Diabetes-You Factors and Modifiable Risks
Foot Care Warning
One of the main health concerns in Diabetes is protection of your feet! Always wear closed toe shoes that fit comfortably. Check your feet daily. Be aware of any cut or blisters. Watch these carefully and see your doctor if they show any sign of infection or do not heal!!!
Type II Diabetes is a very common condition in the United States. Chances are pretty good that you know at least a couple of people who have diabetes already. You cannot just look at someone and know they have Diabetes. It is not as obvious as, say, having two heads. You would have to show an interest and ask the person if they have this condition.
The graph to the right shows the incidence of diabetes among different age groups in America. As you can see, Diabetes is very common. Almost a quarter of the population over 60 years of age has diabetes. What exactly are the risk factors for Diabetes?
Risk factors fall into two categories; non-modifiable and modifiable. Non-modifiable risk factors are things you cannot change about yourself. No, silly, not your hair color! You can change that any time you want. I mean things like your age (being 29 forever doesn't help in this instance); your race (not the one you ran, the one your ancestors belonged to); and your family history (you know this one...you can pick your friends, but not your family).
Modifiable risk factors include the things you can change about yourself. No, no, still not your hair color! Hair color is not a risk factor! No, not how tall you are...unless you mean sideways. Yes, I hate to say it but being overweight is a risk factor. The other main modifiable risk factor is inactivity. (Does this mean I will have to leave my computer for part of the day??!! Don't you know I get separation anxiety!)
Non-Modifiable Risk Factors
We will look at the non-modifiable risk factors first: (1) age (2) race (3) family history.
The risk of having Type II Diabetes increases with age. The majority of new cases are diagnosed in people between the ages of 45 and 59. Even if you have no other risk factors you should begin routine screening for Diabetes at 45 years of age. Changes in metabolism, decreased activity and the change over of muscle mass to fat all contribute to age being a significant risk factor.
If your family heritage includes one of the following, you have an increased risk for developing Diabetes: African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders. There is evidence that these groups also have a higher incidence of complications due to Diabetes.
The NIH, in 2002, offered grants to researchers to study how the "lifestyle, psychosocial factors, stress, family structure, social support, diet and culture, and socioeconomic status vary among racial and ethnic minorities and may contribute to differential risk of developing diabetes complications and progression of complications."
Researchers are investigating how much of this increased risk is attributable to genetics and how much is attributable to social factors, such as age, gender, income, and insurance status. These on-going studies are starting to show that it may be less genetics and more social factors that contribute to the higher rates of Diabetes in these ethnic groups.
Diabetes has a familiar component. This means that if someone in your immediate family has Diabetes, you are at an increased risk to develop Diabetes. Your immediate family is not always the family you live with. Immediate family, in a medical sense, includes your blood relatives: mother, father, sister, brother, aunt, uncle, etc. It does not include your spouse, in-laws or adopted siblings.
Several studies are underway to identify a gene that causes Diabetes. Scientists have identified 16 different genes that may cause Diabetes. The current thought is it is a combination of genes and/or gene mutations.
Modifiable Risk Factors
What can we do to decrease our risk? If you are like me and have one or more non-modifiable risk factors working against you, what can you do to even the odds? Diet, obesity and sedentary lifestyle are the main factors you have control over. Do not leave your health to chance! Take charge of your life and decrease your risk of Diabetes through diet and exercise.
Diet and Obesity
Does this sum up your weight loss techniques? You have tried all the "diets" out there and none of them have worked for you. Sure, you lost some weight on a couple, but within months it was back on. There is no "diet" that works for you. In the current economic situation, you do not have the money to spend on another "diet".
You are 100% correct! There is no "diet" that will work for most people. The only thing that works is to modify your eating habits. Modification through portion control and smart choices will lead to weight loss. However, only you can decide to modify your life. You are the only one who will make a difference in your eating habits.
To start on your journey, keep a food journal for one week. I guarantee you will be surprised at what you eat without even realizing it. The pastry at work, the mid-afternoon candy bar, the Starbucks latte all combine to your downfall. They are the enemy! They worm their way into your love and goodwill by being easy and delicious. Then drop you for the next sucker when you have your first heart attack. Sure, they will take you back...laughing between themselves as they plan for your next trip to the hospital. ("HA, HA, HA, what a chump", they say.)
As in any bad relationship, only you can take the action needed to end it. Don't let these foods use you! You are better than they are! There are many articles about ending a bad relationship. Many of the tips work for your food relationships.
(1) Be prepared, have a plan and stick to it. Bring something from home for your afternoon pick-me-up. Stay away from the lounge or where ever the treats are hanging out. Empty your pockets of money before passing the vending machines.
(2) Have support, do not do this alone. Enlist the help of your friends and family. Ask that they support your choices. Inform them that you will no longer be allowing junk food in the home. Request that they do not offer you the food that you are breaking up with.
(3) Get out of denial and get on with your life. Making excuses like, "just a little bite won't hurt" and "I'll work it off", are just that, excuses. Keep in mind why you are modifying your habits. Remember those pastries are laughing behind your back, while being sweet to your face!
A Note On BMI
- Calculate your BMI - Standard BMI Calculator
Your risk for developing Diabetes increases if you are overweight. You should attempt to keep you BMI (Body Mass Index) below 25. This site has an easy to use BMI calculator. The site also explains what BMI is and gives tips on weight loss.
