Saturday, June 29, 2013

12 Common Diabetes Myths Debunked

http://www.caring.com/articles/diabetes-myths


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Myth #1: People with diabetes can't eat anything sweet.

Relax -- despite what you may have heard, a piece of cake or a couple of cookies won't cause a health crisis. In fact, sweets can be eaten in moderation by people with type 2 diabetes, if eaten as part of a healthy meal plan and combined with exercise, according to the American Diabetes Association.
Still, while avoiding sweet treats isn't mandatory, limiting them is. Sweets often contain not only empty calories but a lot of sugar, a carbohydrate that raises glucose levels considerably. For better glucose control, diabetics should have dessert only after a low-carb meal. It's important to eat that chicken breast, broccoli, and salad before dishing into some ice cream.

Myth #2: Eating too much sugar causes diabetes

No, chocaholics aren't destined to develop diabetes. The disease is thought to be caused by a combination of genetic and lifestyle factors. And the high level of sugar in someone's bloodstream is not the same thing as the refined stuff you buy in bags from the supermarket. That said, being overweight can increase the risk for developing type 2 diabetes, and eating a lot of sugar can pack on the pounds. 

If your family has a history of diabetes, eating healthfully and exercising regularly is recommended to keep everyone's weight in check. For those who already have diabetes, those same things will help them manage the disease.

Myth #3: People with diabetes must eat a special diet.

A healthy diet for someone with diabetes is the same as a healthy diet for anyone else. How does that look? A wholesome meal plan is based on whole-grain foods, lean protein, vegetables, and fruit. Such a diet is low in fat (particularly saturated and trans fat), salt, and simple sugars. So-called diabetic foods offer no special benefits. The best bet is to skip these costly commercial offerings and head for the produce aisle instead.

Myth #4: You can catch diabetes from someone else.

Diabetes is not an infectious or contagious disease. Scientists don't know for sure exactly what causes the disorder, but it can't be caught from another person, like a cold or the flu. There, does, however, appear to be a genetic link with type 2 diabetes: If a family member has the condition, you're at higher risk for the disease.

Myth #5: There are only two types of diabetes.

Not so. Diabetes refers to a group of diseases -- all of which require serious attention -- that have in common the body's inability to properly convert glucose from food into energy, leading to a high level of sugar in the blood. The main kinds include type 1 (formerly known as juvenile-onset diabetes), type 2 (once called adult-onset diabetes), and gestational (which occurs only during pregnancy). 

The suspected causes differ for each type, but managing any type of diabetes requires balancing food, physical activity, and, if needed, medications. And while people with type 1 diabetes need to take insulin every day for their entire lives, type 2 diabetes is no less of a concern, because ignoring it could lead to devastating complications such as blindness, heart attack, and stroke.

Myth #6: Only people with diabetes need insulin.

Everybody needs insulin, a hormone produced by the pancreas that allows the body to convert food into energy for activity. People who don't have diabetes make and use the right amount of this chemical. People with diabetes either don't make any insulin, don't make enough, or can't use the insulin they make properly. 

If you or someone you're caring for has type 2 diabetes, it's important to balance food, activity, and -- in some cases -- medications, which may include insulin injections or an insulin pump (insulin isn't available in pill form), to get the necessary amount of this essential hormone. And to dispense with another myth in this area: Insulin is a tool to manage diabetes, not a cure.

Myth #7: Nothing can be done to prevent diabetes complications.

Nothing could be further from the truth. Studies show that diabetes-related complications can be prevented or delayed by following a self-care treatment plan that keeps blood sugar levels under control and by getting regular medical checkups. 

Many people with type 2 diabetes also have high blood pressure and cholesterol. Keeping these twin conditions in check as well can also go a long way toward warding off complications such as nerve 
damage and kidney failure.

Myth #8: Only overweight people get diabetes.

Here's the skinny on this one: Many people who have type 2 diabetes carry excess pounds, and some are obese, but many elderly people with the condition aren't particularly overweight. 

If you or the person you're caring for needs to shed some weight, it may be motivating to learn that even modest weight loss through healthier eating and increased activity can help keep long-term complications at bay. But diabetes doesn't discriminate: Even Slim Jims can succumb to the disease.

Myth #9: People with diabetes shouldn't exercise.

