Managing Pre-diabetes online

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During this class, you will learn:

What is pre-diabetes, and how it’s measured

What are the risk factors for pre-diabetes

Possible long-term effects of pre-diabetes

How to manage pre-diabetes

How to develop an action plan

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“Health is the greatest of all possessions…..” ~ Jonathan Swift, Irish Play writer

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•Carbohydrates from food are digested and broken down into glucose (also called blood sugar). Some is used within hours. The rest is taken to organs (such as muscle and fat) for storage.

•The body pulls from the reserve in the organs for use when needed.

Inside the blood stream (when things are normal)

The Ups and Downs of Blood Sugar

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Blood glucose numbers change throughout the day.

Blood glucose is higher after eating.

Blood glucose is lower after activity.

Recap

1. Blood sugar is higher after e__________.

2. Blood sugar is lower after a____________.

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What is pre-diabetes?

Defining Pre-diabetes

Pre-diabetes is a condition where your blood

glucose is higher than normal, but not high enough

for a diagnosis of diabetes.

What you should know about Pre-diabetes

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How is blood glucose measured?

A1cFasting Blood Glucose(FBG)

▪ Measures average blood glucose over 2 to 3 months

▪ Checks for hemoglobin with attached glucose

▪ Fasting is not required for test

▪ Measures blood glucose and tests for diabetes

▪ Must not eat 12 hours before the test

▪ Test when you wake up

What is the blood sugar range for pre-diabetes?

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Less than

100 mg/dl

Between

100 & 125 mg/dl

126 mg/dl

or more(taken at least twice)

A1c less than 5.7 A1c: 5.7 to 6.4 A1c: 6.5 or higher

Blood glucose measurement

normal pre-diabetes diabetes

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One or more of these factors can place you at risk:

Risk factors of pre-diabetes

▪ Overweight

▪ History of gestational diabetes or a baby over 9 pounds

▪ Physical inactivity

▪ High blood pressure

▪ Low HDL cholesterol and high triglycerides)

▪ Family history of diabetes

▪ Age

▪ Certain ethnicities

▪ Polycystic Ovarian Syndrome (PCOS)

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Pre-diabetes and your bodyPrediabetes can lead to:

• Diabetes

• Heart disease

• Long term effects to the body –damage to kidneys, eyes, nerves

Pre-diabetes can be

reversed with lifestyle

changes!!

Recap

Name something that can place you at risk for having pre-diabetes.

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Weight control

Eating habits

Activity level

Controlling other ongoing conditions

Other lifestyle habits

Lifestyle factors that contribute to pre-diabetes

To prevent diabetes………………What things would you need to change?

Healthy eating

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What is healthy eating?•At least 3 servings of WHOLE GRAINS daily

•At least 7 servings of FRUITS and

VEGETABLES daily

•

• At least 2 MILK/YOGURT servings daily

• Limit animal PROTEIN to 4 to 6 ounces daily

• Choose LOW-FAT foods within each food group

•Choose heart healthy fats

• LIMIT the intake of sweets (sugary drinks,

desserts, sweeteners)

Grains

•Grains and grain products

•Made from wheat, corn, rice, barley, cornmeal and other cereal groups

•Two types: whole and refined

•Starchy vegetables

•High in carbohydrates

•Examples are potatoes, peas, corn, plantain

•Legumes

•High in fiber

•Dried beans, dried peas, lentils October 14, 2019 17

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Whole Grains

•Foods made from the entire grain seed (often called kernel). It consists of:

•Bran

•Germ

•Endosperm

•Examples of whole grains:

•Brown rice/wild rice - Buckwheat

•Bulgur - Millet

•Whole grain corn - Quinoa

•Whole wheat products- Popcorn

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Fruits

• Come in many forms, including fresh, canned, frozen, dried.

• Naturally low in fat, calories, and sodium.

• Rich in fiber, potassium, vitamin C and folic acid.

• Eat a variety of colors. Try a new color each week.

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Vegetables

• Can be eaten raw, cooked, from frozen, canned, or dehydrated.

• Important source of fiber, vitamin C, vitamin A, folic acid, and potassium,

• Naturally low in calories, sodium, and fat.

• Eat a variety of colors.

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Milk and Yogurt

•Choose low-fat or fat-free yogurt and milk products.

•Calcium-fortified soy milk is a part of this group.

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Protein

•This group includes meat, poultry, seafood, eggs, and processed soy products.

•Choose baked, broiled, grilled. Stay away from charred meat.

•Choose lean red meats, skinless chicken, fish, and tofu.

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Sweets

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▪ Sweets consist of sugary drinks, fruit juice, desserts, sweeteners.

▪ Choose non-sugary drinks.

▪ Use sugar substitutes in place of sugar.

▪ Limit desserts, cookies, and candy.

Fats

•Fats consist of oils (canola, corn, vegetable), solid fats (butter, margarine).

•Choose the healthy fats such as avocado, nuts and seeds, plant oils.

