Diabetes: Prevention and Weight Loss, Part 3

People who have type 2 diabetes often strugle with being overweight. How can they effectively lose weight and maintain the right weight?

We can lose weight by adopting a well-balanced diet rich in fiber.

It is important to pay attention to the quantity of protein, in order to avoid losing muscular mass; the aim is to lose fat mass (especially in the area of abdominal truss). It can be a good idea to measure your waist size every month using a tape measure.

Moreover, it is recommended to avoid snacking and sugary beverages, and to drink enough water.

Practicing a physical activity regularly or walking (a minimum of 5000 steps per day, ideally 10000 steps per day) is essential.

With type 2 diabetes, it is necessary to learn how to manage your cravings and control dietary changes.

What should one pay attention to regarding family history?

It is important to watch out for factors associated with metabolic syndrome: 
-    Obesity
-    Blood sugar level higher than 1g/l 
-    HDL cholesterol (the good cholesterol) level less than 0,40 g/l for men and 0,50 g/l for women
-    Triglycerides level higher than 1,50 g/l
-    Waist measurement more than 80cm for women, and 94 for  men
-    HT: if higher than 13O/85 mm Hg

The metabolic syndrome is a combination of morphological, physiological and biological abnormalities. The development of metabolic syndrome is linked to insulin, which is a storage hormone: it allows the sugar to enter the muscle and the fat acids to enter the fat cells (adipocytes). With less effective insulin (some people experience reduced insulin sensibility), sugar and fats can’t penetrate the tissues anymore. Therefore, the levels of sugar and fat in the blood go up, which gradually leads to metabolic syndrome.

Other issues: controlling your waist measurement and the abdominal fat more than the excess of weight, watching the progressive increase of fasting glucose level (above 1 g/l).

If you have family history of diabetes, it is advised to consult a dietician at least once a year, for nutritional education. It is the only effective solution to prevent the disease (as we consult once a year our ophthalmologist, dentist, dermatologist…). And don’t forget: consider early screening for diabetes with the HOMA method.

Is there anything else you would like to tell us about diabetes?

Yes, you shouldn’t wait, but should get screened for diabetes. It is useless to wait till you blood glucose level reaches 1g/l in order to start acting. It is necessary to start acting as early as possible, by adopting a balanced diet for the whole family and following certain non-negotiable principles starting from the youngest age:
• Eat fresh or cooked vegetables at every meal 
• It is better to sometimes allow yourself a sweet treat after a meal, than in the afternoon or in the evening.

I would also like to talk about different phases of detection, which allow to take measures for preventing type 2 diabetes:
Phase 1: insulin resistance
The HOMA method allows to screen for the insulin resistance several years prior to diabetes diagnosis (if the HOMA index is higher than 2,4, there is a resistance to insulin; if the index is 4, it is already a light version of type 2 diabetes).
Phase 2: pre-diabetes phase
Pre-diabetes phase is reached when blood glucose level is between 1,10 and 1,25 g/l.
Phase 3: diabetes
We are talking about diabetes when fasting glucose level is equal to or higher than 1,26 g/l after 2 successive tests.
Remarks: for phase 1 we check for the presence of clinical signs associated with metabolic syndrome.

It is also necessary to mention diabetes complications. To limit the complications, it is compulsory to monitor your eyes, kidneys, feet, heart, every year and be on the watch for every sign of alert. You shouldn’t forget that one of the main diabetes complications is cardiovascular disease.

What should we do to prevent cardiovascular diseases?

To prevent cardiovascular diseases, you need to be picky about the fats, fill yourself up with antioxidants, limit the salt, and move.

Reduce saturated fats (animal fats), palm fats, hydrogenated or trans margarines, oils rich in Omega 6 (sunflower, corn), fries, but increase unsaturated fats, especially fats rich in Omega 3 (nut oil, rapeseed oil, camelina oil) which are known for preventing cardiovascular diseases, reducing the level of “bad” cholesterol (LDL), and increasing the “good” cholesterol (HDL), preventing the atheroma plaques from forming (a frequent complication of type 2 diabetes). Oils rich in Omega 3 must be stored in the fridge and must not be heated. Use only a bit of oil for cooking.

What nutrients are rich in antioxidants?

Green tea and rooibos, shellfish, spices and aromatic herbs. Fruit and vegetables of all colours (antioxidants are present in the colours).

We can also drink ½ glass of red wine per day, eat 1 to 2 squares of dark chocolate and some Brazil nuts.

Other things you would like to share?

Nutritional education is important. It is necessary to adjust the recipes. Starting from phase 1, you should consider medical care: it is part of prevention.

When a person is diagnosed with type 2 diabetes, I advise hygieno-dietary care during 3-6 months. If at the end of this period haemoglobin A1C level in your blood goes down to 6% or less, the patient continues to apply the preventive measures. If not, taking oral hypoglycaemic agents is recommended.

Thank you very much for this interview!

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