The exact opposite is true: Exercise is a key component of any diabetes treatment plan, as it helps diabetics better use insulin and lower or maintain weight. Alas, exercise is often the most overlooked weapon in the arsenal against this disease, underestimated by both patients and care providers

If the person in your care hasn't been active in a long time, is overweight, or has other medical conditions or mobility issues, then it's wise to get his or her main diabetes care provider's green light before he or she embarks on an exercise regimen. But barring severe disability or serious complications, physical activity of some sort -- and this doesn't have to mean working out at a gym -- should be done regularly by everyone with diabetes, regardless of age. You might encourage the person you're caring for to take walks with you, for instance.

Myth #10: People who follow their treatment plan never have high blood sugar readings.

It's too bad this myth isn't true. Unfortunately, someone with diabetes may experience the odd stubbornly high reading even if he's diligently following all his doctors' orders. Type 2 diabetes isn't an easy disease to manage -- and as we age, our bodies are constantly changing, as is our reaction to stress, infections, illness, medications, exercise, and diet. Little wonder, then, that sometimes our blood sugar doesn't cooperate.
It's best to praise a diabetic's hard work when he does hit his recommended range, but don't let an occasional high reading give him the excuse to throw in the towel. If he keeps on following his treatment plan, he'll find that, overall, his glucose control is on target.

Myth #11: It's possible to have "just a touch" or "a little" diabetes.

Nope, you either have type 2 diabetes or you don't -- period. And if you have the disease, you need to pay attention to it. Even if diet and exercise changes keep the disease in check and you don't need oral medications or insulin injections, the condition still demands that you follow a self-management treatment plan that includes glucose monitoring and making careful lifestyle choices.

Myth #12: People diagnosed with diabetes are doomed.

Far from it. While it's true that diabetes is a long-term disease without a cure and that diabetics might experience some pretty nasty complications if their blood sugar levels are allowed to soar sky-high for years, they can avoid that fate.
Many people can and do lead busy, active, spontaneous lives while also managing their type 2 diabetes. A diabetes diagnosis alone doesn't rule out travel, having fun, or partaking in many common pastimes or pursuits. Simply put, they must follow their treatment regimen, plan ahead, and take extra precautions when necessary, such as checking blood sugar more often if they're traveling across the country, or packing the right foods if they're taking a long car trip. With a little help and support from family or friends and the assistance of a good healthcare team, it's possible to live a full and fulfilling life even with a diabetes diagnosis.

Type 2 Diabetes and Stress: Find out How Stress Affects Blood Sugar Levels

http://www.caring.com/articles/diabetes-and-stress


What is stress, and how does it affect blood glucose levels in someone with type 2 diabetes?

What is stress? Stress is a physiological response to a perceived attack or an event that produces strain. It can be triggered by a physical cause, such as injury, illness, or surgery. Or it can stem from an emotional reaction to problems with health, finances, or relationships. Stress can be "good" (an active vacation or a much-anticipated family visit) or "bad" (sickness, money woes, a family visit that turns contentious). It can be short term (getting stuck in traffic or catching a cold) or long term (dealing with diabetes or coping with an ailing partner).
  • Stress takes a toll on the body. When the body feels stressed, it responds by triggering the fight-or-flight response, in which levels of certain hormones, such as adrenaline, cortisol, and epinephrine, kick in and shoot up. These stress hormones make a lot of stored energy -- specifically glucose and fat -- available to the cells to help the body escape from danger or get ready to do battle.
Everyone experiences stress from time to time. But having many stressors or a long, intense, physical response to stress can lead to health problems such as headaches, migraines, digestive troubles, insomnia, anxiety, and depression, as well as changes in appetite and cravings for caffeine, alcohol, and sugar.
How does stress affect people with type 2 diabetes? In people who have diabetes, the fight-or-flight response doesn't work so well. Insulin isn't always available to unlock cells and let that extra energy in, so glucose starts to back up in the blood. In addition, if someone with diabetes is dealing with an emotional stressor, his body may continue to pump out hormones with no end in sight, as neither fighting nor fleeing helps in a situation where the enemy is actually the mind.
  • Stress elevates glucose levels. If someone you're caring for is experiencing stress, his blood glucose levels are likely to be elevated for a couple of reasons. First, stress hormones can make blood sugar levels soar, sometimes to harmful heights. Second, people under stress often don't take good care of themselves. He may forget to eat or exercise, skip medications, become dehydrated, or feel too under siege to check blood sugar regularly or keep routine medical appointments.
Chronic, long-term stress can be particularly taxing on the body and can increase his risk of routine stress-related health ailments as well as complications linked to diabetes.

