On the road to diabetes: How to halt disease progression and turn back to health

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While diabetes is a serious chronic disease with devastating complications, it usually develops after years of insulin resistance, or pre-diabetes. Pre-diabetes can progress to diabetes when liver and muscle cells become more and more insulin resistant (they don’t respond properly to this internal insulin signal) and have increasing problems removing sugar from the bloodstream.

The good news is that if pre-diabetes is recognized early, it can be reversed. Let’s check in on Gary, who we met earlier.

Gary, a 45-year-old computer engineer, had many signs of pre-diabetes, including excess weight, a big belt size (40 inches), blood pressure of 138/83 and blood tests showing:

  • High blood sugar (glucose) level (113 mg/dL); Optimal less than 90
  • Low HDL, the good cholesterol (27 mg/dL); Optimal greater than 50
  • Increased triglycerides (210 mg/dL); Optimal less than 100

He came to the doctor seeking advice about how to avoid developing diabetes. Based on his doctor’s recommendations, he focused on daily exercise using his home rowing machine for 30 minutes per day. He also cut down on his craft beer intake (each 12 oz. bottle has 200-plus calories) from 12 to 4 per week and started walking daily with his wife for 30 minutes. Three months later, his body weight was down by 8 pounds, his blood pressure was 132/78 and his fasting blood sugar was below 100.

How to you know that you have pre-diabetes?  There are two main approaches to determine if you have pre-diabetes or insulin resistance. The simplest is to look for a fasting blood sugar of 100-125 mg/dL. This is higher than normal, but not yet at a critical diabetes level (greater than or equal to 126 mg/dL). The body can still remove sugar from the blood, but not down to normal levels.

A more sophisticated approach is to diagnose metabolic syndrome. Related to insulin resistance, metabolic syndrome also reflects other health findings that accompany serious insulin resistance. Metabolic syndrome can be diagnosed by any three of the following:

  • Increased waist circumference (greater than or equal to 35 inches in women or 40 inches in men)
  • Fasting blood sugar greater than or equal to 100 mg/dL
  • Blood pressure greater than or equal to 130/85
  • Low good cholesterol (HDL) (less than 50 mg/dL for women or 40 for men)
  • High triglycerides, a type of fat in the blood (greater than 150 mg/dL)

Gary, unfortunately, had all five of these markers.

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