mySugr Coaches Kristen and Maggie fill us in on what causes prediabetes and type 2 diabetes. Learn what you can do about the risk factors you can control and how to shed the guilt around the risk factors you can’t control.

Let’s learn about the factors that can help prevent, delay, and better manage prediabetes and type 2 diabetes, as well as factors that are non-modifiable.

Note: We cannot provide medical advice. Please contact your doctor directly for specific questions about your care.



Topics

• Modifiable risk factors vs. non-modifiable risk factors
• Weight as a risk factor
• Working on small changes that make big impacts

Transcript

Scott K. Johnson – Hey, thanks for tuning in to another episode of Coaches Corner, it is great to see you again. Let me know where you’re watching from today. One small way that mySugr is giving back, is by hosting these short conversations with our diabetes coaches to talk about staying healthy in body and mind. We really appreciate you sharing some time with us. Now I do have to give the standard disclaimer, we cannot provide medical advice. Please contact your doctor directly for specific questions about your care. And another quick housekeeping note, we are shifting to two broadcasts per week through the end of May. On Mondays and Wednesdays at 3 p.m. Pacific time with the exception of next Monday which is Memorial Day. We’re going to take that holiday off. We’ve got some great topics lined up for the rest of the month, so I do hope that you’ll join us. Today, mySugr Coaches, Kristen and Maggie fill us in on what causes pre-diabetes and type 2 diabetes. Learn what you can do about the risk factors you can control and how to shed the guilt around the risk factors you can’t control, let’s take a look. Alright, Kristen and Maggie, always great to have you back again. Today we’re talking about what causes diabetes and pre-diabetes and if I ever heard a loaded question, this is one of them but we’re going to try and break down some of the common topics and dig into this a little bit. So, but maybe before we go into what causes pre-diabetes and type 2 diabetes, how would you define type 2 diabetes?

Maggie Evans – Great question, Scott, so I would think, you know, one of our main pillars that we kind of talk about when it comes to type 2 diabetes is the concept of insulin resistance. So when you think of insulin resistance, we know insulin is a hormone that our pancreas, which is a little organ next to stomach, our pancreas makes insulin which technically acts kind of like a key to a lock on the cell site that allows glucose to go into ourselves to make energy. So for us to live and be active and do the things that we want to do, so we need that mechanism to happen in order to live, essentially. In diabetes and in insulin resistance specifically, we tend to see that, that key mechanism just isn’t working as well, so that insulin just isn’t as effective at getting that glucose into the cell, that sugar into the cell, for it to make energy. So what ends up happening is we tend to see this larger amount of sugar building up in the bloodstream and then the pancreas kind of goes into a little bit more overdrive and tries to produce more insulin in a way to try and get that glucose into the cell. So we see kind of a rise in insulin and it’s just still not as effective. We also see this rise in blood sugar. So that kind of starting point where we see these rises in blood sugar but not necessarily numbers that would merit type 2 diabetes, we call that pre-diabetes. So it could be referred to as like, “impaired fasting glucose,” just “impaired glucose levels.” That might be something that your doctor refers to as that. And then once that gets to a point where the blood sugar numbers are high enough to be classified as diabetes, then we can kind of consider that, to be more so that full-blown insulin resistance.

Scott K. Johnson – And these are, when we talk about doctors checking our glucose levels and things like that, these are typically part of like, an annual physical lab exam, things like that, right? Something that the doctors would look at, on a pretty periodic regular basis.

Maggie Evans – Of course, yeah so these, especially the A1C might be on something more like, a yearly lab panel. There’s something called a complete blood count or a CBC for short and typically our glucose levels will be on there, so no matter what, if you’re fasting for those, you know, monthly or you know, quarterly labs, you can still see your fasting glucose on there and sometimes that can be that indicator that tells your provider, “Hey, these glucose levels are rising,” so there might be potential for that to develop into type 2 diabetes.

Scott K. Johnson – And I know that, understanding where diabetes comes from, what causes diabetes, it’s an incredibly complicated topic. There’s a lot that’s not yet understood and a lot that’s misunderstood. One of the things that many people newly diagnosed with diabetes think about or feel, is that they’ve done this to themselves. They’ve eaten themselves into having diabetes. We’re going to touch on some of the factors but just right off the top I want to put it out there that it’s not quite that simple, alright, that’s not quite the case, but we’re going to look at what these factors are and I like the way that you two are breaking these down into modifiable risks or things that we can actually do something about and then there’s also a handful of non-modifiable risks or things that are very much out of our control. So let’s jump into the factors.

