If you have one sign or symptom, that doesn’t mean you have diabetes. But you should start to be concerned if you have several symptoms. A checkup with your healthcare provider now can start you on treatment to help prevent or reduce the heart, eye, kidney, nerve, and other serious complications diabetes can cause.
Some women develop gestational diabetes in the late stages of pregnancy. This form of diabetes usually goes away after the baby is born. However, a woman who has had gestational diabetes has a greater chance of developing type 2 diabetes later in life.
Recognizing the silent syndrome
A key development in the treatment of diabetes has been an improved understanding by the medical community of one of its major underlying causes: insulin resistance, also called metabolic syndrome. This increased understanding of insulin resistance has resulted in more appropriate medical treatment options.
Insulin resistance occurs when the body fails to respond properly to the insulin it already produces. It is an underlying cluster of symptoms that often precedes the diagnosis of type 2 diabetes. Many people at risk for diabetes do not know what insulin resistance is or even realize that they have signs of diabetes development.
A family history of diabetes, being overweight or obese, and physical inactivity increase your chances of developing insulin resistance. Certain ethnic groups, such as Latinos, Blacks, and Native Americans, are twice as likely as Caucasians to develop insulin resistance and diabetes. Insulin resistance is associated with an increased risk of heart disease and stroke.
Unfortunately, there’s no simple test for insulin resistance. It’s usually marked by a cluster of characteristics. The presence of three or more characteristics can result in a diagnosis of insulin resistance or metabolic syndrome. The characteristics of insulin resistance syndrome are as follows:
Abdominal obesity (a waist measuring more than 35 inches in women or more than 40 inches in men)
Fasting glucose level of 110 mg/dl or greater
Triglycerides of 150 mg/dl or greater
HDL cholesterol less than 50 mg/dl in women or less than 40 mg/dl in men
Blood pressure of 130/85 or greater
Lipid is another name for fat, so blood lipids are fats in your blood. Your doctor can create a profile (a breakdown of the different types of fat in your blood) of your lipids to help determine the type of heart disease you’re at risk for (if any) and also to help determine the dietary approach to best lower your lipids.
When your healthcare provider checks your lipids, you’re likely to get a list of numbers in each of the following categories:
Total cholesterol: This is a measurement of your total blood fats. This includes the sum of the HDL, LDL, and VLDL cholesterol components.
High-density lipoprotein (HDL) cholesterol: This is commonly called “good” cholesterol because it carries excess cholesterol back to the liver, which processes and excretes the cholesterol. You want this number to be greater than 40 mg/dl.
Low-density lipoprotein (LDL) cholesterol: This is commonly called “bad” cholesterol because high levels are linked to increased risk for heart disease. Ideally, you want this number to be below 100 mg/dl.
Very-low-density lipoprotein (VLDL) cholesterol: This number is determined by dividing the triglyceride number by 5. VLDL cholesterol can be converted to LDL or “bad” cholesterol.
Triglycerides: Triglycerides are a blood fat that is not only affected by the fat in your diet but is also increased by excess calories in the diet and by excess carbohydrate in the diet. Triglycerides normally increase after eating a meal, and they usually fall back to normal in two to three hours. Chronically high triglycerides have recently been linked to heart disease. You want this number to be below 150 mg/dl.
Check out Table 4-2for guidance on what blood lipid levels you should be shooting for.
TABLE 4-2Blood Lipid Levels
Type of Cholesterol |
Desirable |
Borderline |
Unacceptable |
Total cholesterol |
Less than 200 |
200 to 239 |
240 or above |
HDL cholesterol |
60 or above |
40 to 59 |
Less than 40 |
LDL cholesterol |
Less than 100 |
100 to 159 |
160 or above |
Triglycerides |
Less than 150 |
150 to 199 |
200 or above |
Spotting early problems with blood pressure
Blood-pressure readings are expressed in two numbers that reflect the pressure on artery walls when the heart contracts. Turn to Table 4-3for information on what your blood pressure reading means.
TABLE 4-3Blood Pressure Reading
Blood Pressure Classification |
Systolic (Top Number) |
|
Diastolic (Bottom Number) |
Normal |
Less than 120 |
and |
Less than 80 |
Elevated |
120 to 129 |
and |
Less than 80 |
High Blood Pressure (Hypertension) Stage 1 |
130 to 139 |
or |
80 to 89 |
High Blood Pressure (Hypertension) Stage 2 |
140 or higher |
or |
90 or higher |
Hypertensive Crisis (consult your doctor immediately) |
Higher Than 180 |
and/or |
Higher than 120 |
New guidelines for blood pressure readings were issued by the American Heart Association, the American College of Cardiology, and nine other health organizations in 2017. These new guidelines lowered the thresholds for blood pressure readings. Health officials recognize a category for blood pressure called elevated. If the top (or systolic ) number in your blood pressure reading is between 120 and 129 and if the bottom (or diastolic ) number is less than 80, you have elevated blood pressure . Elevated is a blood pressure that doesn’t require treatment with medication but still can increase your risk of heart disease and stroke. These guidelines along with medication when indicated encourage you to make lifestyle changes such as losing weight, exercising, quitting smoking, or reducing alcohol intake. A dietary approach known as Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean Diet have been shown to reduce blood pressure. The low-carb Whole Foods Weight Loss Eating Plan described in this book incorporates the principles of the DASH Diet and the Mediterranean Diet.
Understanding the relationships between ethnicity and health risks
Certain diseases seem to be more prevalent in some races than others. So, with no other issues in your family health history, you still may have risk factors for several diseases just by belonging to a particular ethnic group.
Here’s a quick list of some ethnicity-related health concerns. If you belong to any of these groups, pay special attention to the health risks associated with them.
Blacks:Have an increased risk for diabetes and insulin resistanceAre five times more likely than Caucasians to develop kidney disease if diabeticHave the highest heart-disease risk and an increased risk for high blood pressure
Asians:Have an increased risk for osteoporosis (especially women)
Caucasians:Have an increased risk for osteoporosis (especially women)
Latinos:Have an increased risk for diabetes and insulin resistanceAre over six times more likely to develop kidney disease if diabetic
Native Americans:Have an increased risk for diabetes and insulin resistanceAre six times more likely to develop kidney disease if diabetic
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