Prediabetes or Impaired glucose tolerance (IGT) is a condition where blood glucose (blood sugar) levels are higher than normal but are not high enough to be called diabetes. Prediabetes or IGT can lead to Type 2 diabetes, heart disease and stroke.
How does your body use glucose?
- Much of the food you eat becomes a type of sugar called glucose. Glucose travels in your blood to all parts of your body.
- Insulin, a hormone made by your pancreas, helps the glucose get into the cells of our bodies to give us energy.
What happens in IGT?
- You do not produce as much insulin or your body does not use insulin very well (insulin resistance), or both.
- Glucose builds up in the blood causing high blood sugars.
- Below are the blood glucose levels to determine diagnosis:
Normal Glucose Levels (mmol/L):
Fasting blood glucose: 6.1 or less
2 hours after a meal: 7.8 or less
Prediabetes or IGT Levels (mmol/L):
Fasting blood glucose: 6.1 - 6.9
2 hours after a meal: 7.8 - 11.0
Diabetes Levels (mmol/L):
Fasting blood glucose: 7.0 or greater
2 hours after a meal: 11.1 or greater
People with IGT may also have:
- high blood pressure
- high cholesterol and triglycerides
Preventing or delaying onset of diabetes
This pamphlet can help you make lifestyle changes. These changes include healthy eating, losing weight, and increasing activity. Making these changes may keep you from developing diabetes.
A healthy lifestyle can be achieved by following Canada's Food Guide
- Enjoy a variety of foods from all four food groups. Eat the recommended amount and type of food each day:
- 7 to 10 servings of Vegetables and Fruit daily
- 6 to 8 servings of Grain Products daily
- 2 to 3 servings of Milk and Alternatives daily
- 2 to 3 servings of Meat and Alternatives daily
- Emphasize vegetables and fruits, and whole grain breads and cereals.
- Choose lower fat milk and milk alternatives
- Choose lean meats and foods prepared with little or no added fat or salt.
- Limit foods and beverages high in calories, fat, sugar or salt.
- Be active every day.
In addition, you should:
- Distribute food throughout the day by eating 3 meals and including healthy snacks. A balanced meal has at least 3 out of the 4 food groups from Canada's Food Guide.
- If you are overweight, adjust your portion sizes to promote a weight loss of 1 to 2 pounds per week.
- Limit salt, alcohol, caffeine, sugar, and sweet foods.
- If you smoke, quit.
Basics of healthy eating
Eat more fibre
Fibre is found in cereals, breads and other whole grains, vegetables and fruit, beans and lentils. Fibre improves blood sugars, bowel health and lowers cholesterol.
The average woman needs about 25 g of fibre daily and the average man needs about 38 g of fibre daily. Most Canadians only eat half of this amount. Remember to drink plenty of fluids, especially water when increasing fibre intake.
Tips to increase your fibre intake
- choose whole grain products such as rye bread, whole wheat crackers, brown rice and whole wheat pasta
- make at least half of your grain products whole grain each day
- choose high fibre cereals with at least 4 grams of fibre per serving
- sprinkle bran or Bran Buds® on cereal or in yogurt
- choose a minimum of 7 servings of vegetables and fruit each day
- have vegetables and fruit more often than juice
- choose barley, dried peas, beans and lentils often and use them in soups and casseroles
Use sugar in moderation
- limit sugar, sweetened beverages, fruit juice, desserts, candy, syrup, jam and honey
Limit caffeine intake
- limit caffeinated beverages such as diet colas, coffee and tea to 3 to 4 cups (750 mL to 1L) per day
Limit salt intake
- use herbs and spices for flavoring instead of salt
- add less salt when cooking and at the table
- eat less canned, processed and packaged foods
Choose healthier fats in place of saturated and trans fats
Saturated fat is found in animal foods such as meat and milk products as well as coconut and palm oil.
Trans fat is hydrogenated or partially hydrogenated oil. It is found in deep fried foods such as French fries, vegetable oil shortening, coffee whiteners and creamers, donuts and other commercial baked goods.
Note: Both saturated and trans fat raise blood cholesterol levels.
Tips to increase your use of healthy fat
- use oils high in monounsaturated fat, such as canola, olive and peanut oil
- use non-hydrogenated margarine
- avoid buying foods that list hydrogenated oil and/or vegetable oil shortening as ingredients
Use these ideas to cut back on fat
Limit alcohol
- If you choose to drink, do not drink more than 1-2 drinks per day (less than 14 drinks per week for men and 9 drinks per week for women).
- 1 drink is equal to 1 bottle (341 mL) of beer, 5 ounces (150 mL) of wine or 1½ ounces (40 mL) of hard liquor.
