Here’s a common scenario: You see your primary-care doctor for your annual physical, and you are told your sugar is a little high, and you may even have “pre-diabetes”….and you think, wait, what? And the news keeps on coming. Your insulin may be “a little” high as well, or your cholesterol markers show a less than perfect balance. If the numbers are mild, you’re usually told to “eat better, lose weight, exercise”, and if the numbers are really bad, you’re told to start medication.
Without a clear understanding of what these markers mean and how these early imbalances in your sugar system can eventually become full-blown pre-diabetes and then diabetes, you might have little motivation to do the work to change them. And while yes, lifestyle change can feel like work sometimes, you might be surprised to find that some simple changes will do the trick. Perhaps you are a little overweight, are a little stressed out, and/or you aren’t exercising much. Addressing these things with some simple suggestions, can really make a big difference, and that’s why it’s important to take these early abnormal numbers seriously, because now is the best time to reverse the direction that you are heading in.
My goal for our discussion today is to first make it clear that if you ignore these first subtle changes, you will likely find yourself with a bona-fide disease down the road. But even now, the high sugar in your blood is inflammatory and damages your blood vessels and organs. This is a huge issue! There are 84 million people currently diagnosed with pre-diabetes (and rising!) and you don’t want to end up with type 2 diabetes, which is a major contributor to heart and vascular disease — the leading cause of death in the developed world.
That’s why, now is the time to do something about it.
And the good news? High blood sugar, pre-diabetes and yes, even if you already have diabetes, these are all reversible!
4 Steps to Reverse Pre-diabetes
Step 1: Recognize the implications this has on your health.
The first step is to listen to your body and understand what it’s trying to tell you.
Here is what you need to know to tune into your blood sugar system:
- Know your risk: At Blum Center for Health we generally screen everyone for early blood sugar abnormalities and diabetes using a simple blood test. I screen for insulin resistance and pre-diabetes in patients who are older (over 45), overweight, physically inactive, have family members with diabetes, gave birth to a baby over 9 pounds (or had gestational diabetes), have PCOS, and/or have other risk factors for heart disease – like high cholesterol or high blood pressure.
- Check these labs: The list of labs includes fasting glucose, fasting insulin, and hemoglobin A1C (a measure of the average sugar in the blood over a period of time). We do advanced cholesterol testing, because higher triglycerides and lower “good” cholesterol gives clues to insulin resistance. Sometimes we do glucose tolerance testing, where we look at the amount of sugar and insulin in the blood after drinking a sugary drink. This tells us how hard the pancreas is working to produce enough insulin to decrease sugar in the blood.
Step 2: Make impactful changes to your health.
Here is the good news. Catching diabetes before it manifests and treating insulin resistance is relatively straightforward, although you do have to commit to some permanent changes, which for some people can be difficult. The lifestyle changes that improve the entire spectrum of metabolic and blood sugar issues are tried and true. In fact, lifestyle changes have been shown to improve numbers in these early stages of diabetes more than medication.
Focus on these 3 lifestyle behaviors to improve your personal glucose system:
- Diet – Eating a higher protein, higher fat and lower simple carbohydrate diet is key. There are many nuances to this, and we suggest working with a nutritionist or health coach to help you figure this out, because it is the quality of the protein, fat and carbohydrates that counts as much as the amounts. Also, losing weight helps – even a 5% drop in weight (about 8 pounds for a 150 pound person) will improve insulin resistance. I refer nearly all my pre-diabetic patients to our Functional Medicine nutritionist or our Health Coach to create a personalized food plan that dovetails your individualized treatment plan. Learn More If you live far away, you can also work with our Health Coach online! Sign up HERE.
- Exercise – Physical activity allows muscles to use up the sugar from the blood which lowers blood glucose and improves insulin sensitivity. Just 30 minutes of exercise, 5 days a week will help. Brisk walking after meals recruits muscles to move glucose from the blood.
- Sleep – Getting plenty of restful sleep is good for us in so many ways, metabolizing sugar being one of them. Disturbed sleep and sleep apnea is correlated with the spectrum of sugar dysregulation.
Step 3: Get the support you need!
Once you begin to make changes to your daily habits, you might need support to keep you focused and in the game! What can this look like?
- For some people, support is letting everyone around you know what your health concerns are, and why you’ve decided to work on new food and exercise goals. Having your family, coworkers and friends on board can make it less likely for you to slip up.
- Enlisting others to do it with you is another option that can be very satisfying for all involved.
- For others, being mindful and collecting data about your food, activity, and sleep is what is key. Fitbits and other tracking devices, food diaries, and keeping careful logs of sugars can be very helpful for you and your doctor.
- Make sure you have a supportive medical team, including a doctor who is invested and spends time with you to encourage and follow your progress.
- One of the most powerful ways you can create positive change is by working with a Health Coach who will help you overcome obstacles and keep you focused on the prize. Learn More
Step 4: Monitor markers and observe progress.
Keep track of your markers and notice when things change. I guarantee that if you make the changes above, to diet, movement, and rest – the numbers will move in the right direction. If not, something else is brewing and needs our attention.
- Tracking progress: As I discussed above, there are many ways to track insulin sensitivity, prediabetes, and type 2 diabetes. Glucose and hemoglobin A1C are not the only biomarkers playing into this metabolic orchestra. Ask your physician to do more in-depth diabetic screening, advanced lipid testing and hormone testing. If you see a functional medicine doctor, adrenal testing can be telling, as can stool testing for a look into the gut microbiome. Further investigation into inflammatory markers, toxins, and nutrient status can also help guide overall health.
Live in the NYC metro area and want to learn more?
Join me for a community talk An In-Depth Discussion on Diabetes on Wednesday, November 15th at 7pm. Register Now! I will review how we treat these conditions from a functional medicine perspective – dietary guidelines, supplements, and medications that work.
Are you interested in meeting with me or one of my colleagues? We would be happy to help. People travel from all over the world to work with us. Come join our family!
If traveling to us is not possible, you can work with our Director of Nutrition or Health Coach by phone or Skype. Call 914-652-7800 for more information.
Meet Darcy McConnell, M.D.: Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.