How can I help someone minimize the impact of stress on his diabetes and learn to relax?

Reducing the impact of stress

Someone with diabetes usually has some control over how he reacts to stress. If he's aware he's feeling tense, he may be able to learn to relax and reverse the body's hormonal response to distress. Help him recognize when he's stressed and what's upsetting him by asking him to keep a stress journal. By jotting down a few notes when the going gets tense and rating his level of stress before testing his blood sugar, he should be able to figure out what's likely to cause a rise in his numbers.
  • Encourage the person you're caring for to alleviate stress whenever possible. Once he has identified the cause of his distress, ask him to write down his feelings about this stressor, and help him identify potential solutions or options. Then help him come up with an action plan about how he can eliminate this stressor from his life so he feels less frazzled. If, for instance, he knows that his numbers go up whenever the neighbor's son cranks up his stereo after 10 p.m., maybe he can convince the neighbors to keep it down at night. If he bickers constantly with someone in his life and realizes that this makes his blood sugar go wild, perhaps the two of them can consciously work to reduce the squabbling or see a counselor.
  • Consider his personality. Different personality types have different ways of coping with stress. If, for example, the person you're caring for has a problem-solving mindset, he may be able to reduce stress by asking himself: "How can I handle this predicament?" and taking action. If he finds it easier to let things go, he might try telling himself, "This problem really isn't so important after all," meditate, or play cards for an hour or so. Neither approach is right or wrong: The goal is to encourage him to handle stress in constructive ways without making his blood sugar levels swing out of control.
  • Set small, healthy goals. During stressful times, help your friend or relative set small, achievable goals for keeping his blood sugar on track so he won't feel overwhelmed -- and tempted to blow his treatment plan altogether. Maybe he's willing to take a short walk around the neighborhood with you. Or perhaps he'll agree to eat three veggies today or have two cookies instead of five. Maybe he'll agree to check his blood glucose at least once -- or let you do it for him. Little steps like these can help keep him motivated and prevent him from throwing in the towel under pressure.

Helping someone with diabetes relax

Many simple relaxation strategies can help the person you're caring for prevent or lessen the impact of stress. These include:
  • Breathing exercises, yoga, meditation, massage, and other similar activities that can calm the mind.
  • Progressive relaxation therapy that includes learning to tense and relax major muscles in a sequence.
  • Exercise, which raises levels of endorphins and serotonin, two brain chemicals that influence mood and sense of well-being. Exercise is an invaluable stress reliever with loads of other health-related benefits as well.
  • Behavior modification, a fancy term that can simply mean replacing unhelpful thoughts with helpful ones and emptying distracting thoughts from the mind. He can learn techniques for doing this from a therapist.
  • Time spent outside -- don't underestimate the soothing effects of fresh air, sunlight, and nature.
  • Sleep: Inadequate rest can make stress worse and lower his ability to cope with it. Conversely, healthy slumber habits can increase energy and improve attitude. If he struggles to get enough shut-eye at night, suggest a restorative short nap during the day.
Whichever strategies the person you're caring for tries, encourage him to practice for a few weeks or months before discarding them. Like learning a new sport or hobby, it takes time and practice to discover how to truly chill out.

How can I help someone if his diabetes is causing him stress?


Diabetes is a stressor that isn't going to go away, no matter what he does. That said, there are ways to lower or limit the stresses associated with living with diabetes.
  • Suggest a support group. These groups can be an invaluable help. The person you're caring for is likely to feel less lonely if he has peers in the same situation he can relate to, learn from, and befriend. So find a peer support system near him or help him access one online (try searching using the key words diabetes online support group).
  • Help organize his care regimen. Sometimes the sheer logistics of self-managing diabetes is a source of stress. It's understandable that dealing with this chronic condition can leave your friend or relative feeling frustrated and tired of all the effort it takes to look after himself. One way to lower or eliminate this source of tension is by helping him keep to-do lists and a notebook or journal to monitor medications, diet, exercise, and doctors' appointments. You can also help him stay organized by keeping all his diabetes drugs and devices in a convenient container and location, minimizing the stress of figuring out where these items are when he needs them.
And you can make sure he has a written plan for dealing with high or low blood sugar episodes or sick days. Check, too, that he has the supplies on hand to deal with these situations. Of course, when he's under stress he should monitor blood glucose more often so his blood sugar levels don't get out of whack.
  • Help him find a new interest. Some people combat stress by adding something positive to their life. This could be a form of exercise such as hiking or a new activity such as bird-watching. Learning a hobby or craft -- say, pottery or knitting -- may have a calming effect. Doing something to help others, such as volunteering at a school, in a hospital, or for a favorite cause, is often beneficial. Playing or listening to music can also soothe an agitated mind.
  • Identify the top challenges. Tackling diabetes-related stress head-on may also help. Ask your friend or relative which aspects of the disease give him the most trouble and help him address these concerns and make changes for the better. If, say, remembering to take medications is the most bothersome aspect, then help him find a way to make this task less irksome. Or if getting more active is a challenge, figure out a way to make it more fun. Maybe he'd enjoy walking with a friend more than exercising alone, for instance.
  • Listen empathetically. Allowing him to share his feelings and frustrations about his disease -- without giving him advice or judging -- can go a long way toward reducing his stress. He needs your support and empathy in dealing with this progressive, long-term disorder.
  • Get help when needed. Remember that you and the person you're caring for don't have to manage his stress on your own. Ask a member of his diabetes team for a referral if you think he could benefit from therapy, or search online for a mental health practitioner. Talking with a social worker, counselor, or psychotherapist may help him come to grips with his problems or help him find new coping strategies or make behavioral changes to keep stress at bay.
  • Encourage him to let his doctor know about unusual stressors. Chronic stress, such as that caused by an ongoing financial crisis or the pain of a degenerative illness, may warrant an adjustment in medications, since long-term stress is particularly damaging to his body. If this is the case, or if you have any concerns or questions about the level of stress he's under or how to help him handle it, discuss this situation with his doctor or other primary diabetes healthcare provider.

Chronic Diabetes Complications: How to Avoid 10 Chronic Diabetes Complications

http://www.caring.com/articles/chronic-diabetes-complications

Caring.com User - Sarah Henry

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Quick summary

Older adults are at increased risk for many serious, sometimes life-threatening diabetes-related conditions, often the result of years of undetected or untreated high blood sugar levels. That's why it's vitally important that the person you're caring for practice good diabetes management by keeping blood glucose under control, giving up cigarettes, eating well, staying active, maintaining a healthy weight, and taking medications, which together can go a long way toward avoiding or slowing down common complications.

Diabetes-related complications that threaten a patient's heart

1. High blood pressure

What it is: This condition, also known as hypertension, occurs when blood flows through the body's blood vessels with greater than normal pressure. Normal blood pressure is 120/80 millimeters of mercury or below; blood pressure of 130/80 or higher is considered hypertension.
What it does: High blood pressure can place excess strain on the heart, damage blood vessels, and increase the risk of heart attack, stroke, and kidney problems.
How to prevent it: A balanced, low-salt diet; regular exercise; stress management; and moderate alcohol consumption can all help. So can prescription medications. The patient should have her blood pressure checked at every doctor's visit.

2. Heart disease and stroke

What it is: Heart disease, also known as cardiovascular disease or coronary artery disease, damages the arteries and veins of the heart -- and high blood glucose is thought to make this disease worse or more complicated. A stroke is the result of damage to blood vessels in the brain.
What it does: High blood sugar can cause hardening of the heart arteries, known as atherosclerosis, which can lead to heart attack or stroke, depriving the brain of oxygen. That can lead in turn to speech or mobility loss. Heart disease and stroke combined account for about 65 percent of deaths in people with diabetes.

How to prevent it: The person you're caring for should aim to keep her blood pressure and lipid or fat levels -- including cholesterol and triglycerides -- within the recommended range. Lifestyle changes, such as diet and exercise, and medications can also help. The American Diabetes Association recommends that most people with type 2 diabetes take an aspirin a day, as aspirin use has been linked to a lower risk of heart attack. The suggested dose ranges from 81 milligrams (mg) a day, the amount found in baby aspirin, to 325 mg a day, the amount contained in an adult tablet. Using the lowest possible dosage may help reduce such side effects as gastrointestinal problems. But be sure to ask the doctor what he recommends. Heart disease is easiest to treat when detected early, so make sure the patient sees her main diabetes doctor at least two or three times a year.

