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Stopping prediabetes in its tracks – Mary’s Promise

Hello Readers,

Last month was National Diabetes Awareness month and we’re coming up on almost two years ago I was diagnosed as being prediabetic. I thought it was about time for a little update on my battle to prevent falling victim to diabetes.

What is prediabetes?

Prediabetes is when your blood sugar level is higher than normal, but not high enough to considered Type 2 Diabetes. However, if you don’t make lifestyle changes your prediabetes is likely to develop into Type 2 Diabetes. Unfortunately, the long-term impact on your heart, blood vessels and kidneys may already be underway if you’re prediabetic. You can’t wait to take action to stem the impact of diabetes and prediabetes.

I thought of my prediabetes diagnosis as a warning sign.  It scared me to think that not only did I have a number of other health issues that needed immediate attention, but that those might be complicated by diabetes. Once again the TMC Wellness programs came to my rescue. Talking with Mary and Laurie about my prediabetes diagnosis and adjusting my diet and my exercise level to help my body heal worked.

Today my A1C  (the A1C test reveals how much glucose is attaching to the hemoglobin in your blood and is a good indicator of how effectively your body is processing sugar) is now 5.3 where once it was 6.4. My doctor explained to the A1C guidelines as the following:

DIABETES 6.5 or higher

PRE DIABETES 5.7 to 6.4

NORMAL  Below 5.7

As you can see with my 6.4 A1C I was teetering on the edge of full blown diabetes. I was given three months to lower that number or I would be put on medication.  Most people aren’t aware of any symptoms of diabetes until you get your physical and blood tests which include an A1C test. There are some side effects which I had, but never paid any attention to them. The top 3 are:

1. Thirstier than normal .

2. You have to go to the bathroom more often.

3. You’re more tired than usual .

There are also risks factors which I had all of them as well. Here are the main ones:

1. Overweight

If you are overweight you are at high risk.

2. Lack of physical activity

If you aren’t physically active you are more likely to develop prediabetes .

3. Family History

Prediabetes has a heredity component. If someone in your close family has or had Type 2 Diabetes, you are more likely to develop it.

I did my research and learned through the WELLNESS PROGRAMS how to bring my A1C down to normal level.  With my doctors approval and monitoring I did the following:

Lost weight

I joined the TMC Wellness programs and learned everything to make a lifestyle change .

Added exercise to my day

Including cardio (walking, jogging, dancing and yard work), weight training (light weight curls, push ups and pull ups), and worked on balance and stretching with yoga.

By making a healthy lifestyle change which included losing weight and exercising I moved into the normal range though I still get monitored every 3 months.

If your A1C is in the dangerous range make an appointment to talk with the TMC Wellness team or with the TMC Diabetes Educators.

Get help

For patients that have been diagnosed with pre-diabetes, TMC offers an eight-hour class, Journey for Control, Wednesdays from 1-3 p.m. To learn more or to register, please call (520) 324-1960.

Additionally, TMC offers free education sessions and support that cover a wide variety of helpful topics. Discussion is facilitated by a certified diabetes educator. Classes are held on the second Wednesday of each month from 5-6 p.m. at the El Dorado Health Campus Cafeteria. No registration is necessary. To look at the full schedule of classes, click here.

Mary H Kmak

Health Warrior

Mary Kmak has turned her life around, losing over one hundred and thirty-one pounds, and found a path to health through the Tucson Medical Center Wellness program. In Mary’s Promise she shares tips, recipes, challenges that she has learned along the way. Today, she shares her journey to battle one of the nations largest health risks, diabetes.

Want to make the kind of changes that Mary has and see similar results? Make an appointment to see one of TMC’s Registered Dietitians for a one on one and gain a whole world of scientifically based, tried and true techniques to improve your health and fits your individual lifestyle.




Stopping prediabetes in its tracks – Heather has an action plan

Heather – educator, mom, locavore and prediabetic

In her early 40’s Heather is in the kind of physical condition that most of us would like to have been in our thirties or twenties. She is athletic, muscular, and has that healthy glow of someone who eats all their fruits and veggies. In fact, Heather would not be out of place as a model in one of those catalogs for women’s outdoor athletic wear. You know, the catalogs where the model is climbing a rocky crag or slack lining between two palm trees on a sandy beach and there is a little side note which says ‘Heather-educator, mom, and locavore’.  Yet, earlier this year she found herself checking in with the doctor concerned about some worrying symptoms.

I was super fatigued, low energy and by mid afternoon everyday I wanted to take a nap. I felt foggy, my fingers and toes tingled. At first I explained it  away…it was my sleeping position, I’d stopping breastfeeding etc., but I was peeing twenty times a day, and at night I might get up 5 times in an hour to go to the bathroom. I couldn’t explain that away. I went to the doctor.

