Pre-Diabetes Advice
Pre Diabetes is a term used when blood glucose levels are raised above normal and are an indication that the person is progressing towards a diagnosis of type 2 diabetes
The blood test used to identify this is called a HbA1c and measures the levels of glucose that attach themselves to a red blood cell over a 12 week period
HbA1c Levels
Normal |
41mmol/mol |
(< 6%) |
Pre Diabetes |
42 – 46mmol/mol |
(6 - 6.4%) |
Diabetes |
48mmol/ml |
(6.5%) |
People with a family history of diabetes are more likely to develop diabetes, but it is also associated with raised cholesterol, blood pressure, heart disease, gestational diabetes and particularly obesity
The number of people developing type 2 diabetes is estimated to increase to five million by 2025 and so it is very important that we identify people who are at risk and try to prevent them progressing to type 2 diabetes
Pre diabetic patients have a 36% incidence of developing type 2 diabetes within 3 years. Many studies have established that type 2 diabetes could be avoided or delayed if lifestyle changes are made such as weight reduction and increased physical activity, which can normalise blood glucose levels
DIET ADVICE
Aim to lose weight as this will improve how your body uses glucose for energy and lower your HBA1c Main meals should be divided on a plate into - half vegetables, 1 quarter meat, 1 quarter carbohydrate
- Eat smaller portions
- Reduce carbohydrates
All Carbohydrates turn into glucose when digested. Carbohydrates are divided into 2 groups -
Sugar Carbohydrates
Sugar, Cakes, Biscuits, Puddings, Chocolate, Fruit, Yogurt, Milk
Starch Carbohydrates
Potatoes, Rice, Bread, Pasta, Cereal, Beans, Pulses
- Boiled potatoes are best (mashed is absorbed quicker and puts your glucose up more rapidly)
- Brown rice or basmati rice is better than white rice
- Granary bread (the husks/grains slow down absorption) wholemeal/wholegrain is also good White bread is absorbed quicker and puts your glucose up more rapidly
- Brown pasta is best but the portion size is most important
- Wheat-based cereals or wholegrain are good (weetabix, shredded wheat, plain cheerio's) Low-sugar muesli (small portion). Porridge is excellent (absorbs slowly and helps to lower cholesterol)
- Look for low sugar baked beans
- Alcohol - beer/lager and wine all contain sugar. Men - 3-4 units/day, Women 1-2 units/day
- Drinks - buy diet drinks (lemonade, coke, tonic water) No-added sugar squash. Drink more water
- No-added sugar jams/marmalade (spread very thinly)
- Fruit - Fruit is a natural sugar so the body can break it down more easily. Fruit is good for you but be careful not to have too much at any one time. Space portions of fruit throughout the day
- Berries - 1 small cupful
- Banana - small harder banana
- Choose harder fruits (not ripening/softening fruits)
- Grapes - small handful only
- Melon - 1-2 pieces
Reduce fat by:
- Eat more white meat (chicken, turkey and fish) than red meat
- Grill food, do not fry
- Cut off any fat/rind from meat. Do not eat the skin on the chicken
- Use Olive oil if necessary
- Use low fat spreads
- Restrict all cheeses
- Restrict foods with pastry
- Restrict cakes, biscuits, puddings, chocolate
- Semi or skimmed milk
- Yogurts - beware low fat yogurts often contain lots of sugar. Buy plain natural low fat yogurt and add your own fruit
EXERCISE
Exercise is proven to help aid weight loss and lowers blood glucose levels. It also improves low mood
Aim to do some exercise everyday and this will soon become a normal routine
- Walking briskly for 30 minutes or as fast as you can manage (build up gradually)
- Swimming
- Dancing
- Join a gym
- Cycling
- Sports activities
- Wii Fit
REVIEW
Initially a 6 monthly HbA1c blood test to monitor levels, then annually if improved or stable
Please book your own blood test and telephone 1 week later for your results
*Pre Diabetes can be resolved by lifestyle changes*
Sarah Chare
Practice Nurse Team Manager/Diabetes Nurse