Here are a few easy tips to help:
- Set realistic goals. Do not focus on losing 25 pounds, focus on losing 5 pounds at a time. A healthy goal is 1 to 2 pounds a week. Do not lose hope, plan on 5 weeks to lose 5 pounds.
- Never, ever, ever shop when you are hungry. You will buy things you should not!
- Buy fruits and vegetables for sweet and crunchy treats.
- Stay away from chips, cookies, white bread...items that are high in processed sugars, flours and fats.
- Learn to read the nutritional food labels! The main ingredients are first.
- Eat at home, bring lunch to work, and stay away from fast food.
- Learn to "Create your Plate". Divide your plate in half. Fill one half with a non-starchy vegetable. Divide the other half into thirds. Fill one third with grains or starchy vegetables. Fill one third with meat or protein of some sort. Put some fruit in the last third.
- Don't lose hope if you eat something you shouldn't. A habit takes at least 6 weeks to break, and our eating habits are just that. Remember Rome was not built in a day. Change take persistence.
- My Food Advisor
This link will give you advice on how to make your favorite recipes healthier. You can learn about the foods you eat everyday to assist you in making informed decisions. You will find recipes to fit your lifestyle.
You are eating healthier and you have decided to get more exercise. Where do you start? You don't have time to go to the gym every day. If you're work schedule is like mine, and you do not know when you will be able to leave each afternoon (or evening), committing to exercise is difficult.
You have work, kids, dinner, homework, grocery shopping, house cleaning, laundry, pets...and you would really like to start a garden this year! Where will you ever fit exercise in? Will it come down to the garden or the exercise? You were really looking forward to having the fresh vegetables to help out with your modified eating habits.
Well, guess what? Gardening and housework are exercise. If you have been moderately sedentary over the last few years, you will see results by gardening 30 minutes a day and housecleaning 30 minutes a day. The great thing is, if you spend 30 minutes a day cleaning your house you have less house cleaning left for the weekends! This leaves your weekends open to do more enjoyable activities.
The key to starting to exercise is starting to move. If you prefer, take a 30 minute walk every day. Try to get your heart rate up, no matter what you do. Find some way to move for at least 30 minutes daily. Start small and as you see and feel the results, you will be inspired to do more. You will have more energy and feel better. You will sleep better and wake more refreshed. Your stress levels will decrease. Exercise produces endorphins, a naturally occurring "feel good" hormone. It can become addictive with time!
A Little Inspirational Story
What to do Before You Begin to Exercise
First, have your activity level and physical capabilities evaluated:
Depending on your current activity level, your age, and any health problems it may be a good idea to see your doctor before you start exercising. If you are a male over 45 or a female over 55 years of age, see your doctor prior to starting an exercise program. If you have any health problems, such as cardiovascular disease, see your doctor.
Your doctor can help you decide what type and how much exercise you can tolerate. You will need to set realistic goals and try to develop a plan. Your doctor will either be able to advise you, or will be able to recommend someone who can advise you. Either way, your doctor will know your physical capabilities when you are starting out.
Second, decide what type of exercise you will do, how often and for how long:
There are many types of exercise. Always be sure to include stretching prior to exercising, and a cool down period after. Try to stick to your routine, but to not become discouraged if you plan to exercise five times a week and find that in reality you are only doing 3 days. Examine the reasons that prevent you from exercising and decide if you should modify your plan.
Do not, I repeat, do not go out and buy a lot of clothes, videos or equipment! There are many resources available on the Internet. You Tube has several videos for beginners to exercising. A 16oz can of vegetables or fruit is a perfect one pound weight. Or use a plastic ketchup bottle to have more ease gripping it. If you wait until you have all the clothes and equipment you need, you will never start. (Believe me, I know!)
One of the easiest ways to begin exercising is to go for a walk. Walking does not require any special clothes, no special shoes and no special path. Yes, you can get all these for walking, but to begin you just have to step out of your front (or back) door. Walking has some great health benefits in addition to losing weight.
- Walking builds bone density in the long bones. Increased bone density means decreased chance of breaking a hip or leg when falling. Women are prone to lose bone density after menopause, so walk to counteract this fact of nature.
- Being outside increases your vitamin D. The only natural way to get vitamin D is by being in the sun. In a recent article in the "US News and World Report", it was said that over 3 out of every 4 Americans had a vitamin D deficiency. Vitamin D is necessary for healthy bones and helps to prevent heart disease and cancers of the breast, prostate and colon. Vitamin D also helps to prevent depression, insomnia and autoimmune diseases.
- Walking has numerous other health benefits. It strengthens your heart, lowers your cholesterol, improves your mood, and decreases feelings of stress to name a few.
Other Risk Factors
Although I have covered the major risk factors for developing Diabetes, smoking, gestational diabetes, and having a child over 9 pounds are among the other risk factors. For a more comprehensive list go to this site.
Below is a table presenting testing criteria for adults. My next hub on Diabetes will address diagnostic testing.
- Risk Test
Could you have diabetes and not know it? Take this test to see if you are at risk for having or developing type 2 diabetes. The test is easy and will take less than a minute to take. You do not have to sign up, results are immediate.