Weight Loss Diabetes Prevention Enterprise

Sleep Disorders Symptoms & Treatments Guide

Do you ever lie awake at night, feeling as though you may be the only one in the world who is having trouble sleeping? Do you drag yourself out of bed and through your day, thinking that sleep deprivation is just part of life?

Well, you most certainly are not alone if you are having trouble sleeping. Statistics show that the country is tired! The Centers for Disease Control and Prevention, or CDC, estimates that over 35% of U.S. adults fall short of the recommended average of at least 7 hours of sleep per night. The American Sleep Association, or ASA, reports that 37.9%, or nearly 2 in 5, adults admit to accidentally falling asleep during the day within the past month.

The ASA also estimates that 50 to 70 million U.S. adults have a sleep disorder, also known as a sleep-wake disorder. Nearly half of Americans snore – a problem that could range from annoying to partners to indicative of sleep apnea or higher risk for atherosclerosis – and 25 million U.S. adults have sleep apnea.

The good news is that sleep deprivation is not inevitable. Sleeping problems may be common, but that does not mean you have to succumb to all of their effects.

This guide presents the main types of sleeping disorders and what to do when you can’t sleep. You can also learn what you can do if you are having trouble sleeping. Options range from seeing a medical professional to taking a look at your own sleep habits. Plus, there is a good chance that a convenient app, such as Lark, can give you insights on your sleep patterns, and healthy sleep habits.

What Are Sleep Disorders?

Sleep disorders are conditions that interfere with your ability to get a sufficient amount of high-quality sleep. They include trouble falling asleep, trouble staying asleep, and inability to stay awake when you want to during the day.

Sleep disorders can stem from poor habits around bedtime, or they can be the result of other factors. Examples include:

· Mood or anxiety disorders.

· Alcohol abuse.

· Respiratory conditions, such as asthma.

· Discomfort, such as pain or indigestion.

· Medication use.

· Stress.

 

Effects of Sleeping Problems

Inability to sleep can lead to consequences that can be anything from unpleasant to downright dangerous and unhealthy. If you can’t sleep as much as you need to most nights, it is a good idea to get help to figure out how to get the shuteye you need.

Impaired Energy and Alertness

You are almost sure to know firsthand how sleep deprivation feels. You may have reduced energy, which makes getting through the day harder and often less enjoyable. Your ability to focus diminishes, and you may find yourself nodding off. Concentrating and remembering were the top two daily activities that people reported having trouble with due to lack of sleep, according to the CDC.

Be honest, now: last time you were short on sleep, how well did you focus during your afternoon meeting? Did you remember much of it afterwards? And, did you have to fight the urge to nod off during it?

Unintentional Weight Gain

Intuitively, it might make sense that sleeping less would help with weight loss, since you would be spending less time lying in bed and more time up and about, presumably burning more calories. That is not the case. Here are some ways that sleep deprivation can increase risk for weight gain, as described by the Harvard School of Public Health and a review article in the journal, “Obesity (Silver Spring).”

·         More hunger: You may have higher levels of ghrelin, which is a hormone that increases hunger, and lower levels of leptin, which is a hormone that lets you know that you are satisfied.

·         More time to eat: You might burn a few more calories during those late-night hours while awake compared to if you were sleeping, but having even a few extra peanuts is likely to outweigh the extra calorie burn. Regularly having a more typical late-night snack can pile on the pounds.

·         Poorer choices: Sleep-deprived people crave more high-fat, high-carbohydrate, high-sugar foods, and have less ability to resist them. That means you are more likely to choose the pizza over the salad, and you are not going to stop at one potato chip.

·         Lower metabolism: your body temperature may drop so you burn fewer calories throughout the day.

·         Less energy: if you are too tired to exercise or even move around much during the day, you will burn fewer calories.

The ASA estimates that being short on sleep could account for as much as 5% of obesity!

Chronic Health Conditions

Sleep affects your physical and mental health in many ways. Being short on sleep is linked to increased risk for the following conditions.

·         Type 2 diabetes.

·         Heart disease.

·         Stroke.

·         Depression and other mood disorders.

·         Hypertension.

Vehicular and Other Accidents

Not surprisingly, given the importance of sleep for concentration and coordination, lack of sleep has been linked to accidents on the roads and in the workplace.

·         Nearly 1 in 25 drivers has admitted to falling asleep at the wheel within the past month.

