What To Do When Your Lab Values Indicate You Are Pre-Diabetic

By Kristi Kalinsky, RD, LD
September 26, 2023

If you’ve had a recent physical, you may notice a standard lab draw that is done at each visit: your fasting blood glucose. The results may also list a hemoglobin A1C number, which is the average amount of glucose, or sugar, in your bloodstream over the last three months. Both numbers are indicative of the potential for developing or having type 2 diabetes. When your fasting blood glucose lab is between 100-125 mg/dL or if your hemoglobin A1C is between 5.7% and 6.4%, this qualifies as a prediabetes diagnosis. Numbers higher than this range, with a fasting blood sugar of 126 mg/dL and above or an A1C of 6.5% and above qualifies for a diagnosis of type 2 diabetes.

Unfortunately, this is a very common problem. Research from the Journal of American Medicine revealed that 50% of the population has prediabetes or type 2 diabetes.

The important question to ask yourself is, “what should I do if my numbers are falling into this prediabetes or diabetes range?” Many doctors will recommend waiting and watching these numbers on a yearly basis to see what happens. However, statistics show 50% of people diagnosed with prediabetes will progress to type 2 diabetes within five years. At Nutritional Weight and Wellness, we like to take a more proactive approach to dealing with this problem. If treated early enough, a prediabetes or diabetes diagnosis can be reversed with good nutrition and potential supplementation.

 

What Causes High Blood Sugar

When educating clients, I like to explain what is going on in their bodies that is making blood sugar levels higher than what they should be. Healthy blood sugar means fasting blood glucose levels are less than 100 mg/dL and your A1C is5.6% or less. In a body with these healthy lab values, the carbohydrates that get eaten are broken down, placed in the blood stream, and are taken into each cell with the help of insulin to make energy for our bodies.

Over time, as we eat and expose our cells to bad or unhealthy fats (think processed, damaged oils such as vegetable oil, canola oil, sunflower oil, peanut oil, etc.) and eat an excessive amount of carbohydrate rich foods (pizza, muffins, cookies, popcorn, bread, crackers, sugary coffee drinks, soda and even healthy foods such as potatoes, rice or fruit that exceed more than a ½ cup) at meals and/or snacks, our cell receptor sites will become damaged over time so the insulin can’t work as efficiently.

I like to explain it in a visual way in that the lock, or receptor sites, on our cells are like the lock on a door. In pre-diabetes and type 2 diabetes the locks of the cells have gotten damaged over time, which makes it difficult to get the insulin “key” into the “lock” receptor sites to open up the cell to receive the energy. It will eventually open, but it takes a lot of time, making our blood sugar levels higher than normal as the sugar or glucose sits and waits in the bloodstream to enter the cells. Eventually over time, our pancreas burns out from kicking out this extra insulin to try and help clear the blood sugar from our bloodstream and type 2 diabetes sets in.

At Nutritional Weight and Wellness, we like to take a more proactive approach to dealing with pre-diabetic lab values. If treated early enough, a prediabetes or diabetes diagnosis can be reversed with good nutrition and potential supplementation.

Why Healthy Blood Sugar Matters

And why should we care if we have extra glucose hanging out in the blood stream? Over time, too much sugar in the blood stream can injure our delicate blood vessels, particularly the capillaries, which can then cause complications for our larger organs like the heart, kidneys, eyes, and nerves. It’s important for the health of all the cells to keep tabs on blood glucose levels.

The challenging thing for prediabetes is it often doesn’t come with any obvious symptoms, which is why getting your lab work done yearly is key to early prevention. Some symptoms for type 2 diabetes would be excessive thirst, frequent urination, more hunger than usual, blurred vision, wounds or sores that won’t heal, numbness or tingling in the hands and feet, unexplained weight loss and feeling tired, to name a few.

Food Solutions for Blood Sugar

In order to correct this problem, it is important to do a couple of different things. The first being that you want to minimize your exposure to the bad fats/bad oils to prevent the cell receptor site damage. Choose healthy fats, such as avocado oil, coconut oil, olive oil, real butter (not margarine), avocados, etc. that support the metabolism, contribute to joint lubrication, and don’t cause damage to the cell receptors.  

The second thing you can do is choose healthy starchy carbohydrates and avoid processed carbohydrates (think foods that come in a bag or a box from a factory). The healthy starchy carbohydrates, such as potatoes, beets, brown rice, fruit, beans, etc. must be limited to no more than a ½ cup at each meal and snack. We have found that amount to be what the body needs for energy. Excessive amounts of healthy starchy carbs can create too much glucose or sugar in the bloodstream. This excess sugar puts a burden on the cells ability to respond to insulin and assists in the development of prediabetes and diabetes.

Over time, if these bad fats are minimized and starchy carbohydrates are limited to about a ½ cup at each meal and snack, the body becomes less resistant to the insulin the pancreas is making. The insulin “key” can then get into the “lock” more easily to allow the natural flow of sugar into the cells, and in turn, normal fasting blood sugar and A1C numbers will begin to be seen.

Additional Blood Sugar Support: Supplements & Exercise

Along with dietary changes, possible supplementation may be needed as well, but that will vary on a case-by-case basis. This is something you can work with your dietitian on to determine if that is something you need to do. Working with a dietitian or nutritionist, like me or my colleagues, is beneficial because we can help you figure out the timing with supplements and diet changes to make sure you’re really feeling your best and making the biggest impact on your blood sugars. Let’s make sure you are using all the tools available to help you on this journey!

Exercise provides the benefit of making the body more sensitive to insulin, meaning that the body doesn’t need as much insulin to remove the glucose or sugar out of the blood stream. The less insulin that needs to be secreted, the less the pancreas has to work, so it doesn’t become burnt out leading to type 2 diabetes. While any type of exercise is helpful, the most benefit comes from doing a mix of cardiovascular exercise and strength training with weights during a workout. Some examples would be going for a brisk 30-minute walk followed by counter push ups and bicep curls with soup cans or going for a 15-minute bike ride followed by toe raises, toe taps and mini squats. It could even be as simple as gardening or other yard work while wearing a weighted vest. Insulin sensitivity can be improved for up to 24 hours after doing these activities.

Tips If You Have Pre-Diabetic Lab Results:

1. Add in real food, healthy fats
2. Avoid damaged fats and oils
3. Eat lots of non-starchy veggies and about half cup of starchy veggies and fruits
4. Incorporate exercise and movement into your day
5. Work with a nutritionist or dietitian on supplements to support blood sugar

You Have Options!

It is reassuring to know that prediabetes and even type 2 diabetes can be a reversible process and not something you have to live with for the rest of your life. We work with individuals in clinic all the time to support them through changes that positively impact their lab work.

To recap, start by replacing damaged fats and oils with real food fats, like avocado oil, coconut oil, olive oil, butter, ghee, avocadoes. When planning your meals and snacks, focus on lots of non-starchy carbohydrates, like broccoli, cauliflower, leafy greens, while including no more than a ½ cup servings of starchy carbohydrates like berries, potatoes, beets, and grains. Find ways to move your body and incorporate supplements with the help of your registered and licensed dietitian or nutritionist.

For more information on blood sugar, check out these resources:

• Listen: The Carb Connection To Prediabetes & Type 2 Diabetes
• Listen: Insulin Resistant Or Not – Ask A Nutritionist
• Read: Is Insulin Resistance To Blame For Your Slow Metabolism?
• Read: Moving Your Body For Better Health

 

Resources:
Diabetes – Symptoms and causes – Mayo Clinic

Type 2 diabetes - Symptoms and causes - Mayo Clinic