Post on 24-Dec-2021
2 October 14, 2019
During this class, you will learn:
What is pre-diabetes, and how it’s measured
What are the risk factors for pre-diabetes
Possible long-term effects of pre-diabetes
How to manage pre-diabetes
How to develop an action plan
3
|
October 14, 2019
“Health is the greatest of all possessions…..” ~ Jonathan Swift, Irish Play writer
4
|
October 14, 2019
•Carbohydrates from food are digested and broken down into glucose (also called blood sugar). Some is used within hours. The rest is taken to organs (such as muscle and fat) for storage.
•The body pulls from the reserve in the organs for use when needed.
Inside the blood stream (when things are normal)
The Ups and Downs of Blood Sugar
5
|
October 14, 2019
Blood glucose numbers change throughout the day.
Blood glucose is higher after eating.
Blood glucose is lower after activity.
Recap
1. Blood sugar is higher after e__________.
2. Blood sugar is lower after a____________.
6
|
October 14, 2019
7
|
October 14, 2019
What is pre-diabetes?
Defining Pre-diabetes
Pre-diabetes is a condition where your blood
glucose is higher than normal, but not high enough
for a diagnosis of diabetes.
What you should know about Pre-diabetes
8
|
October 14, 2019
How is blood glucose measured?
A1cFasting Blood Glucose(FBG)
▪ Measures average blood glucose over 2 to 3 months
▪ Checks for hemoglobin with attached glucose
▪ Fasting is not required for test
▪ Measures blood glucose and tests for diabetes
▪ Must not eat 12 hours before the test
▪ Test when you wake up
What is the blood sugar range for pre-diabetes?
9
|
October 14, 2019
Less than
100 mg/dl
Between
100 & 125 mg/dl
126 mg/dl
or more(taken at least twice)
A1c less than 5.7 A1c: 5.7 to 6.4 A1c: 6.5 or higher
Blood glucose measurement
normal pre-diabetes diabetes
10
|
October 14, 2019
One or more of these factors can place you at risk:
Risk factors of pre-diabetes
▪ Overweight
▪ History of gestational diabetes or a baby over 9 pounds
▪ Physical inactivity
▪ High blood pressure
▪ Low HDL cholesterol and high triglycerides)
▪ Family history of diabetes
▪ Age
▪ Certain ethnicities
▪ Polycystic Ovarian Syndrome (PCOS)
11
|
October 14, 2019
Pre-diabetes and your bodyPrediabetes can lead to:
• Diabetes
• Heart disease
• Long term effects to the body –damage to kidneys, eyes, nerves
Pre-diabetes can be
reversed with lifestyle
changes!!
Weight control
Eating habits
Activity level
Controlling other ongoing conditions
Other lifestyle habits
Lifestyle factors that contribute to pre-diabetes
16
|
October 14, 2019
What is healthy eating?•At least 3 servings of WHOLE GRAINS daily
•At least 7 servings of FRUITS and
VEGETABLES daily
•
• At least 2 MILK/YOGURT servings daily
• Limit animal PROTEIN to 4 to 6 ounces daily
• Choose LOW-FAT foods within each food group
•Choose heart healthy fats
• LIMIT the intake of sweets (sugary drinks,
desserts, sweeteners)
Grains
•Grains and grain products
•Made from wheat, corn, rice, barley, cornmeal and other cereal groups
•Two types: whole and refined
•Starchy vegetables
•High in carbohydrates
•Examples are potatoes, peas, corn, plantain
•Legumes
•High in fiber
•Dried beans, dried peas, lentils October 14, 2019 17
|
Whole Grains
•Foods made from the entire grain seed (often called kernel). It consists of:
•Bran
•Germ
•Endosperm
•Examples of whole grains:
•Brown rice/wild rice - Buckwheat
•Bulgur - Millet
•Whole grain corn - Quinoa
•Whole wheat products- Popcorn
October 14, 2019 18
|
Fruits
• Come in many forms, including fresh, canned, frozen, dried.
• Naturally low in fat, calories, and sodium.
• Rich in fiber, potassium, vitamin C and folic acid.
• Eat a variety of colors. Try a new color each week.
October 14, 2019 19
|
Vegetables
• Can be eaten raw, cooked, from frozen, canned, or dehydrated.
• Important source of fiber, vitamin C, vitamin A, folic acid, and potassium,
• Naturally low in calories, sodium, and fat.
• Eat a variety of colors.
October 14, 2019 20
|
Milk and Yogurt
•Choose low-fat or fat-free yogurt and milk products.
•Calcium-fortified soy milk is a part of this group.
October 14, 2019 21
|
Protein
•This group includes meat, poultry, seafood, eggs, and processed soy products.
•Choose baked, broiled, grilled. Stay away from charred meat.
•Choose lean red meats, skinless chicken, fish, and tofu.
22
|
October 14, 2019
Sweets
23
|
October 14, 2019
▪ Sweets consist of sugary drinks, fruit juice, desserts, sweeteners.
▪ Choose non-sugary drinks.
▪ Use sugar substitutes in place of sugar.
▪ Limit desserts, cookies, and candy.
Fats
•Fats consist of oils (canola, corn, vegetable), solid fats (butter, margarine).
•Choose the healthy fats such as avocado, nuts and seeds, plant oils.
24
|
October 14, 2019
RECAP!Give one example for each food group:
•STARCH: _______________________
•VEGETABLES: ___________________
•FRUITS: ________________________
•MILK AND YOGURT: ________________________
•MEAT: _________________________
•FAT: _______________________________
25
|
October 14, 2019
Busting myths about carbohydrates
• Carbohydrates are important and needed part for good
health.
– Example: provide energy
• Healthy choices are found in the starch, milk and fruit
groups. Examples are whole grains (brown rice), low-fat
yogurt, and grapes.
• Be sure to spread out your carbohydrates throughout the
day in different meals.
• 1 serving of carbohydrate = 15 grams
Ideas for breakfast
27 | October 14, 2019
1 cup of
oatmeal
1 egg or ¼
cup egg
substitute
8-ounce
glass of
milk
1 orange
28
|
October 14, 2019
Ideas for lunch
1 roast beef
sandwich: 2 oz
roast beef, 2 slices
whole wheat bread,
lettuce and tomato,1
teaspoon
mayonnaise,
mustard
½ cup of carrots
1 small banana
8 frosted
mini
wheats or
light
yogurt
Ideas for dinner 3 ounces of
salmon
1 cup red
potatoes
(broiled,
steamed)
1 cup steamed
broccoli
Tossed salad
with 2
tablespoons
low-fat
dressing
1 cup melon
Putting it all together on your plate: dinner
30
|
October 14, 2019
9-inch plate with: • ½ vegetables• ¼ meat• ¼ grain• fruit• dairy
Plate method
Reading the Food Label
31
|
October 14, 2019
• Serving Size: The nutrition information provided is for the serving size listed.
• Calories: Fat free and low-fat foods may have the same or more calories than the foods they replace.
• Fat: Avoid low fat items unless they include simple unsaturated fats. Try to limit your fat intake to 30% of your diet.
• Sodium: Many foods don’t taste salty but are quite high in sodium. The recommended intake of sodium for healthy adults is 2400 mg/day. Limit your intake to 1500 mg/day if you are over age 50, African-American, or have high blood pressure.
• Total Carbohydrates Look at the total, not just the sugar.
Reading the Food
Label
Reading the Food
Label
Make better choices
32
|
October 14, 2019
Instead of this: Try this:
½ cup of peanuts in
shells =
350 calories
½ cup of raw carrots =
30 calories
1 fried chicken breast
(Popeyes) =
510 calories
Baked skinless chicken
breast =
166 calories
1 cup fried rice (Panda Express
456 calories)
1 cup brown steamed rice
220 calorie
Making smart fast food choices
Why be physically active?
…..It helps prevent Type 2 Diabetes
•Helps your body use insulin better
•Improves mood and energy level
•Improves health and how well your heart works
•Increases metabolism – helping your body use glucose and you lose weight
•Can help cut risk of diabetes
34
|
October 14, 2019
How much activity should you get?
35
|
October 14, 2019
Adults
Children
Minimum 150 minutes
a week
60 minutes of activity most
days of the week
Make sure your activity includes:
36
|
October 14, 2019
Aerobic endurance Flexibility
▪ Increases breathing and heart rate, help burns calories
▪ Aim for at least 30 minutes most days of the week
▪ Keeps body limber and reduces muscle stiffness
▪ Do slowly without jerking, holding for 10 seconds
▪ Stretch after doing strength and aerobic activities
Muscle strengthening
▪ Build muscle, maintains bones and increases body metabolism
▪ Do 2 to 4 times per week in set of 1 to 3 with 8 repetitions per set
Get ready, get set, get active
Getting out of exercise ruts
38
|
October 14, 2019
Roadblock Detours
You don’t have time to
exercise
Build activity into something
you already do. For example,
walk around when talking on
the phone or walk in place
during TV commercials.
You can’t seem to get
started
Set a realistic goal you can
achieve. Do not try to do
everything. For example,
choose something simple you
feel you can do and commit to
a time to start.
Exercise is boring Include a mix of ways to be
active. Try jumping rope, an
exercise tape, flag football,
soccer, or softball.
Recap
39
|
October 14, 2019
How many minutes of physical
activity do you need each week?
a. 30 minutes
b. 60 minutes
c. 90 minutes
d. 150 minutes
40
|
October 14, 2019
“A man’s health can be judged by which he takes two at a time – pills or stairs.” ~ Joan Welsh, editor and writer
42
|
October 14, 2019
What is a Healthy Weight?
Obesity
Normal weight
Overweight
Third Key Point30 to 39.9
19 to 24.9
25 to 29.9
BMI = height to weight calculation that helps determine if you are at risk for weight-related health problems.
**Not as accurate for people with higher muscle mass
Severe Obesity Over 40
BMI Handout
Aim for a healthy weight:
44
|
October 14, 2019
Eat healthy meals
Be physically active
Watch for portion distortion
Monitor your food, fluid and activity
Portions
45
|
October 14, 2019
A portion is how much food you choose to eat at one time. Sometimes the portion is more than one serving
Portion distortion
46
|
October 14, 2019
• Within the past 20 years, portions have greatly increased in size, calories, fat, sodium, cholesterol and carbohydrates.
• One hundred extra calories per day can lead to 10 pound increase each year.
Size matters
47
|
October 14, 2019
20 Years Ago Today
333 calories
590 calories
You have to lift weights for 1 hour and 30 minutes to burn the extra 257 calories.
Changes over the past 20 years
Changes over the past 20 years
48
|
October 14, 2019
250 Calories
20 ounces
20 Years AgoToday
85 Calories
6.5 ounces
You would have to work 35 minutes in the garden to burn the extra 165 calories.
Tips for healthy living
49
|
October 14, 2019
• Choose healthy foods• Learn portion sizes• Spread carbohydrates throughout the day• Choose water • Space meals throughout the day• Move more• Record what you eat/drink and activity• Weigh in daily or weekly• Get enough sleep
Keys to Success
52
|
October 14, 2019
• Keep a food and activity and journal • Find support• Prepare in advance for difficult situations –eating out, parties • Practice positive, realistic thinking • Reduce stress
Manage your health
54
|
October 14, 2019
Blood Pressure• Normal blood pressure: 119/79 or less• Blood pressure with Chronic Kidney Disease, high blood pressure, or
diabetes: 139/89 or lower Cholesterol• Have a lower LDL and higher HDLImmunizations/Vaccines: • Have an annual flu shot every year• Have a Pneumococcal shot if you are at risk or over 65 years old • Screenings
Starting at age 21, have a pap smear every three years • From age 50 to 74, have a mammogram every one to two years• From age 50 to 75, have a FIT done every year. Talk to your doctor
about any other screenings that may be for you.
Committing to Quit
55
|
October 14, 2019
• Cigarette smoking is the number one preventable cause of early death
• Nicotine raises your heart rate and blood pressure
• Tobacco increases your risk for heart attack and stroke
• Secondhand smoke is also linked to risk for disease
• Help those around you try and quit
Limit Alcohol
56
|
October 14, 2019
Limit how much alcohol you drink:
▪ 1 drink each day for women
▪ 2 drinks each day for men
One drink equals:5 ounces of wine 12 ounces of beer 1.5 ounces of distilled liquor
Many drugs should not be taken with alcohol! Be sure to talk with your provider or pharmacist.
If your doctor has placed you on medicine: • Consider taking them at night
• Keep a list of medicines in your wallet
• Be sure not to run out of medicine
• Order online at kp.org/rxrefill or call the pharmacy
Medicine: Tips to Help
Need help remembering to take your medicine?
▪Place a reminder on the fridge or computer
▪Use a calendar
▪Use a pill box
▪Leave yourself a message on your phone
▪Take pills with another activity you do everyday, like brushing your teeth
Tips On Taking Your Medicine
• You can get addicted to these medicines
• You can never get off medicines once you start them
• Taking medicine means you are a failure
• When you start to take medicine, it means you are really sick
Myths about medicines
You CAN Do It!
60
|
October 14, 2019
To begin lifestyle changes, take these steps:
• Make a plan to change behavior
• Be specific - what and how often you will do it
• Plan what you need to get ready
• Think about what might prevent you from
reaching your goals
• Find people who will support and encourage you
• Decide how you will reward yourself
Goal Setting
In Summary
63
How Can You Reduce Your Risk?
o Achieve a healthy weight
•Aim for a 5-7% weight loss if over weight
o Aim for regular activity
• 30 minutes at least 5 days per week or
• 10,000 steps per day
o Make healthy food choices
•Include a variety of fruits, vegetables and whole grains
every day
•Include more plant proteins (legumes and soy foods) and
seafood and less red meat and poultry
•Select more plant fats such as vegetable oils, nuts,
avocado, olives and less animal fat
The Many Ways to Prevent
Prediabetes
Kaiser Permanente Healthy Living Classes
To register for following classes, call an appointment representative Monday – Friday 8:30 a.m. to 5 p.m. at (703) 359-7878 or 1-800-777-7904; TTY: (703) 359-7616 or 1-800-700-4901. Here are a few examples:
▪Nutrition for Weight Control
▪Prenatal classes
▪Living with Heart Failure
▪Nutrition for Cholesterol Control
View other healthy living classes at kp.org/classes.
Online Resources
65
|
October 14, 2019
kp.org/healthyliving
▪Healthy Living tools and resources to manage your health
▪ 10,000 Steps® Program
▪ Videos and podcasts
kp.org/healthylifestyles
▪Online self management programs to help manage conditions
▪Health Assessments and personal online plan to improve your
well-being and the quality of your life
kp.org/doctor
▪View an EMMI program through your doctor’s homepage or ask
your doctor to select the best appointments for you
Healthy Lifestyles Program
Flyer
Want to talk wellness?
66 | October 14, 2019
▪ Contact our wellness coaches, available at times that are good for you!
– Focus on healthy habits
– Create customized plan
– Schedule convenient phone sessions
– Discuss topics such as weight management, stress, and how to quit tobacco
▪ Call 1-866-862-4295, Monday through Friday, from 7 a.m. to 8 p.m. Eastern time, to make an appointment.
Wellness Coaching Flyer
National resources
67
|
October 14, 2019
National Diabetes Education Program
www.ndep.nih.gov
Choose My Plate
www.choosemyplate.gov
Academy of Nutrition and Dietetics
www.eatright.org
Food & Drug Administration
www.fda.gov