Diabetes-related complications that threaten a patient's limbs


3. Foot problems

What they are: People with diabetes are prone to a host of foot ailments including calluses, ulcers, and poor blood flow or circulation. These conditions are more likely if the patient also has loss of feeling in her feet due to nerve damage.
What they do: Left unchecked, even the most mundane foot ailments -- like an ingrown toenail -- can get worse and lead to serious infections and other complications.
How to prevent them: Make sure the person you're caring for examines her feet on a daily basis for any cuts, sores, patches of redness, swelling, or hot spots, which should be promptly reported to her doctor. She should also remove her shoes and socks and have her doctor check her feet at every routine doctor's visit. Exercise can help poor circulation. However, infections, ulcers, or foot injuries require her to stay off her feet until the problem heals.

4. Nerve damage

What it is: The most common form of nerve damage in people with diabetes is known as peripheral neuropathy, which mainly affects the lower legs and feet. Nerve damage that affects the stomach is called gastroparesis.
What it does: Neuropathy causes pain, numbness, weakness, or an uncomfortable tingling sensation, which can increase the chance of foot injuries. Gastroparesis may delay or otherwise affect digestion, resulting in nausea, vomiting, or bloating; this can make blood glucose control difficult.
How to prevent it: Lowering blood pressure, losing excess weight if necessary, and -- of course -- managing blood glucose levels can all help ward off neuropathy.

5. Amputation

What it is: The removal of a limb or extremity. The most common amputations for people with diabetes involve the lower legs or feet.
Why it happens: Many people with diabetes have artery damage, which can result in less blood flow to the feet. Many people with diabetes also have nerve disease, which can reduce feeling in the feet. Together, these predicaments make it easy for ulcers or infections to take hold -- and, if left untreated, they may lead to amputation.
How to prevent it: Fortunately, most amputations are preventable with routine self-care, proper footwear, and regular foot checks from a healthcare provider.

Other diabetes-related complications patients need to be aware of


6. Kidney disease

What it is: High blood sugar and high blood pressure can damage the kidneys and lead to a disease known as nephropathy, in which protein leaks out of damaged kidneys into the urine. As a result, the kidneys can no longer remove waste and extra fluids from the blood.
What it does: Left untreated, kidney disease can cause kidney failure, known as end-stage renal disease. Diabetes is the leading cause of kidney failure, and a person with this condition needs long-term dialysis (in which a machine eliminates waste from the blood) or a kidney transplant.
How to prevent it: Keeping blood pressure and blood glucose under control is key, whether through lifestyle changes, medications, or both. Protein in the urine is often the first sign of nephropathy, so your friend or relative should be checked annually for this condition; early intervention with medication may help protect the kidneys from further damage.

7. Gum disease

What it is: Gingivitis is a gum condition characterized by inflammation and bleeding. Left unchecked, this ailment can lead to the more serious gum disorder known as periodontal disease.
What it does: Almost one-third of people with diabetes have severe periodontal disease, which can weaken the gums so much that they can no longer support teeth.
How to prevent it: The person you're caring for needs to brush at least twice a day, floss once a day, and make sure she sees a dentist twice a year for checkups and cleanings. She may be advised to go more often if she already has gum disease.

8. Eye disorders

What they are: Several eye conditions are more frequent in people with diabetes, including glaucoma, an increase in fluid pressure inside the eye; retinopathy, damage to the small blood vessels in the retina; cataracts, a clouding of the lens of the eye; and macular degeneration, damage to the part of the retina responsible for central vision.
What they do: Warning signs of eye trouble include blurred vision, sudden loss of vision, black spots, cobwebs or flashing lights, redness, pain, or pressure in the eye. To avoid any permanent vision loss, you or the patient should call her doctor if she experiences any of these symptoms. Diabetic retinopathy is the leading cause of blindness in adults.
How to prevent them: The patient should have an annual eye exam to catch problems before they begin or treat them before they progress. If she has poorly controlled diabetes, high blood pressure, high cholesterol, or kidney disease, she may need to see an eye specialist more often.

9. Erectile dysfunction

What it is: Erectile dysfunction, also known as impotence, refers to the inability to get or maintain an erection during sexual activity.
What it does: Impotence interferes with sexual pleasure. Men with diabetes are twice as likely to experience this dilemma as men without the disease.
How to prevent it: As with all these disorders, keeping blood sugar within the target range is key. Erectile dysfunction can be a side effect of some diabetes medications; the patient should discuss this with his doctor. Depression, stress, or anxiety can contribute to impotence; he may want to seek professional help for these conditions. Reducing alcohol intake and stopping smoking are also highly recommended.