·         Sleep deprivation is responsible for 1,550 fatalities annually in the U.S.

·         Sleep deprivation costs about $54 million per year in lost productivity, plus 5 extra missed days of work per worker with insomnia.

Types of Sleep Behavior Disorders

There are many types of sleep behavior disorders. They can lead to difficulty falling or staying asleep, and they can be chronic or acute. They all can make you feel tired, but they can all be prevented, treated or managed. Examples include rapid-eye-movement (REM) sleep disorder, circadian rhythm disorders, insomnia, and sleep apnea.

Rapid Eye Movement Sleep Behavior Disorder

You go through different stages when you sleep. Non-rapid eye movement (non-REM) sleep comprises up to 80% of normal sleep, while the rest is REM sleep. During REM sleep, your brain remains as active as it is while you are awake, but your muscles are paralyzed, your blood pressure rises, and your eyelids move rapidly.

Rapid eye movement sleep behavior disorder, also known as RBD, happens when your muscles do not get paralyzed. So, it makes sense that REM sleep behavior disorder symptoms include physically acting out your dreams, since the

The condition is often linked to neurodegenerative conditions, such as Parkinson’s disease, although it tends to appear years before diagnosis of a neurodegenerative condition. Acute RBD can result from withdrawal from alcohol, certain antidepressants, or other medications.

Treatment for REM sleep behavior disorder can include putting up safeguards to keep yourself and your partner safe as you act out your dreams, sometimes vigorously, and taking medications.

·         Put up barriers on the side of the bed or padding on the floor nearby.

·         Consider sleeping separately from your partner until your symptoms go away.

·         Melatonin is a generally safe dietary supplement that is also natural sleep hormone in your body. It can reduce symptoms.

·         Clonazepam is a prescription medication that is a common REM sleep behavior disorder treatment. It is also an anti-anxiety medication.

Circadian Rhythm Sleep Disorders

Your circadian rhythm is your body’s internal clock. It regulates sleep and wake cycles, as well as other biological patterns such as the regular increase and decrease of various hormone levels. For most people, the circadian rhythm is linked to the natural light and dark cycle of the 24-hour day and night, although the human cycle is typically slightly longer than 24 hours.

Disruptions to your regular cycle can lead circadian rhythm sleep disorders. Causes can include:

·         Taking certain medications.

·         Working night shifts or changing your work schedule frequently.

·         Changing time zones.

·         Changing your sleep schedule by staying up late or sleeping in for a long time.

·         Experiencing mental health issues or medical problems.

Circadian rhythm sleep disorder symptoms reflect the difficulty your body has staying in sync with the clock. You might feel alert at night and sleepy during the day. You might have trouble falling asleep when you go to bed, and feel groggy when it is time to get up.

There are several types of circadian rhythm sleep disorders, as outlined in the journal, “Neurologic clinics.”

·         Jet lag occurs when you change time zones, and your body has difficulty adjusting to the new time zone. You might have difficulty falling asleep if you have traveled west and set the clock back at least 2 hours. You could have trouble getting up on time if you have traveled east and set the clock ahead at least 2 hours.

·         Delayed phase sleep disorder (DPSD) is a condition in which you are not tired until late at night, and you have trouble getting up the morning. People with DPSD might be seen as night owls.

·         Advanced phase sleep disorder (APSD) is a condition in which you get tired early in the evening, and wake up early in the morning, such as between 1 and 5:00 a.m.

·         Irregular Sleep-Wake Rhythm (ISWR) happens when you have an irregular rhythm, and cannot predict sleepiness and wakefulness well.

·         Non-24 Hour Sleep Wake Disorder happens when the circadian rhythm tends to be too long. This is common among individuals who are blind and do not have the trigger of natural daylight for production of melatonin. 

Circadian rhythm sleep disorder treatment includes improving sleep hygiene, such as following a regular schedule. Other treatment approaches include:

·         Using melatonin to normalize the circadian rhythm.

·         Using a bright light before bed for APSD, or in the morning for DPSD.

·         Getting more natural light and socializing during the day for ISWR.

Other Sleep Disorders

There are many other sleep disorders that lead to difficulty sleeping and the consequences of sleep deprivation, including grogginess during the day and health risks.

