Have You Been Told You Have Pre-Diabetes?

Featured Speaker

Beth Cook, RD, CDE

Beth Cook, RD, CDE

About this Podcast

About This Podcast

Aspirus providers, dieticians and diabetes educators work with patients of all ages and all types of diabetes. We know having diabetes or prediabetes greatly impacts your life and can be difficult to manage, but we work with you as a team to manage your condition and prevent complications from occurring.

If you have diabetes or pre-diabetes we can help you manage and care for your condition in the healthiest way possible!

Listen in as Beth Cook, RD, CDE explains that having prediabetes is a wake-up call to take action to improve your health.



Melanie Cole (Host): Aspirus providers, dieticians and diabetes educators work with patients of all ages and all types of diabetes. They know having diabetes or pre-diabetes can greatly impact your life and can be difficult to manage. My guest today is Beth Cook. She’s a registered dietician, nutrition and dietetics manager and a certified diabetes educator at Aspirus Keweenaw Hospital. Welcome to the show, Beth. People have heard the term lately in the media, “pre-diabetes”. Tell us what that is and how do you even know if you have it?

Beth Cook (Guest): Well, pre-diabetes, what we used to call “borderline diabetes,” is an area of diagnosis where our sugars are higher than they normally should be but they’re not in a range that is considered diabetes yet. And, we don’t know if we have it unless we have a lab draw and they would test our fasting blood sugar.

Melanie: So, there are a few different lab draws that people have heard about or they see on their blood tests--the A1C or the fasting plasma glucose. Tell us about some of those draws and what do they mean? What do the numbers mean and what are you guys looking for?

Beth: A normal blood sugar for someone who does not have diabetes after eating a meal should not go over 140 mg/dL in our blood. With someone who has pre-diabetes, this number is elevated to probably after a meal, anywhere from 140-199. Now, if we are to diagnose pre-diabetes, the physician or provider would order a fasting lab draw. They would fast over the evening for 8-12 hours, and this fasting glucose number will see what our body’s doing through the evening and how much blood sugar is in our system. Any range for a fasting between 100-125 mg/dL would be considered a diagnosis of pre-diabetes.

Melanie: If somebody gets that diagnosis, what does that mean for them? Does that mean they’re automatically going to get diabetes?

Beth: That’s a good question. We do know that people who develop pre-diabetes may eventually go on to develop type 2 diabetes. They are at higher risk. But, being able to diagnose pre-diabetes early on, we realize that with some small lifestyle changes, we could prevent or prolong the diagnosis of type 2.

Melanie: And so, what do you tell them? What are those lifestyle changes?

Beth: Some of the lifestyle modifications can start with changing your overall healthy eating habits and your lifestyle physical activity. We talk about eating food in moderation, portion control. We certainly want to cut back on the high-fat foods and limit our sugar intake. Eating more fruits and vegetables, high-fiber whole grains will help us fill up, and can help with weight loss. It is also noted that weight loss of anywhere from 5-7%, which is about 15 pounds for someone who is about 200 pounds. That percentage of weight loss can greatly decrease our risk of developing diabetes by 58%.

Melanie: So, what do they do nutritionally because that’s where people really get confused. They don’t understand if they’re allowed to eat carbohydrates, what’s a good carbohydrate, what’s a bad one, what are the sugars that they should stay away from? It can be very confusing, Beth.

Beth: Yes, it can be confusing. I realize back in the day during my grandmother’s time when she had diabetes, people thought that eating regular cane sugar or honey, was something to avoid completely. We now realize that other foods are broken down into sugar, like we said, carbohydrates. So, that could be our starchy vegetables such as potatoes, corn, peas. We also have the grains, anything made with flour. So, bread, baked goods, doughnuts. Milk also has lactose or milk carb in it, and we know fruit is sweet so it has natural sugar in it as well. So, I talk to patients who have pre-diabetes and pretty much discuss how we could eat all of those foods along with the cookies and cakes but in moderation and we talk about portion control and how we setup our meal plan by using the plate method. Now, the plate method has replaced the food guide pyramid in way of helping us design our meals. We want half of our plate to be full of vegetables; a quarter of your plate will be your starch, your potato, rice and pasta; and the other quarter of your plate will be your low-fat lean meat, chicken, beans, beef; and then, on the side you would have either milk or fruit. This helps guide them through their carbohydrate choices.