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RECAP!Give one example for each food group:

•STARCH: _______________________

•VEGETABLES: ___________________

•FRUITS: ________________________

•MILK AND YOGURT: ________________________

•MEAT: _________________________

•FAT: _______________________________

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Busting myths about carbohydrates

• Carbohydrates are important and needed part for good

health.

– Example: provide energy

• Healthy choices are found in the starch, milk and fruit

groups. Examples are whole grains (brown rice), low-fat

yogurt, and grapes.

• Be sure to spread out your carbohydrates throughout the

day in different meals.

• 1 serving of carbohydrate = 15 grams

Ideas for breakfast

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1 cup of

oatmeal

1 egg or ¼

cup egg

substitute

8-ounce

glass of

milk

1 orange

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Ideas for lunch

1 roast beef

sandwich: 2 oz

roast beef, 2 slices

whole wheat bread,

lettuce and tomato,1

teaspoon

mayonnaise,

mustard

½ cup of carrots

1 small banana

8 frosted

mini

wheats or

light

yogurt

Ideas for dinner 3 ounces of

salmon

1 cup red

potatoes

(broiled,

steamed)

1 cup steamed

broccoli

Tossed salad

with 2

tablespoons

low-fat

dressing

1 cup melon

Putting it all together on your plate: dinner

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9-inch plate with: • ½ vegetables• ¼ meat• ¼ grain• fruit• dairy

Plate method

Reading the Food Label

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• Serving Size: The nutrition information provided is for the serving size listed.

• Calories: Fat free and low-fat foods may have the same or more calories than the foods they replace.

• Fat: Avoid low fat items unless they include simple unsaturated fats. Try to limit your fat intake to 30% of your diet.

• Sodium: Many foods don’t taste salty but are quite high in sodium. The recommended intake of sodium for healthy adults is 2400 mg/day. Limit your intake to 1500 mg/day if you are over age 50, African-American, or have high blood pressure.

• Total Carbohydrates Look at the total, not just the sugar.

Reading the Food

Label

Reading the Food

Label

Make better choices

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Instead of this: Try this:

½ cup of peanuts in

shells =

350 calories

½ cup of raw carrots =

30 calories

1 fried chicken breast

(Popeyes) =

510 calories

Baked skinless chicken

breast =

166 calories

1 cup fried rice (Panda Express

456 calories)

1 cup brown steamed rice

220 calorie

Making smart fast food choices

Physical activity

Why be physically active?

…..It helps prevent Type 2 Diabetes

•Helps your body use insulin better

•Improves mood and energy level

•Improves health and how well your heart works

•Increases metabolism – helping your body use glucose and you lose weight

•Can help cut risk of diabetes

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How much activity should you get?

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Adults

Children

Minimum 150 minutes

a week

60 minutes of activity most

days of the week

Make sure your activity includes:

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Aerobic endurance Flexibility

▪ Increases breathing and heart rate, help burns calories

▪ Aim for at least 30 minutes most days of the week

▪ Keeps body limber and reduces muscle stiffness

▪ Do slowly without jerking, holding for 10 seconds

▪ Stretch after doing strength and aerobic activities

Muscle strengthening

▪ Build muscle, maintains bones and increases body metabolism

▪ Do 2 to 4 times per week in set of 1 to 3 with 8 repetitions per set

Get ready, get set, get active

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Walking: A Step in the

Right Direction

Getting out of exercise ruts

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Roadblock Detours

You don’t have time to

exercise

Build activity into something

you already do. For example,

walk around when talking on

the phone or walk in place

during TV commercials.

You can’t seem to get

started

Set a realistic goal you can

achieve. Do not try to do

everything. For example,

choose something simple you

feel you can do and commit to

a time to start.

Exercise is boring Include a mix of ways to be

active. Try jumping rope, an

exercise tape, flag football,

soccer, or softball.

Recap

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How many minutes of physical

activity do you need each week?

a. 30 minutes

b. 60 minutes

c. 90 minutes

d. 150 minutes

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“A man’s health can be judged by which he takes two at a time – pills or stairs.” ~ Joan Welsh, editor and writer

Weight Control

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What is a Healthy Weight?

Obesity

Normal weight

Overweight

Third Key Point30 to 39.9

19 to 24.9

25 to 29.9

BMI = height to weight calculation that helps determine if you are at risk for weight-related health problems.

**Not as accurate for people with higher muscle mass

Severe Obesity Over 40

BMI Handout

Weight management is….

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A BALANCE of:

Calories in

Calories out

Aim for a healthy weight:

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Eat healthy meals

Be physically active

Watch for portion distortion

Monitor your food, fluid and activity

Portions

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A portion is how much food you choose to eat at one time. Sometimes the portion is more than one serving

Portion distortion

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• Within the past 20 years, portions have greatly increased in size, calories, fat, sodium, cholesterol and carbohydrates.

• One hundred extra calories per day can lead to 10 pound increase each year.

Size matters

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20 Years Ago Today

333 calories

590 calories

You have to lift weights for 1 hour and 30 minutes to burn the extra 257 calories.