Portion sizes
Choosing smaller portions of your food will help you lose weight and improve your blood sugars. For portion sizes of some common foods see Canada's Food Guide. Some handy ways to measure your food are:
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Spreading food throughout the day by eating 3 smaller meals and 2 to 3 snacks at regular times will help prevent your blood sugar from going too high.
- Eating smaller portion sizes will help you to reach or stay at a healthy weight for your height.
- Eating high fibre foods may lower blood sugar and blood cholesterol levels.
- Limiting high fat foods will help to manage your weight, blood sugar, and blood cholesterol.
- Limiting sweet foods like sugar, regular pop, desserts, candy, jam and honey will help keep blood sugar levels in your target range.
- Drinking water to quench your thirst instead of regular pop or fruit juice will help you control your blood sugars.
Physical activity
Everyone can be physically active. Physical activity helps to:
- promote weight loss and maintenance
- lower blood sugars and decreases insulin resistance
- lower blood fat levels (cholesterol and triglycerides)
- control blood pressure
- maintain healthy muscles, bones and joints
- relieve anxiety and depression
- Adults with prediabetes (IGT) are advised to do 2 types of activity to keep their body healthy: endurance activities and strength activities.
Endurance activities are activities that increase your heart rate and may make you breathe a little heavier such as brisk walking, swimming, dancing, raking leaves, and biking. These need to be done at least 10 minutes at a time, for a total of 30 to 60 minutes on most days of the week.
Strength activities use your muscles to move a weight or lift or push something heavy such as weight lifting or using weight machines. These should be done at least 3 times per week, with a one day break in between each session.
Who has the time?
All you need to start is 10 minutes a day. Try the tips below to slowly increase your activity level.
- Go for a 10 minute walk after meals.
- Take the stairs instead of the elevator.
- Make time for a new activity by watching less TV. Try walking, biking, skating or swimming.
- Take an exercise class like yoga, dancing or aquasize.
- Use a pedometer to count your steps. Try to add about 2000 steps each week.
Note: Before you start a new physical activity program discuss with your doctor the types of activity you would like to begin to make sure they are safe for you.
Sample meal plan
This is a sample meal plan to show you how to apply Canada's Food Guide. It is about 1800 calories. The amount you eat may be smaller or larger depending on your activity level and whether you want to change your weight.
Breakfast
2 slices whole wheat toast
1 tsp (5 mL) non-hydrogenated margarine
1 tsp (5 mL) light jam
1 cup (250 mL) skim or 1% milk
1 large orange
1 boiled egg
Coffee or tea
Morning Snack
1 small banana
Lunch
2 slices whole wheat bread
2 tsp (10 mL) non-hydrogenated margarine
2 oz (60g) chicken
Lettuce/tomato slices
Mustard
1 cup or 20 grapes
1 cup (250 mL) skim or 1% milk
Water or tea or coffee
Afternoon Snack
1 apple OR 3 graham wafers
Diet Pop
Supper
1 cup (250 mL) potato
1 cup (250 mL) carrots
2 1/2 oz (75 g) lean roast beef
2 Tbsp (30 mL) gravy
Green salad
2 Tbsp (30 mL) light salad dressing
1/2 cup (250 mL) unsweetened canned fruit
Water or tea or coffee
Evening Snack
1 cup (250 mL) high fibre cereal (4 g of fibre or more per serving)
1 cup (250 mL) skim or 1% milk
Healthy Snack Ideas
The following examples are shown as 1 serving.Vegetables and Fruit
- 1 piece of fresh fruit
- 1 cup (250 mL) baby carrots
- ½ cup (125 mL) unsweetened canned fruit
- ½ cup (125 mL) unsweetened applesauce
- 6 dried apricots or 3 prunes
Grain Products
- 2 to 3 low fat crackers like melba toast, Ryvita®
or Stoned Wheat Thins® - 1 slice of whole grain bread
- 3 low fat cookies, like arrowroots or graham wafers
- ½ cup (125 mL) of a high fiber cereal
- 1 small low fat muffin
- 1 low fat granola bar
Milk products
For more information on preventing diabetes, talk to a registered dietitian, community health nutritionist, nurse or doctor. The Canadian Diabetes Association (CDA) can provide information on living with and preventing diabetes. Visit the CDA website at www.diabetes.ca.
To register yourself in the Prediabetes (Impaired Glucose Tolerance) education classes in the Capital Health Region, call (780) 401- 2651.
For health advice and information 24 hours a day, seven days a week, call Capital Health Link at 408-LINK (5465) or, outside the local calling area, call toll-free 1-866-408-LINK. For health information online, visit www.capitalhealth.ca
Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)
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