A hemoglobin A1c test revealed that Heather was prediabetic. Her suspicions confirmed, Heather shares that she felt empowered by the knowledge of what had ailed her. Now she knew what was wrong she also knew that there was something that she could do about the diagnosis.

Heather sought help in modifying her diet and increased her exercise. (The Diabetes Education Program at Tucson Medical Center provides individual counseling for physician-referred patients with Type 1, Type 2 and gestational diabetes) Her diet hadn’t been terrible prior, although she describes it as ‘quality junk food’. Yes, she was cooking from scratch, using organic foods, but it was still cookies she was eating, or ice cream, and vast amounts of fruit. She cut back on the obvious culprits, the sugary carbs: cookies, ice cream and fruit, but also the starchy vegetables, breads, rice and dried fruits and she upped her leafy greens. Rather than exercising intensely 2-3 times a week as she had before she started exercising 4-5 times a week, not as intensely, but more often.

Heather’s approach mirrors the advice Nancy Klug RN, CDE, coordinator of the Diabetes Education Program, suggests for people who are prediabetic:
1.  Start walking regularly
2.  Lower your carbohydrate portions at meals
3.  Meet with a Certified Diabetes Educator for training.

Rapidly, Heather’s symptoms have disappeared. Heather is due for a follow-up blood test, hopefully to confirm what she suspects from the disappearance of her symptoms that she is no longer prediabetic. However, even if she is no longer prediabetic Heather is committed to these new eating and exercise habits. “I have so much more energy, and I’m thinking so much more clearly.” Heather hopes to have caught the prediabetes before it escalated into diabetes, but she knows that this is an ongoing challenge. Her advice to someone newly diagnosed –
1. Ask lots of questions.
2. Make sure you are clear about what the recommendations mean. Especially, seek help regarding the nutritional recommendations.

Nancy Klug stresses the importance of meeting with a Certified Diabetes Educator explaining that misconceptions about diabetes are rife. People think they can never eat sugar again or that if they have to go on insulin, they have failed.   Nancy explains some people diagnosed with prediabetes or borderline diabetes dismiss the diagnosis as just a minor thing which is a huge mistake, or think that if they just lose weight the diabetes will go away.    With the help of a Certified Diabetes Educator you can come up with a plan to manage successfully your diabetes.

Diagnosing and managing prediabetes

Kay Reed is a tall, lean, fit-looking woman who just turned seventy. She’s an avid hiker and has enough energy to keep up with her four grandchildren, two of whom live in Tucson.  She loves her grandkids more than anything, and the feeling is mutual. Grandma Kay plans to be around for a long time and watch them grow up.

She appears to be the picture of clean living and excellent health, which is, for the most part, true. What you can’t tell by looking at Kay is that she is prediabetic. How did Kay find out? And what does this mean for her?

For starters, there’s family history to consider.

Kay’s paternal grandfather had adult onset diabetes, also known as type-two diabetes. He developed type-two diabetes before the era of insulin replacement. which probably contributed to an earlier-than-expected death. A person with type-two diabetes has a pancreas that produces little or no insulin, leading to dangerously high blood-sugar levels.

This type of diabetes differs from type-one diabetes, which typically starts in youth, which is why it used to be known as “juvenile diabetes”.  In type-one diabetes, the pancreas makes no insulin, and blood sugar must be monitored daily, and regular injections of insulin are required to maintain a healthy blood level.

Kay’s father had adult onset diabetes as well, but he was able to keep his blood sugar in check through the use of various medications, and did not need to take insulin. He lived to be 90, but his cause of death was likely partially related to complications from diabetes.

Because of her family history, Kay thought it was smart to check some bloodwork done to see if she too was prediabetic. So she requested an A1C test to check her glycohemoglobin. This is different than a regular blood sugar test in that it shows a person’s blood sugar levels over a period of several months, rather than simply what one’s current glucose level is. As blood sugar levels can vary throughout time, even in a matter of hour, this test gives a much clearer picture of a person’s glucose levels.

Sure enough, the test results showed a sustained increase in glucose levels over an extended period, and Kay is now clinically prediabetic. She will continue to get regular glycohemoglobin tests to track her blood sugar, and to see if her lifestyle changes are helping her stay as healthy as possible.

So what changes has this already healthy woman made? She already ate little junk food, and mainly consumed whole grains, vegetables, fruit, and some fish. Now, she avoids white flour, refined sugar, animal fat, and tries to get more exercise. “I’ve always tried to eat healthfully, but this has made me even more conscious about my diet. I’m a bit stricter with myself. Also, I know that a daily walk will really help me keep my blood sugar under control.”

“Interestingly, I don’t crave sweets as much as I used to, but I do love a little piece of dark chocolate every day.”