HERSHEY, Pa. — More than 38 million Americans are part of a club they never wanted to join — they are among the 11.6% of the population living with diabetes, according to the American Diabetes Association. On the waiting list? The 97.6 million Americans with prediabetes. Blood sugars are surging nationwide, but health care providers like Mandel Johnson Smith, lead diabetes program coordinator at Penn State Health St. Joseph Medical Center in Reading, have good news — it’s not too late to fight.
Modifying lifestyle to combat diabetes
While Type 1 diabetes is an autoimmune disease, the vast majority of people diagnosed with diabetes have Type 2 diabetes. The good news? Type 2 diabetes is preventable, and remission can be achieved using medication, diet and exercise. It’s also not entirely caused by poor eating habits, said Smith, and people with a recent diagnosis shouldn’t feel like the condition is self-imposed.
“People often say, I don’t really eat sweets. How did I get diabetes?” Smith said. “It’s often a combination of lifestyle, genetics and where you live. People aren’t just putting themselves in this situation. It’s simply your pancreas not producing enough insulin or the body’s resistance to the insulin that is produced, and unfortunately, we can’t control our pancreas.”
What we can control makes a big difference, fortunately. Smith helps her patients modify their lifestyles through education and personalized plans to combat the progression of their Type 2 diabetes. She starts with the ABCs: A1Cs, blood pressure and cholesterol. These three factors are measurable indicators of how diabetes is managed.
A1Cs
Diabetes develops when the pancreas fails to produce adequate insulin to regulate blood sugar. When that happens, blood sugar numbers soar, causing some of the initial indicators of diabetes, like increased thirst and urination, blurry vision, fatigue and headaches. Patients with diabetes check their blood sugars using a blood glucose test, which gives them their blood sugar levels at that exact moment.
An A1C is an extended view of your blood sugar levels. Instead of a single indicator, the test averages blood sugar levels over three to four months, giving a more accurate view of how the pancreas performs. Smith says an A1C number of 7 or lower is the goal many of her patients strive to achieve.
“If you can keep your blood sugars at that level, you can reduce your chances of developing some of the serious complications that go along with having diabetes,” Smith said.
Blood pressure
One of those serious complications is cardiovascular disease — it’s the leading cause of death in people living with diabetes. Smith says that keeping blood pressure in a healthy range can help keep cardiovascular problems at bay. A blood pressure goal for people with diabetes is 130 over 80. Not sure if you have high blood pressure? The self-serve blood pressure monitor at your local pharmacy can be a convenient tool to monitor in between doctor’s visits. Or, purchase a home monitor to keep track of your blood pressure.
Cholesterol
Higher blood sugars can also correlate with higher levels of “bad” or low-density lipoprotein (LDL) cholesterol, leading to cardiovascular disease. High cholesterol is often treated with medication, but a diet low in saturated fats can also help. Smith said a diet high in fruits and vegetables, like the Mediterranean diet or the DASH (Dietary Approaches to Stop Hypertension) diet, are great ways to reorient your eating habits to lower blood pressure and cholesterol.
Using the ABCs to your advantage
Fortunately, there are three simple steps to achieving your ideal ABCs. Smith said diet, exercise and taking your medication if prescribed can help patients regain their health and quality of life fairly quickly.
She recommends walking as the best fast start to lowering A1Cs and blood pressure.
“If you measure your blood sugars before going on a walk and after a 20- to 30-minute walk, your blood sugars can decrease in that short time,” Smith said. “If you walk 20 to 30 minutes a day, your blood sugar will get a little lower every day and bring those A1Cs down.”
People short on time or physically incapable of a 30-minute walk can start smaller. Smith suggests breaking up the 30 minutes into 10-minute increments when you can fit them in. Even short bursts of exercise can help if done consistently.
Eating and exercising for success
The proof is in the (sugar-free) pudding. Gilma Santos, 22, of Reading, enrolled in one of Smith’s educational courses after learning her gestational diabetes had progressed to Type 2 diabetes. She says that Smith worked with her to develop a healthy eating plan focused on smaller portions and guided by the Diabetes Plate Method to illustrate health ratios of fruits, vegetables, grains, protein and dairy. Smith also encouraged an easy-to-follow exercise plan of walking and building strength.
“When I entered the program, my A1C was over 7, and now it’s 5.7,” Santos says. “She taught me how to eat to stay full. It was really helpful.”
Related content:
- The Medical Minute: The truth about diabetes
- Diabetes disparities: Penn State Health diabetes specialist works to improve health equity
The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.