Melanie: And, where does exercise fit into this picture?

Beth: Well, we know that exercise, in moderation, can certainly help lower blood sugar. I even advise people to take a small walk after eating a meal, of up to 10 minutes. Moderate exercise, 30 minutes a day for 5 days a week, can also help reduce the risk of developing diabetes. That follows along the exercise guidelines of 150 minutes a week. Consider maybe walking or a brisk walk, swimming, bicycling. Those are examples of moderate activity.

Melanie: So, if somebody does have a lot of weight to lose and they go about trying to lose that weight, will that help them stave off the possibility and decrease their risk of contracting full-blown type 2 diabetes?

Beth: Yes, it certainly could. One of the reasons that the body is having difficulties monitoring their blood sugars is because of insulin resistance. Our body is creating insulin but it’s not working well with opening the doors to our cells to let the sugar in. A lot of this is due to having fat or adiposity in our mid-stomach, abdominal region. If we were to have that 5-7%weight loss, it greatly helps the insulin work more efficiently and can open those doors.

Melanie: What else would you like to tell them about keeping track of the food when they’re trying to lose weight because that’s another hard thing. They’re not sure, if they are trying to lose weight to avoid diabetes, should they be stepping on the scale? Should they be writing down their food? What do you tell people every day, Beth, about journaling and keeping track and being their own best accountable person?

Beth: Well, some people find a lot of support with writing down what they’re eating because they find they’re more mindful of what they choose to eat. They can also track when they’re choosing higher sugar foods and then they realize. It’s a nice eye opening experience to journal for a while. Some people don’t like journaling but through counseling we can identify some of those high-sugar foods or beverages. For instance, just by cutting out sugar pop or 100% juice, which is also very high in sugar, some patients can lose up to one to two pounds a week which can be very encouraging. I also advise them to consider getting on the scale once a week which could give them motivation to see those pounds coming off.

Melanie: What about alcohol? A glass of wine? Because those sugars react differently in our body. So, where does that fit into that glucose tolerance picture?

Beth: Well, alcohol also has calories, so mostly in the pre-diabetes state, I talk about the amount of calories we’re consuming in a day. It depends on what kind of beverage you’re choosing. If you’re choosing a daiquiri or a margarita, it could be up to 300 or 400 calories. Or, is it one glass of beer which might be 150. So, making wise choices that way. The recommendation for women is one to two drinks a day and men two to three for alcohol. So, I think we need to think about moderation and being mindful of our choices.

Melanie: That’s so important. Such great information. Wrap it up for us. Pre-diabetes--would the people have any symptoms that would even send them to the doctor in the first place? And, what’s the best thing that they can do to hopefully avoid this or prevent it?

Beth: Well, there are no symptoms to pre-diabetes. If we continue to follow up with our providers annually for our labs and our follow-up, the providers may suggest taking a blood test, and this would indicate if we have pre-diabetes or not. I think it’s important to say that we should follow-up with our providers as scheduled to check some of these diagnoses that we may not until down the road. Certainly, maintaining an overall healthy weight and being active can help stave off developing pre-diabetes or diabetes down the road. So, being mindful about how long we’re sitting, about our daily routine and our daily food intake, can make a big difference.

Melanie: Tell the listeners why they should come to Aspirus Health System for their care.

Beth: Aspirus has a wonderful team of diabetes educators and providers who work individually with each patient to help them develop a plan and a goal to address their diabetes and weight management. So, I encourage people to consider making Aspirus their choice.

Melanie: Thank you so much for being with us today. You’re listening to Aspirus Health Talk. For more information, you can go to www.aspirus.org. That’s www.aspirus.org. This is Melanie Cole. Thanks so much for listening.