Changes over the past 20 years

Changes over the past 20 years

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250 Calories

20 ounces

20 Years AgoToday

85 Calories

6.5 ounces

You would have to work 35 minutes in the garden to burn the extra 165 calories.

Tips for healthy living

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• Choose healthy foods• Learn portion sizes• Spread carbohydrates throughout the day• Choose water • Space meals throughout the day• Move more• Record what you eat/drink and activity• Weigh in daily or weekly• Get enough sleep

Recap

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What is one thing you can do to cut your portions?

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“To lengthen thy Life, lessen thy meals.” ~ Benjamin Franklin

Keys to Success

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• Keep a food and activity and journal • Find support• Prepare in advance for difficult situations –eating out, parties • Practice positive, realistic thinking • Reduce stress

Managing other ongoing conditions and lifestyle

habits

Manage your health

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Blood Pressure• Normal blood pressure: 119/79 or less• Blood pressure with Chronic Kidney Disease, high blood pressure, or

diabetes: 139/89 or lower Cholesterol• Have a lower LDL and higher HDLImmunizations/Vaccines: • Have an annual flu shot every year• Have a Pneumococcal shot if you are at risk or over 65 years old • Screenings

Starting at age 21, have a pap smear every three years • From age 50 to 74, have a mammogram every one to two years• From age 50 to 75, have a FIT done every year. Talk to your doctor

about any other screenings that may be for you.

Committing to Quit

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• Cigarette smoking is the number one preventable cause of early death

• Nicotine raises your heart rate and blood pressure

• Tobacco increases your risk for heart attack and stroke

• Secondhand smoke is also linked to risk for disease

• Help those around you try and quit

Limit Alcohol

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Limit how much alcohol you drink:

▪ 1 drink each day for women

▪ 2 drinks each day for men

One drink equals:5 ounces of wine 12 ounces of beer 1.5 ounces of distilled liquor

Many drugs should not be taken with alcohol! Be sure to talk with your provider or pharmacist.

If your doctor has placed you on medicine: • Consider taking them at night

• Keep a list of medicines in your wallet

• Be sure not to run out of medicine

• Order online at kp.org/rxrefill or call the pharmacy

Medicine: Tips to Help

Need help remembering to take your medicine?

▪Place a reminder on the fridge or computer

▪Use a calendar

▪Use a pill box

▪Leave yourself a message on your phone

▪Take pills with another activity you do everyday, like brushing your teeth

Tips On Taking Your Medicine

• You can get addicted to these medicines

• You can never get off medicines once you start them

• Taking medicine means you are a failure

• When you start to take medicine, it means you are really sick

Myths about medicines

You CAN Do It!

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To begin lifestyle changes, take these steps:

• Make a plan to change behavior

• Be specific - what and how often you will do it

• Plan what you need to get ready

• Think about what might prevent you from

reaching your goals

• Find people who will support and encourage you

• Decide how you will reward yourself

Goal Setting

How ready are you?

Stages of Change

Stages of Change

In Summary

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How Can You Reduce Your Risk?

o Achieve a healthy weight

•Aim for a 5-7% weight loss if over weight

o Aim for regular activity

• 30 minutes at least 5 days per week or

• 10,000 steps per day

o Make healthy food choices

•Include a variety of fruits, vegetables and whole grains

every day

•Include more plant proteins (legumes and soy foods) and

seafood and less red meat and poultry

•Select more plant fats such as vegetable oils, nuts,

avocado, olives and less animal fat

The Many Ways to Prevent

Prediabetes

Kaiser Permanente Healthy Living Classes

To register for following classes, call an appointment representative Monday – Friday 8:30 a.m. to 5 p.m. at (703) 359-7878 or 1-800-777-7904; TTY: (703) 359-7616 or 1-800-700-4901. Here are a few examples:

▪Nutrition for Weight Control

▪Prenatal classes

▪Living with Heart Failure

▪Nutrition for Cholesterol Control

View other healthy living classes at kp.org/classes.

Online Resources

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kp.org/healthyliving

▪Healthy Living tools and resources to manage your health

▪ 10,000 Steps® Program

▪ Videos and podcasts

kp.org/healthylifestyles

▪Online self management programs to help manage conditions

▪Health Assessments and personal online plan to improve your

well-being and the quality of your life

kp.org/doctor

▪View an EMMI program through your doctor’s homepage or ask

your doctor to select the best appointments for you

Healthy Lifestyles Program

Flyer

Want to talk wellness?

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▪ Contact our wellness coaches, available at times that are good for you!

– Focus on healthy habits

– Create customized plan

– Schedule convenient phone sessions

– Discuss topics such as weight management, stress, and how to quit tobacco

▪ Call 1-866-862-4295, Monday through Friday, from 7 a.m. to 8 p.m. Eastern time, to make an appointment.

Wellness Coaching Flyer

National resources

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National Diabetes Education Program

www.ndep.nih.gov

Choose My Plate

www.choosemyplate.gov

Academy of Nutrition and Dietetics

www.eatright.org

Food & Drug Administration

www.fda.gov

Who has the first question?

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Thank you for your time!

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