10. Bladder and vaginal infections

What they are: Cystitis, an inflammation of the bladder that's usually caused by a bacterial infection, and yeast infections, a fungal infection of the vagina, can become recurrent problems if the person you're caring for has a blood glucose level that's higher than recommended.
What they do: Elevated blood sugar levels provide an excellent environment for bacteria and yeast to grow, causing these uncomfortable, even painful, conditions to thrive.
How to prevent them: Glucose control is key. Other self-care measures that may help include drinking enough water, urinating whenever there's an urge to go and emptying the bladder completely, avoiding scented personal hygiene products, and wiping from front to back after using the toilet.

Prediabetes Risk Factors: 5 Signs You Might Be at Risk for Diabetes

http://www.caring.com/articles/5-early-warning-signs-of-diabetes

 Caring.com User - Paula Spencer Scott

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Incredibly, one in four Americans over age 20 has prediabetes -- and most don't even know it. Being prediabetic means that your blood glucose levels are higher than normal but short of being classified as diabetic levels. Studies show that most people with prediabetes go on to develop type 2 diabetes within 10 years, unless they lose weight and make dietary and exercise changes.
Because prediabetes develops gradually over years, it's often said that there are no obvious symptoms. But it's possible to notice certain warning signs of growing insulin resistance, the inability to process the energy in food properly that's a key aspect of prediabetes, says Beth Reardon, director of nutrition for Duke Integrative Medicine at Duke University.
Paying close attention to such warning signs gives you plenty of time to make changes before the situation progresses to type 2 diabetes, she says.
"These symptoms usually occur in tandem with one another; together they create a bigger picture that says insulin resistance is going on," Reardon says. "Some signs can be measured, some we feel, some we can just see."
If you're experiencing the following signs, you should ask your doctor about an insulin response test to measure your insulin and blood sugar levels. If the tests confirm that your body is starting to have trouble managing its glucose, it may be incentive for you to commit to the diet and exercise changes that can help move you away from the path toward diabetes.

What Feeling Tired and Sluggish After Eating Might Mean

Ready to nap right after a big meal? This is a normal response to an influx of carbs (think of that post-Thanksgiving dinner feeling). But if it happens often, your body may be sending a message that your diet is too diabetes-friendly.
After eating, all carbohydrates -- whether in a doughnut or a carrot -- are broken down into the bloodstream as glucose (blood sugar), the body's main energy source. When the blood containing the glucose hits the pancreas, this organ gets the message to release insulin, a hormone it produces to help the cells throughout the body use glucose. Cells have insulin receptors that allow glucose to enter and either be stored as future energy or used right away.
It's a great system. But a diet that's high in simple carbs like sugar, white flour, and sweet beverages -- especially when consumed in large quantities at one sitting -- overwhelms it. According to Reardon, the cells' insulin receptors eventually stop receiving the insulin, which means they can't take in the glucose. The glucose builds up in the blood while the needy cells don't get any. The pancreas, meanwhile, notes the glucose level is still high in the blood that flows through it, and it pumps out still more insulin in response. Net result: You feel sleepy and may find it hard to think, because your brain and body are depleted until the system rights itself.
"Over time, this cycle can cause someone to become chronically insulin resistant. The body simply can't keep up with the demands that all those simple sugars and fats are placing on it," Reardon says.

What helps: Slow your carb load. Choose more complex carbohydrates, such as whole grains (barley, oats, quinoa, spelt, brown rice), vegetables, and whole fruits (not juices) that the body has to work harder to digest. This means blood sugar stays stable longer. Move around right after eating -- take a 15-minute walk; even washing the dishes helps -- rather than plopping in front of the TV. The activity will help your body begin to process the big glucose intake faster and more efficiently. In fact, a Mayo Clinic study presented at the 2011 American Diabetes Association annual meeting reported blood sugar levels rose only half as much after eating in a group that was moderately active after a meal, compared to a control group that ate, then rested.

