November 14th was World Diabetes Day. To acknowledge this, it is important to understand why there is a day dedicated to diabetes awareness. The burden of diabetes has quadrupled over the past decades; the World Health Organization estimates there are 422 million adults who currently have diabetes worldwide. That is 1 in 11 adults. Data from the National Diabetes Statistics Report found that in 2017, there were 30.3 million people who had diabetes, of which 23.1 million people are diagnosed and 7.2 million people remain undiagnosed.
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The burden of diabetes is not just in the numbers affected but also in health costs, and, most importantly, quality of life. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputations. WHO projects that diabetes will be the seventh leading cause of death in 2030. Currently, it is estimated that 1.6 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose in 2015 and 2012, respectively.
The above numbers are why we must focus on awareness, prevention and treatment of diabetes.
What are the symptoms of diabetes?
Diabetes can be treated. Dietary and lifestyles factors have been proven to make the largest impact on decreasing, preventing and treating the complications from diabetes. As with most progressive illnesses, diabetes onset typically goes unrecognized by the patient for a number of years, with the exception of type 1 diabetes, which is typically a sudden onset of symptoms. So what are the warning signs of high blood sugars and possibly undiagnosed diabetes?
Symptoms of hyperglycemia to look for:
- Frequent urination
- Frequent thirst and hunger, even right after eating
- Extreme fatigue
- Changes in vision
- Sores that won’t heal
- Gum disease, gums pulling away from teeth, red, swollen gums or changes in the way your dentures fit
- Weight loss
- Tingling, pain or numbness in hands or feet
How does a diabetes diagnosis happen?
When should someone consider getting screened for diabetes?
- Are overweight (BMI >25)
- Are 45 years or older
- Have a parent or sibling with type 2 diabetes
- Have ever had gestational diabetes or given birth to a baby who weighed more than 9 pounds
- Are African American, Hispanic/Latino American, American Indian, or Alaska Native (Some Pacific Islanders and Asian Americans are also at higher risk.)
What tests will my providers/doctors order, and what will they mean?
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| Result | A1c |
| Normal | less than 5.7% |
| Prediabetes | 5.7% to 6.4% |
| Diabetes | 6.5% or higher |
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| Result | Fasting Plasma Glucose (FPG) |
| Normal | less than 100 mg/dl |
| Prediabetes | 100 mg/dl to 125 mg/dl |
| Diabetes | 126 mg/dl or higher |
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| Result | Oral Glucose Tolerance Test (OGTT) |
| Normal | less than 140 mg/dl |
| Prediabetes | 140 mg/dl to 199 mg/dl |
| Diabetes | 200 mg/dl or higher |
Your doctor will typically use two methods to confirm a diagnosis of prediabetes or diabetes.
What comes after a diabetes diagnosis?
In either case of prediabetes or diabetes, the treatment includes a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco. It is important to incorporate these with any medication regimen your doctor may prescribe. In fact, diet and lifestyle changes have been shown to decrease your hemoglobin A1c by one to two percent!
When you are thinking of beginning a new dietary plan, you must incorporate schedule, food behaviors, and even your favorite foods. For example, if you grew up on meat and potatoes, I would not say you could never eat those foods again. Instead, it is important to discuss healthier cuts of meat or poultry or healthier types, portions and ways to prepare potatoes. Many people think a diet is depriving yourself of food—instead think of adding new foods to portion-controlled foods you enjoy. A good guideline is the USDA’s Plate Method.
Using this method, you can incorporate a controlled amount of carbohydrate sources, while increasing your non-starchy vegetable intake. The most challenging part for most individuals is making half of your plate non-starchy vegetables. It helps to get creative with your vegetables—explore zucchini noodles, spaghetti squash pasta or even eggplant pizzas! Or, try this cauliflower rice recipe:
Cauliflower “Rice” Salad
Salad
- 12 ounces of cauliflower florets or pre-made cauliflower “rice”
- 1 cup cucumber, diced
- 1 cup grape tomatoes, cut in half
- 2 green onions, sliced
- 3 tablespoons sliced Kalamata olives
Dressing
- 1/4 cup red wine vinegar
- 2 tablespoons olive oil
- 1/2 tablespoon Dijon mustard
Instructions
- Make your own cauliflower rice by placing cauliflower florets in a food processor and processing them to rice-like consistency. (Be careful not to over-process.)
- In a salad bowl, combine all salad ingredients.
- In a small bowl, whisk together the dressing ingredients.
- Pour dressing over salad and serve with reduced-fat feta cheese, if desired.
Try cauliflower rice in other traditional rice dishes—you might be surprised!
From http://www.diabetes.org/mfa-recipes/recipes/2016-07-cauliflower-rice-salad.html.
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