Kristen Bourque – Yeah so, kind of as Maggie put it so well about, you know, we talk about pre-diabetes and type 2 diabetes, so when I kind of go over this a little bit, this is where it’s very important to work on those modifiable factors, like you mentioned, Scott so, if I were to put two separate columns, essentially, non-modifiable risk factors are things that maybe, again are, of course including like, age, ethnicity, a family history of type 2 diabetes, so things that of course we can’t change or modify which is why it’s called a non-modifiable factor. But there is this whole other category of modifiable risk factors, things that we can work on and of course modify to help either prevent or delay the development of type 2 diabetes but also if we do have type 2 diabetes, to help manage it better. So of course when we look at a couple things that right off the bat of course, is our intake of our, you know, nutrition, right, so our diet as well as our activity. So those are two things that can really have a substantial impact on our blood sugar values, depending on where our numbers are in terms of our weight, and we do want to preface this by saying, of course, this is something you want to talk with your doctor about, but weight loss might be a recommendation that is beneficial for you to either again, delay type 2 diabetes or again manage it better. Also there’s another piece of it too is medication so depending on the type of medications and we know that can actually encourage things like, weight gain, excuse me, as well as like, steroids which can impact blood sugar values too. So it’s hard to put that category of medications ’cause it may be something that you need to have in your life as well, so potentially could be a non-modifiable risk, but in general, it might be something where it’s a short period of time that you’re on that medication and that might be causing those values to be a little bit higher. So again we always like to encourage people to kind of look at what are the things that we can work on and change, to help improve those blood sugar values, over time as well.

Scott K. Johnson – You mentioned around the topic of weight, that often times some weight loss can actually help matters quite a bit, but what are we looking at in terms of numbers or you know, if someone is overweight, dealing with diabetes or pre-diabetes, I think they can often have this misconception that they need to go from where they are today to this super fit athlete, you know, lose a bunch of weight, but that’s not really true, is it?

Kristen Bourque – No and that’s such a great point too and this is why I kind of say, you know, make sure and talk with your doctor about kind of, where your numbers are at. Something that we do use is our body mass index, it’s a measurement of our height versus our weight, but the problem is, it doesn’t account for a lot of important factors so, you know, age, of course, muscle mass, so there’s a lot of pieces of that puzzle missing. One thing that we really like to recommend is, and you could do this at home, it’s actually just to measure your waist circumference. We found that people that have a larger waist circumference or more, we call visceral fat, so, fat in that midsection area do also have an increased risk of developing type 2 diabetes and that insulin resistance that Maggie was mentioning, so I actually prefer that, over the BMI because we can simply measure it at home, and we also know even if we don’t have a tape measure, we know, if those pants are fitting a little tighter, that maybe we are struggling a little bit. But that could be a good marker of, you know, again, even if we were to lose a couple inches, we’re also going to help improve those numbers and those other risk factors, you know, again in turn as well too, you know, again, just overall, the big picture there.

Maggie Evans – Another measure that we can use too, is just simply about 5% of your weight as well so a reduction in about 5%. So it doesn’t have to be a large number. For most people that ends up being just about 5 or 10 pounds and of course when, you know, we’re working with people and we make these recommendations, this isn’t 5 pounds in a week, it’s 5 pounds over a period of time. It’s making these slower, more sustainable changes over that period of time to really help make us more insulin-sensitive versus insulin-resistant.

Scott K. Johnson – Yeah that helps put it into perspective quite a bit. So when I look at the, and hear the list of things that are modifiable risks or things that are in my control, I’m actually quite encouraged that there’s a lot that I can do to help myself if I’m worried about or dealing with pre-diabetes or type 2 diabetes, so I really appreciate breaking it down in that way.

Kristen Bourque – Yeah and I think, Scott you bring up a great point that, I know it can seem overwhelming, especially if your doctor, you know, tells you that you have a diagnosis of pre-diabetes or type 2 diabetes but even working on one of these risk factors will help improve those values so I know it can seem a little bit overwhelming to digest all that information, but even small, small changes make a big impact over time.

Scott K. Johnson – It’s a great point, alright well, thank you, this was a quick session on pre-diabetes and type 2 diabetes but I think that we covered quite a bit. Is there anything else that either if you want to go into on this topic?

Kristen Bourque – I think we covered it pretty well yes and definitely, message your coach if you, you know want to, again work on some of these modifiable risk factors, we’re here to support you on that journey for sure.

Scott K. Johnson – Sounds good, thank you and we’ll see you again very soon for another session. Alright I hope that that was helpful and if you have additional questions or want us to dive deeper, go ahead and leave us those questions in the comments. We are happy to follow up and address them in an upcoming episode. And then I hope that you’ll come back on Wednesday, when I catch up again with Maggie and Kristen about the signs and symptoms of pre-diabetes and type 2 diabetes. Until then, stay well and we’ll see you next time, bye.

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Read more about A1c, Fasting Blood Sugars, insulin, Intensive management, mySugr, type 2 diabetes risk factors, weight.