• Dr. Kate Ricciardi

March is National Kidney Month.


Kidneys are one of the main organs that are affected by high blood sugar (glucose) levels. A blood sugar level that is high, but not high enough to be diagnosed as Diabetes, is referred to as Prediabetes.


According to the National Institutes of Health, 1/3 of adults in the United States have prediabetes.




That's over 84 million people over the age of 18.


You may have heard of prediabetes before and likely know one, two, or a few people with prediabetes.


So, what exactly is it?

Prediabetes is when your blood sugar (blood glucose) is high, but not high enough to be diagnosed with diabetes. It's your body's warning sign that it's not as efficient as it should be to get the glucose/sugar out of the blood and into your cells. Maybe it's being overworked with trying to produce enough insulin to manage the foods/beverages you are consuming. Basically, you're on the healthcare provider's radar for diabetes.



I have heard about insulin and diabetes. How is that connected?

Insulin is a hormone that is made in the pancreas to help glucose from the food you eat get into your cells where it is needed for energy. So, you eat. Your food breaks down to glucose in your blood and the pancreas is signaled to release insulin to get the glucose out of the blood and into the cells. When everything is working properly, the right amount of insulin is released and your lab work for blood glucose/blood sugar will come back "normal."


If your cells don't respond well to insulin, that is called insulin resistance. It's not as easy for them to get the glucose they need from your blood. When this happens, the pancreas (where insulin is produced) makes MORE insulin to help those cells out and get what they need. There is no specific test for insulin resistance that is used clinically. Instead, your healthcare provider may consider several factors, including blood glucose readings are elevated (maybe an A1C reading is available), triglyceride are high and HDL cholesterol levels are low to suggest insulin resistance.


Sometimes, if the pancreas just isn't able to make enough insulin to keep up with demand and then the glucose/sugar stays in your blood instead of being taken into your cells. This leads to the higher reading on a blood test.



Who gets prediabetes?

Well, there are certain individuals that are more likely to develop insulin resistance or prediabetes based on certain risk factors. Some risk factors we can't control, like age and ethnicity, but we can choose foods and exercise...


Take a look at what you're eating. Glucose comes from foods being broken down in the body. It's a great place to start. If your diet consists of alot of red meat and processed meats, as well as frequent sugary beverages, it increases your risk.



Those who tend to consume a diet of whole grains, vegetables, fruits tend to have a reduced risk for prediabetes.



Being overweight puts more strain on the body. There is a calculation for ideal body weight based on height and gender, +/- 10%. When one tends to have more fatty tissue inside muscle and around the abdomen, cells become more resistant to insulin. Perhaps you have heard of the apple shape? Insulin resistance risk increases in men when the waist size is over 40 inches and increases in women with waist sizes over 35 inches. You may have heard of the stress hormone, cortisol. We now know that hormones are produced in abdominal fat "belly fat" and these hormones can contribute to inflammation, heart disease, and other chronic conditions.



Diet, weight and exercise levels all go hand in hand. Sometimes hormones have a hand in weight and it becomes more complicated, but in general...less movement increases risk. Exercise helps to use the energy from the foods you consume. If you are regularly exercising, your cells know they need that energy and they tend to be more efficient/sensitive/aware of the glucose in your blood and the insulin they need to capture it.




Only 24% of Americans over the age of 18 years met the 2008 federal physical activity guidelines for both aerobic and muscle strength activities based on survey between January and June of 2018.


As we age, exercise participation tends to decline, which is why age is a risk factor. Also, with age, muscle mass decreases. Without direct strengthening, after the age of 30 muscle mass begins to decline. After the age of 45 the risk increases the risk of prediabetes.


Genetics also play a part. If there is a family history, that increases your risk especially if you have a parent or sibling with type 2 diabetes. Also, certain races are more likely to experience prediabetes, despite research being entirely clear as to why. Practice based evidence indicates that people of Pacific Island, Native American, African, Asian and Hispanic descent are at an increased risk. Yet, not all risk factors are equal among these groups.


Individuals with certain medical conditions/medical history such as: sleep apnea, obesity, polycystic ovary syndrome, metabolic syndrome, gestational diabetes, high blood pressure, low HDL cholesterol, high triclycerides, increase the risk of prediabetes.


The NIH/NIDDK also reports that there usually aren't symptoms of Insulin resistance and prediabetes. Sometimes people develop dark areas of skin and maybe skin tags in those areas, too, but that is not a definitive guideline. It's not until type 2 diabetes has developed that you likely will develop the symptoms of increased thirst, urination, fatigue, blurry vision.



So, let's prevent this from turning into type 2 diabetes


The best tools in your preventative toolbox are:

Consulting with a Registered Dietitian Nutritionist to help improve your food choices.


We are what we eat, and what we absorb. When one makes changes away from processed foods and to more real, whole foods it can naturally affect our weight, improve blood sugar, as well as blood pressure and cholesterol/triglyceride (lipids) levels for the better.


Consulting with a Physical Therapist is a great place to start for a personalized exercise program based on YOUR specific anatomy and functional abilities and with appropriate guidance for resistance and progressions of strengthening, aerobic exercises.


According to the Diabetes Prevention Program(DPP), for people at high risk of developing diabetes, losing 5 to 7 percent of their starting weight helped reduce their chance of developing the disease. People in the study lost weight by changing their diet and being more physically active.


If this sounds like you or someone you know, schedule an appointment with us today!



Invest in yourself. Schedule a nutrition education package to get a full review of your intake with customized recommendations or a meal planning session that includes a 1 month custom meal plan here.


#nationalnutritionmonth #RDN #nutrition #prediabetes #insulinresistance #insulinsensitivity #health #exercise #inflammation #mealplanning





References

1. National Diabetes Statistics Report, 2017. Centers for Disease Control and Prevention website. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html . Updated July 17, 2017. Accessed October 19, 2017.

2. https://www.cdc.gov/nchs/nhis/releases/released201806.htm#7

3. American Diabetes Association. Standards of medical care in diabetes—2017. Diabetes Care. 2017;40(Suppl 1).

4. Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet: Diabetes & Endocrinology. 2015;3(11):866‒875.

5. https://www.mayoclinic.org/diseases-conditions/prediabetes/diagnosis-treatment/drc-20355284

6. https://public.tableau.com/profile/nhis#!/vizhome/FIGURE7_5/Dashboard7_5

7. Muscles Ligaments Tendons J. 2013 Oct-Dec; 3(4): 346–350.Published online 2014 Feb 24. Strength and muscle mass loss with aging process. Age and strength loss. Keller, K and Engelhardt M.


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 All content contained within this website is for informational purposes only for the general public and is not to be interpreted as individualized medical advice, diagnosis, treatment, prevention, cure.   Always ask your licensed, qualified health care provider any questions you may have regarding medical diagnoses, conditions, or treatment before undertaking a new health care regimen independently. Never disregard professional medical advice or delay/refrain from seeking medical treatment because of content anywhere on this website

     Dr. Kate Ricciardi, DPT RDN CLT     919-797-9296       rdnutritionconsulting.com      info@rdnutritionconsulting.com

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