What Carb Cravings Might Mean

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Among the most craved foods: chocolate, chips, and French fries. They're loaded with sugar, salt, and fat -- three substances that taste so good, they light up the reward system of the brain, which begs for more, more, more.
But what happens next in the body can be dangerous, says nutritionist Beth Reardon. Simple carbs such as sugars and white flour break down very quickly, providing a fast hit of energy. Soon, however -- because the insulin-resistant cells essentially ignore this entry of glucose into the blood -- the pancreas overcompensates, releasing more and more insulin to handle the glucose. What follows is a dramatic drop in blood sugar as the extra insulin quickly shuttles the glucose to the cells -- and energy levels plummet. The body is caught in a wave of fatigue. So, naturally, it craves another quick hit of energy to bring blood sugar back up. The brain becomes obsessed with this mission. And before you know it, you're reaching for a pick-me-up guzzle of soda, another handful of pretzels, a second cookie (or three).
People get sucked into a vicious cycle before they realize it, getting hooked on problematic foods they think they're craving -- while gaining weight.
What helps: Kick your food cravings. It's challenging, but one starting place is to avoid triggers that you associate with these foods. Just seeing a fast-food sign or the cookie package in your cupboard can be enough to set off the pleasure system in the brain that fixates on having the craved food.
Instead of quick-hit snacks like candy bars or chips, substitute slower-to-digest choices, like a handful of nuts, a banana, or raw carrots dipped into a tablespoon of peanut butter, which will keep you feeling sated longer. Be persistent: It can take as many as a dozen "successes" in resisting an old craving before your new habit is established.

How Being Overweight Might Put You at Risk for Diabetes


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Most prediabetics carry excess weight, says Duke University's Beth Reardon. That fact alone is a major risk factor for diabetes. But especially worrisome is when you try to cut back on calories and still can't see the scale budge. Stubborn weight loss despite best efforts can be the result of mixed messages that our cells are receiving, Reardon says. "The cells are starving because the fuel they need (in the form of glucose) is not being absorbed at the insulin receptor site on the cell. In the face of a perceived fuel shortage, the body will hold tightly onto existing stores of energy -- fat," she says. What little is absorbed also goes straight into storage -- as more fat.
What helps: Incremental change. Don't think, "OMG, I have to lose 50 pounds; I can never do that." Instead, think small. Losing just 5 to 7 percent of body weight prevents or delays diabetes by 60 percent, according to the Diabetes Prevention Program (DPP), a major multicenter research study. People over age 60 see even greater benefits, according to the DPP. Five percent of body weight translates to just 10 pounds for a 200-pound person. A combination of lifestyle changes (especially changes in diet) and medication is often needed to address weight loss in these circumstances.

What It Might Mean if You Look More Like an Apple Than a Pear

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Weight gain is weight gain, and all of it risks moving you down the path toward diabetes. But added pounds in one particular area -- the midsection -- are especially associated with insulin resistance and prediabetes.
Weight gain around the waist and abdomen (visceral fat) is considered more dangerous than extra padding in the thighs and rear. So-called "belly fat" is linked to a higher rate of high blood pressure, heart disease, stroke, and dangerous cholesterol levels -- all risk factors for diabetes. Having an apple-shaped middle has also been linked to Alzheimer's disease.
For men, the danger point is considered to be a waist circumference of 40 inches or more; for women, the dangerous measurement is a waist of 35 inches or more.
What helps: Diet, weight loss -- and exercise. The third leg of a diabetes-thwarting approach is moving. It's not true that sit-ups and other abdominal exercises will target belly fat. (Though they do build muscles.) Exercise plays a critical role because when you build muscle, you increase the number of enzymes that are able to metabolize glucose as a fuel source for those cells, nutrition expert Beth Reardon says. Aim for 30 to 60 minutes of moderate exercise (like a brisk walk) most days of the week.

How High Blood Pressure Might Put You at Risk for Diabetes


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High blood pressure is linked to many different conditions. But prediabetes may be the cause when it appears in tandem with excess weight gain (especially around the middle), fatigue, and other negative numbers on a medical workup (abnormal cholesterol levels and high triglycerides). Many people with high blood pressure worry about their heart without recognizing that the presence of hypertension -- along with these other signs -- is a neon red sign for prediabetes.
The numbers to beware: blood pressure equal to or higher than 130/85, an HDL "good" cholesterol level below 40 mg/Dl for men and below 50 mg/Dl for women, and triglycerides of 150 mg/Dl.
Blood pressure elevates in part because of inflammation, a damaging cascade of events in the body that high insulin levels contribute to. "Blood becomes stickier and more viscous, and blood clotting factors increase, making it more difficult for the body to move the blood around," Duke University's Beth Reardon says. "Insulin also has an effect on the pliability of blood vessels, making them less elastic and therefore less able to respond to changes in pressure. This, in combination with blood that doesn't flow as easily, results in elevated blood pressure."
What helps: Losing weight slowly through dietary changes and increased exercise.