Prediabetes is the stepping stone to full blown diabetes

By Dr Harold Gunatillake - Health Writer

If you are a non- diabetic you are blessed to be free with your dietetic habits, but over-indulgence may catch you in some other ways for the same risk factors, such as heart disease, high blood pressure and so on.

So, do not be complacent being free of diabetes, to consume high glycaemic foods. High glycaemic foods are those carbs that have a GI of over 60. These include round grain rice like samba, also called short grain, or any other white rice has a GI of 73 when glucose is based as 100.

Boiled brown rice has a lower GI of about 68 and over. This difference is, the brown outer covering in brown rice referred to as bran delays digestion with slower absorption. The other common high GI foods are potatoes, white bread, foods made from processed wheat, white rice and those with added sugar as in ice-cream and beverages. Basmati rice has a GI of 59 and is preferred for diabetics to eat when rice is chosen.

The common low GI foods are soy products, some fruits, pasta, grainy bread, porridge, lentils and other high fibre foods. Sri Lankans are blessed, because they love lentil curry that goes well with any other staple food and quite cheap too, for the average man.

Medium GI foods, i.e. those between 55 to 65 are orange juice, honey, basmati rice, wholemeal bread and so on.

Any form of resistant rice seems to have a low GI as the absorption is very slow, and most of it passes through to the large gut for the benefit of the microbiota.
All carbs with high fibre content have lower GI than processed low fibre foods.

The definition of prediabetes is when your HbA1c ranges between 5.7% to 6.4%. Non-diabetics have a Hb A1c of less than 5.7% and full-blown diabetics have a higher GI of over 7% and varies according whether diabetes is controlled.

Most of you may not know what HbA1c test is. Simply explained, the blood sugar gets into the haemoglobin in the red cells and are stored for 2-3 months. So, HbA1c is referred to as a memory test because it refers to the amount of glucose stored in the red cells for that period through a process called glycation. When you test your fasting, post-prandial (after food) or random blood sugar, you check on the blood sugar reading at that moment. The advantage of the HBA1c test is that the reading gives an estimate of the consumption of sugars for over 2 months.

This is the most reliable blood sugar test to diagnose and assess the control of your diabetes.

In terms of the instant fasting blood sugar test- if the reading is 100- 125 milligrams per decilitre (mg/dL) and the HbA1c is between the range of 5-7% to 6.4%, you are labelled as a prediabetic.

In the US about 86 million people over the age of 20 are prediabetics. You could image the over-indulging lifestyles of these people for being born an American. In the third world countries people need to eat high glycaemic processed foods because they are cheaper and provide quick energy for survival. Most unprocessed foods are not within the reach of the average person. A good example is bread.

White hot bread produced by the local bakery costs 70-80 rupees, whilst brown bread and multigrade varieties are over three times the cost in Sri Lanka. Furthermore, white bread seems to give a better pleasing taste to go with curries than the brown unprocessed varieties.

How can one know whether he or she is a prediabetic when there are no symptoms? But really there are symptoms that go unnoticed.You could feel extra thirsty and pass more urine. Your vision could be blurry and may be tired at the end of the day.

If you feel that you experience any of the above early symptoms you need to have first a fasting blood sugar, and a HbA1c test. You may also have early metabolic syndrome needing control, too

Metabolic syndrome is a cluster of signs that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. The syndrome includes high blood pressure, high blood sugar, excess fat around your waist and high cholesterol and triglycerides. Controlling metabolic syndrome reverses prediabetes.

Most important are dietary changes by switching on to low carbohydrate with low glycaemic, high fibre foods
Avoid sugar sweetened beverages
Avoid foods containing trans-fat.
Avoid white bread, Pasta and white rice
Fruit flavoured yogurt
Sweetened breakfast cereals
Flavoured coffee drinks
Dried fruits.

High glycaemic foods result in a quick spike in insulin and blood sugar. Low glycaemic foods have a slower, smaller effect. In addition to diet restrictions the good news is that people with pre-diabetes can start some regular exercise and lose weight to prevent progressing into full blown diabetes. Walking 10,000 steps a day seems to be the panacea to prevent and cure most diseases, including cancer. Reversing pre-diabetes is not a cure but maintaining the blood sugar level within normal range with strict discipline

Suitable foods for breakfast are- smoothies, oatmeal, eggs, plain unsweetened yogurt, brown bread and fruits containing low sugar. Sri Lankans love their rice and curry for lunch and dinner. Brown and red rice are unprocessed and are preferred to white polished rice.

Do not eat more than half a cup of rice and fill the plate with high fibre curries and leaves, such as lentils, and green leafy veggies, including the crucifers like cabbage, cauliflower, kale, broccoli, Brussels sprouts, bok choy and so on. These veggies have been linked with many health benefits such as a reduced risk of cancer and heart disease Eating fried rice and biriyani do not give blood sugar spikes, because the rice is more resistant being cooked with added oil. They may increase your waistline if you eat regularly.

The better choice is to add a teaspoon of oil whilst the rice is boiling, keep it overnight in the fridge and enjoy the next day. This rice seems to be more resistant and most of it passes into the large bowel for the benefit of the microbes.

Keep your weight down, exercise daily, et low glycaemic high fibre foods with low salt and that regime would reverse pre-diabetes.

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Copyright © 2002 ~ 2019 Harold Gunatillake