When I first began researching pre-diabetes a few years ago, most resources focused on managing Type 2 diabetes. Now, pre-diabetes has come into the spotlight, too — a good thing, because an estimated 1 in 3 Americans is pre-diabetic, and 90% don’t know it, according to the CDC. Those are incredibly high numbers, but it’s the second part of that sentence – the 90% – that is most alarming. Because once you know about pre-diabetes, there are myriad ways to attack the problem. It’s the not knowing, the unawareness of what’s happening beneath the surface, that is dangerous.
How do you attack the problem? Eat “better”, exercise, lose weight? Sure, but there’s much more to it than that – more options and more specific guidance. I tripped and stumbled a few times in my effort to get my A1c under control, simply because I didn’t know enough about this very complex condition. Most people don’t. In my first six months of knowing I was pre-diabetic, I went down a path that may have been “healthy” but did nothing to help my blood sugar control – so I share these missteps in the hope of saving others some amount of trial and error.
- Misperception #1 – Sugar is the enemy, not carbs.
Right around the time I was diagnosed, I began reading articles by Dr. Robert Lustig and Gary Taubes, who later came out with “The Case Against Sugar.” We had also recently bought Mark Bittman’s “VB6,” which encourages a vegan diet most of the time (e.g. “before 6”) and eating smaller portions of meat for dinner. Worthy books, both, and I highly recommend them to anyone interested in better health from the inside out. However, my takeaways at the time were to cut out sugar and eat more whole foods, without any focus on carb-counting. Here were some of the things I ate almost every day for six months:
- Breakfast – steel-cut oatmeal with blueberries
- Lunch – grain salads with vegetables
- Snacks – oranges and apples
- Dinner varied, but I frequently made whole-wheat pasta with lots of veggies, such as Bittman’s Vegetable Ziti Bake
- Dessert – swapped my favorite 70% chocolate (Lindt Orange) to plain 90% (note: This change stuck with me, and I still enjoy a bit of 90% chocolate every day.)
I love vegetables, and cooking up big batches of oats on the weekends made me feel so healthy. And this food was good for me in some ways — my cholesterol dropped like a stone.
However, my A1c level crept up to 6.3 (6.5 is considered diabetic).
I will never forget the moment I got that test result — I was completely baffled. And frightened. I truly thought I had made positive changes in my diet.
Lesson learned: People with insulin resistance have to worry about their total carbohydrate intake, not just the sugar. Whole grains like barley or farro have more fiber and nutrients, and a less severe impact on blood sugar than, say, a piece of birthday cake, but they will still raise your blood sugar levels if the portion size is too large. Similarly, I thought I was doing well by eating whole oranges as opposed to drinking juice, but for a pre-diabetic person, a whole orange at once is a lot of carbohydrate.
Which brings me to:
- Misperception #2 – Portion size doesn’t matter because “this food is all ‘good’ for me.”
I’m not talking giant bowls of quinoa or mountains of oatmeal, but I did not pay attention to a key tenet of a healthy lifestyle – balance. A healthy meal that’s friendly to your blood sugar levels has a balance of protein, lean fats, non-starchy vegetables and fruit/carbs. My revised diet now looks something like this:
- Breakfast – 4-6 oz. yogurt or cottage cheese, 3/4 c. berries, 1/4 c. nuts
- Lunch – 1/2 c. grains plus vegetables and protein, or better yet, a salad with protein
- Snacks – 1/2 apple and hard-boiled egg; Cherry tomatoes & an individual portion of mozzarella cheese
- Dinner varies, but often consists of vegetable-based soups and stews, or chicken/fish plus a side of veggies and 1/2 c. grains
- Dessert – still enjoy 2-3 squares of 90% chocolate
This diet is heavier on protein and lighter on carbs. The portions of everything, but especially carbs, are better defined.
Lesson learned: Check every meal for balance and portion sizes. I’ve been doing it for over a year now, and it’s become almost automatic. The plate method is an excellent way to get started.
These are two key, overarching lessons from my first six months of dealing with pre-diabetes. In the second six months, I found some additional tools that were absolutely essential to bringing down my A1c – stay tuned for details in the next post!
In the meantime, this article is one of the most well-sourced, comprehensive list of diabetes prevention suggestions I’ve seen. I was excited to find it because, even after more than a year of researching this issue, there were items on the list that were new to me (particularly #13, natural herbs). Notice that low-carb diets and portion control are #6 and #7, respectively!