Author, Nesrine Cheikh, RD
My doctor told me I have high blood sugars: So what now?
So you’ve gone for your regular doctor’s visit or physical and your doctor tells you that you have elevated blood sugars. You may be wondering “what does that mean?”. “Does this mean I have diabetes?” “Do I need to be on a restrictive diet?” “Do I need to be on medications?”
Your doctor reassures you that you do not have diabetes, but you may be considered “prediabetic”. Prediabetes is defined as having an elevated blood sugar or blood sugar that is a bit higher than normal. This is usually determined by looking at a couple different blood- sugar markers in your lab work. Your doctor may have done a “random blood glucose test”, “fasting blood sugar”, “Oral Glucose Tolerance Test (OGTT) and/or “Hemoglobin A1C” test to identify this. Prediabetes affects over 6 million Canadians and, if left unmanaged, can result in type 2 diabetes.
What is prediabetes?
Having “prediabetes” or higher than normal blood sugar (but not high enough to be considered type 2 diabetes) means that a hormone produced by your pancreas called insulin may not be functioning at its fullest capacity. This may sometimes be referred to as “insulin resistance”. When you eat something containing carbohydrates (think sugars and starch), insulin responds by bringing the sugar from the bloodstream into the body’s cells. When you have insulin resistance, this system may not be functioning very well, and extra sugar will hang around in your bloodstream resulting in higher blood sugars. Some symptoms of high blood sugars include frequent urination and increased thirst, however, most people with prediabetes don’t feel anything at all! Many individuals with high blood sugars may also have high cholesterol and/or triglycerides as well as elevated blood pressure or “hypertension”. Having high blood sugars along with these conditions can increase your risk of:
- Kidney disease
- Heart disease and stroke
- Vision loss
- Nerve damage & amputation
- Mental Health issues
Therefore, making diet and lifestyle changes can reduce your risk of many complications.
Tips from a Registered Dietitian
You may have been told by your doctor to lose some weight, exercise more or make healthier choices. Diabetes Canada highly recommends working with a Registered Dietitian to help you meet these goals. Let’s delve into these topics a bit further!
1) Lose weight: Did you know that losing 5-10% of your body weight can reduce insulin resistance, improve blood sugars and blood pressure? If being overweight is a strong risk factor for you, mild weight loss can actually be very beneficial. I can’t stress enough that weight loss NEEDS to be tailored to you! There is NO “one size fits all” dietary approach, and working with a dietitian will help you find out what changes can be made to your lifestyle to help you lose weight in a sustainable and healthy manner.
2) Exercise more: There is tremendous research showing the benefits of physical activity, especially for individuals looking for ways to reduce blood sugar. It is recommended that combining both cardio and strength activities has shown optimal benefits on reducing blood sugar. Overall recommendations are to obtain a minimum of 150 minutes of cardio/aerobic exercise and at least 2 sessions of resistance/strength activities per week, though even small changes in activity level has still shown improvements on blood sugar! In order to stay motivated, it is very important to find something you enjoy doing. You can join supervised exercise programs in a group or individual settings and/or set very specific goals that are measurable and attainable for you! Keep in mind that prolonged sitting is associated with increased risk of death and dangerous cardiovascular events-so keep moving!
3) Make healthier choices: Nutrition therapy alone can have the biggest impact on diabetes prevention and/or blood sugar control. Consistently practicing healthy behaviours can lead to better weight management, improved fitness, reduction of cardiovascular events and lower blood sugars. Here are a few behaviours that have shown some of the strongest impact on blood sugar control:
- Choose low Glycemic index (GI) foods: The glycemic index is a list of carbohydrate-rich foods that are divided by how quickly they can raise your blood sugar. Low GI foods tend to be higher in fiber and other nutrients that can slow down the absorption of carbs into the body, resulting in improved blood-sugar control. Examples of low GI foods include: whole grain/rye bread, sweet potatoes, oats and most fruit.
- Including more nutritious carbs in the right portions at the right times: Research shows that consistency in spacing out meals 3-4 hours apart and monitoring portions of carbohydrate-rich foods can result in improved blood sugar levels. Identifying appropriate carbohydrate quantities with your dietitian is also key in managing blood sugars.
- Increase fiber: Fibre plays a huge role in helping to reduce blood sugar over time. Soluble fiber from oats and psyllium have not only shown great improvements on blood sugar, but on cholesterol levels too! It is recommended to consume 25g/day for women and 38g/day for men of total fibre.
- Reduce processed foods and cook at home: Prepare meals together as a family and use fresh, less-processed foods to make healthy, balanced and nutritious meals. Reduce sugar-sweetened beverages and packaged goods as well as refined foods. This not only helps with lowering blood sugars, but reducing other cardiovascular risk factors like high blood pressure, cholesterol and/or heart issues.
- Consider adopting a new style of eating: Research has shown strong benefits of the Mediterranean, DASH, Nordic-style and vegetarian diets, showing significant improvement on blood sugar control. These diets tend to emphasize more whole grains, vegetables and fruit, healthy fats and fish, as well as a reduction in processed carbs and red meat. Talk to your dietitian to find out if any of these diets may work for you!
Take home message
Now, you may be feeling overwhelmed, confused, maybe a bit scared. You are not alone! Making healthier lifestyle choices has been shown to reduce the risk of developing diabetes by 60%! Changing your lifestyle can feel daunting, but it doesn’t have to be. Small, gradual changes can make major differences. Always discuss with your healthcare team what choices may be best for you and talk to a Registered Dietitian to find out what lifestyle changes you can start to make today.
Learn more about Nesrine Cheikh, RD, DDePT, MScFN, CDE: