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6 Ways to Lower Your Risk
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Making lifestyle changes can help you take control of your diabetes and keep your blood sugar in check. These changes don't have to be drastic, though. Even modest weight loss, for example, can pay huge dividends. Here are 6 simple strategies to improve your health. Try one at a time and add on as you're ready. Day by day, little by little, you'll lower your diabetes risk and develop healthy habits for a lifetime.

EAT RIGHT

You know this: a balanced diet, low in calories goes a long way in not just preventing diabetes but keeping you healthy overall. "Paying heed to calories is especially important if you are trying to lose weight," says Bengaluru-based nutritional consultant Sheela Krishnaswamy. "If you are off by even 100 calories a day, you can end up gaining 2 to 5 kilos in a year, she adds.

Follow the MyPlate advice to build a healthy plate at mealtimes. Fill half your plate with veggies, raw and cooked and slightly more than a quarter with grains (half of which should be wholegrains. Protein,lean meat, skinless poultry, fish, eggs, beans or tofu-- should take up just under a quarter of your plate. Also practise portion control and eat smaller, frequent meals. (see Shrink Deadly Belly Fat with Food).


MOVE MORE

That exercise can help control diabetes is well known . It helps you burn unwanted calories and lose weight. Says Dr Anoop Misra, Prevention advisor and chairman, Fortis C-DOC, Centre for Excellence for Diabetes and Metabolic Diseases, New Delhi, "Physical activity increases the rate at which glucose in the blood is taken up by the muscle cells. This happens as the efficiency of cellular transport vehicle for glucose (GLUT-4) increases, in turn improving insulin sensitivity and lowering blood glucose." No wonder a major Finnish study found that subjects who exercised regularly reduced their risk of developing type 2 diabetes by up to 70%, compared with subjects who were less active.

Aerobic exercise is a good start. But new research suggests that interval training,which alternates easy pace activities with bursts of high-intensity movement,generates better glucose control. Another diabetes-fighting form of exercise experts are now swearing by: strength training. Resistance training equals aerobic exercise at improving glucose control, provided, the calories burnt are the same. In fact, it even offers a bonus: it creates more muscle tissue and insulin receptors, further improving the absorption of glucose into muscles. And muscle tissue is where glucose should be, not floating in the blood or being converted to fat. As the muscles absorb glucose, your pancreas heave a sigh of relief! Experts recommend a combination of cardio and strength training for best results. "An hour of exercise daily,including about 30 minutes of cardio, 10-15 minutes of resistance training and 15 minutes of walking or similar exercise incorporated through the day,is ideal," adds Misra.

SLEEP BETTER

Sleep plays a vital role in maintaining normal blood sugar levels. There is some data that indicates that sleep deprivation leads to worsening of insulin resistance and in turn leads to irregularities of glucose metabolism, says Dr Binayak Sinha, consultant endocrinologist, AMRI Hospitals, Kolkata. Get less than six hours on most nights and you're three times more likely to have elevated blood sugar levels, according to recent research in the Annals of Epidemiology. Even just one sleepless night can interfere with your body's ability to use insulin, according to Dutch researchers.

Too little sleep also leads to more weight gain. In an American survey of 87,000 people, one-third of participants who slept less than six hours were obese. And when researchers at Columbia University analysed 20 years' worth of data on more than 68,000 women, they found that those who got five hours or less weighed about 2.3 kg more and were 15% more likely to become obese than those who slept seven hours. What's the correlation? Sleep deprivation alters blood levels of hunger-regulation hormones, ghrelin and lowers leptin,a bad combo that prompts an increase in appetite as well as a preference for sugary snacks and starches.

Most adults need between seven and eight hours a night, says Sinha. However, we seem to be getting fewer hours, he adds. And it's not just the quantity, but also the quality of sleep that counts: disturbed sleep can spike blood sugar levels too. The best strategy to improve sleep, according to experts: maintain a consistent sleep schedule. It keeps your biological clock in sync so you rest better. Some other tips for sound sleep include: exercising during the day, but not too close to bedtime, avoiding too much food, too close to bedtime (keep a gap of 2 to 3 hours), unwinding with meditation or soft music or a book, turning down lights and switching off gadgets.


STRESS LESS

Chronic stress,the kind that grinds endlessly,can increase your chances of developing type 2 diabetes, especially if you're genetically susceptible to it. Why? Because stress prompts your liver to make glucose available to the cells as fuel for the fight-or-flight response. "When stress is short-term, your body is able to use this excess sugar and maintain balance. However, in case of long-term stress, sugar is continually released into your bloodstream which your body is unable to use up. Over time, this may be responsible for rise in blood sugar," says Misra

Moreover, chronic stress doesn't just elevate your blood sugar reading, it also widens your waistline,in part because all the cortisol coursing through the bloodstream triggers craving for high-fat, high-sugar comfort foods. This may explain why many of us turn to food when we are stressed out and why we are likely to turn to a chocolate brownie rather than steamed veggies as comfort foods. The continuous flow of cortisol due to chronic stress also redistributes your body fat and accumulates around the belly, adds Misra.

Good news is that stress doesn't arise from a particular incident or circumstance, but from our perception of and reaction to it. Developing an optimistic attitude and resilience is the way to beat stress.


MANAGE WEIGHT


Shedding as little as 4.5 kilos can help you get a handle on diabetes. Controlling your weight is one of the most effective things you can do to improve your blood sugar and lower your risk of developing diabetes. And losing just a small percentage of your body weight can make a difference. In one study, even extremely overweight people were 70% less likely to develop diabetes when they lost just 5% of their weight,even if they didn't exercise. If you weigh 80 kg, that's less than 4 kg!

Also keep in mind that central obesity or belly fat ups your risk. Why? Because visceral fat or belly fat, lies deep within the abdomen, around the vital internal organs. Moreover, it is highly metabolic. "It breaks down quickly and enters the bloodstream directly, travelling around the body and parking themselves in various tissues including those of the pancreas,the insulin production house," explains Dr Ambrish Mithal, chairman, Division of Endocrinology and Diabetes, Medanta-The Medicity, Gurgaon. Moreover, when metabolised, visceral fat also secretes chemicals and other lousy stuff that disturb the hormonal balance, says Mithal. Finally, visceral fat also hampers the ability of the body's cells to communicate with one another via chemical signals. Though researchers don't fully understand why, it may help to explain the insulin resistance and visceral fat connection: the hormone can't ‘talk' to the cells. So watch your waistline. "For a woman the waistline should be below 30" and for a man, below 33"," says Mithal. Also keep your BMI within normal range: 18.5 to 22.9 kg/m2.


GET TESTED

Many diabetes symptoms are silent. A simple blood test can reveal whether sugar levels put you at risk for the condition. A fasting score of 100mg/dL in normal; 100 and 125 mg/dl indicates prediabetes. People with prediabetes or slightly elevated blood sugar levels often develop a full-blown case within 10 years. Knowing your blood sugar levels are a little high can put you on a track to steadying them,with simple diet and exercise changes,before diabetes sets in and medications may be necessary. Get tested starting age 30. Earlier if you have risk factors such as being overweight, a family history and high cholesterol and BP.