, stroke, certain types of cancer, relieves stress, strengthens your heart, muscles and bones, improves your blood circulation, tones your muscles and keeps your body and your joints flexible. A complete physical activity routine includes four kinds of activity: basic activity, like walking, using the stairs and moving around throughout the day; aerobic exercise, such as brisk walking, swimming or dancing; strength training, like lifting light weights; and flexibility exercises, such as stretching. Even if you have never exercised before, you can find ways to add physical activity to your day. You’ll get benefits, even if your activities aren’t strenuous.

What research is being done to reverse the rise in diabetes?

New methods are needed to improve the public health and reverse the alarming rise in diabetes, its cardiovascular complications and other obesity-related illnesses. In research supported by the National Institutes of Health, a multiple session “Lifestyle Balance” group intervention, Diabetes Prevention Program (DPP), proved to be effective in helping obese patients lose weight, increase physical activity and reduce the risk of developing diabetes.

Drs. Paula Trief and Ruth Weinstock, of the Joslin Diabetes Center at Upstate, recently explored ways that the principles of DPP could be delivered with broader reach at less cost.

“Since patients have regular and ongoing contact with their primary-care physicians, an intervention to prevent type 2 diabetes that can be delivered through primary care practices could have better long-term outcomes,” explains Weinstock.

Their recent study reached out to patients at risk of developing diabetes–including the elderly, disabled and working adults–who might not be able to attend classes. They trained educators from primary-care practices in Syracuse, LaFayette, Oneida and Pulaski to work with patients over the phone to see if this intervention helped patients achieve significant and lasting weight loss.

“Both of the intervention groups {solo and group calls} were able to successfully lose weight. Second, while participants in both interventions lost weight after one year, at two years those in the solo intervention started to regain,” reports Weinstock. “However, those in the group intervention {done via conference calls} continued to lose, so the group intervention was more effective in the longer term.”

Researchers at Upstate are continuing to explore ways to prevent and reduce the symptoms of diabetes. To learn about participation in local clinical trials and a multidisciplinary approach to help people with type 2 diabetes, contact the Joslin Diabetes Center at Upstate at 464-9007.

Are there local DPP programs?

The YMCA Diabetes Prevention Program, based on the DPP, includes 16 core sessions and follow-up support, designed to help participants reduce body weight by 7 percent and to increase physical activity to 150 minutes per week. For information, email intake@syracuseymca.org, or call 474-6851, Ext. 339.

Marnie Blount-Gowan is a mind/body health practitioner and member of the Crouse Hospital Integrative Health Alliance.

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