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Dr. D’s Medical Update

November is National Diabetes Awareness month. I have discussed diabetes multiple times in this space and this month I am going to discuss what happens before a person is diagnosed with diabetes. The condition is called pre-diabetes or impaired fasting glucose and one in three Americans may have it. A blood glucose level between 100 and 125 is considered pre-diabetes. At a level of 126 and above, a patient may have diabetes.

This topic has become personal for me since I was diagnosed with pre-diabetes a few months ago. My dad had diabetes, as did others in his family. My mom did her best to help him control it, but it was a challenge for both of them. Changing habits and making good choices can be a challenge for many.

There are things that can be done to prevent diabetes and reverse pre-diabetes. Continuing to live and eat like one is currently doing, will not result in a positive change. That said, everything does not need to change overnight. One of my favorite sayings is that “no one can do never.” If I told a patient to never have another tortilla or piece of cake, they’d look at me like I was crazy and probably find another doctor. The key is to begin and make small changes you can live with. Let’s look at some of those.

The first is to move more. Increasing activity helps to lose weight and increase heart health. A person doesn’t need to start with running a marathon, however start with moving 30 minutes a day eventually doing this 5 days a week. Even if that is too much at the beginning, just starting on that path can make a difference.

Most of us have issues with what we eat. Finding healthy food can be a challenge, but it is possible. Look for foods higher in fiber and lower in sugar and fats. Meals should be balanced with vegetables, healthy protein and carbohydrates. Simple sugars raise blood sugar levels almost immediately. That is why whole wheat bread is better than a flour tortilla. It takes longer for our bodies to break down the more complex carbohydrates and our sugar levels do not go up as much. One of my favorite restaurants on the West Side is Juanito’s on Culebra. My lunch there is a chicken fajita plate with no rice and one corn tortilla. It is filling and relatively low in carbohydrates. Cutting back or eliminating sweet drinks also makes a big difference. Going from sweet to unsweet tea can be a shock, but moving in that direction is a great start. If sodas are a weakness, cutting back from two or three a day to one or two a week is progress.

Between moving more and eating better, you should start to see some weight loss. Losing 5 to 7 percent of our body weight (10-14 pounds for a 200 pound person) can help prevent diabetes and normalize blood sugars. The key to the lifestyle changes we are talking about is to make them last a lifetime. Losing the weight and keeping it off is very important.

Finding support is also critical. Talk with your family about the changes you need to make may motivate others to start living a healthier lifestyle and join you on this journey. Talk with your doctor about outside help, as well, like a nutritionist or one of our diabetes or healthy living classes at HealthTexas Primary Care Doctors.

Finally, get vaccinated! Those of us with pre-diabetes and diabetes are at increased risk if we get COVID or the Flu. And, that encouragement goes for everyone! We’ll get to the other side of this pandemic when more and more people are vaccinated.

Michael Dominguez, MD, FAAFP is board certified in Family Medicine. His office is located at HealthTexas Medical Group, 590 N. General McMullen, 78228, phone: 210-249-0212.