Insomnia

Insomnia is the most common sleep disorder, according to the ASA. It refers to trouble falling or staying asleep, or the tendency to wake up too early in the morning – in other words it is an inability to sleep properly. About 1 in 10 adults have chronic, or secondary, insomnia, while 3 in 10 have acute insomnia. You may be able to overcome acute insomnia with behavior changes, such as better sleep hygiene. Chronic insomnia might require medical evaluation, and often intervention to treat the underlying cause.

Sleep Apnea

The partner of someone with sleep apnea may know it as an annoying, loud nighttime nuisance, but the truth is that sleep apnea can be dangerous. With sleep apnea, the flap of tissue at the back of your throat can close and stop breathing for seconds or longer. Your brain is notified to wake up so you can resume breathing. This can happen many times per night and prevent you from getting the rest you need. You are likely to be exhausted all the time.

Up to 1 in 5 women have sleep apnea, and 1 in 3 or 4 men have it. Since obesity is a major cause, losing weight can help. Also, a continuous positive airway pressure, or CPAP, machine to hold open your airways is a common treatment.

Narcolepsy

Narcolepsy may seem comical if you hear about it from someone else, but it is anything but funny if you experience it. It is a sleep-wake disorder in which you have trouble staying awake for normal periods of time. Instead, you might nod off in the middle of the day, even while engaged in activities such as talking to people. Other symptoms include cataplexy, or loss of muscle control, leading to trouble moving or speaking, and hallucinations, since you might have dreams as you are just falling asleep or waking up.

There is no cure for narcolepsy. Your doctor might prescribe medications, such as stimulants to keep you awake. At home, you can improve your sleep hygiene, such as having a regular bedtime and pre-bed routine, and being sure to get enough exercise during the day.

Periodic Limb Movement Disorder and Restless Legs Syndrome

Periodic limb movement disorder, or PLMD, and restless legs syndrome, or RLS, are two distinct sleep disorders, but most people with RLS also have PLMD. In PLMD, your legs may cramp and move periodically, which disrupts sleep and can make you tired during the day. In RLS, you may have an urge to move your legs just before you fall asleep, which can make it nearly impossible to get enough rest.

They can have unknown causes, or can be caused by medications or conditions including diabetes and anemia. Medications to relax muscles can sometimes help. Other relaxation techniques that could help with RLS include leg massages and application of ice packs to your legs.

Sleep Disorder Quiz

I can’t sleep. Do I have a sleep disorder? If you are wondering whether you may have a sleep wake disorder, you can take a sleep disorder quiz. Several are available online, including the following one presented by WebMD.

1.      Do you snore loudly and/or heavily while asleep? Yes or No

2.      Are you excessively sleepy or do you lack energy in the daytime? Yes or No

3.      Do you have trouble with concentration or memory loss? Yes or No

4.      Do you fall asleep while driving, in meetings, while reading a book, or while watching television? Yes or No

5.      Do you often have occasional morning headaches? Yes or No

6.      Do you sleepwalk, have nightmares, or have night terrors? Yes or No

7.      Do you suffer from depression or mood changes? Yes or No

8.      Do you have trouble going to sleep or staying asleep? Yes or No

9.      Have you experienced recent weight gain or high blood pressure? Yes or No

10.  Have you been told you hold your breath when you sleep? Yes or No

It takes only minutes to take the quiz, and scoring is simple. If you answered, “Yes,” to one or more of the questions, you may have a sleep disorder, and should consult your doctor. (Note that you should consult your doctor anyway if you think you have a sleep behavior disorder, even if you did not answer, “Yes,” to any of the above questions.)

Medical Help for Sleep Disorders – Sleep Disorder Institutes and Doctors

It is a good idea to seek medical help if you think you may have a sleep disorder or the results of a sleep disorder quiz suggest that you may have one. A sleep disorder institute or clinic is specifically equipped to help diagnosis and treat sleep disorders. There, you can see a doctor who is a specialist in helping patients achieve healthy sleep.

A sleep disorder doctor can assess your sleep disorder to better be able to treat it. The doctor will review your health and sleep history, and any symptoms at night or during the day that may be related to trouble sleeping. The doctor can ask your partner for information about any symptoms that may occur while you are sleeping and that you may be unaware of, such as flailing your arms or snoring.

Your doctor might ask you to record your sleep patterns in a sleep journal. You could also get blood tests to see whether your sleep wake disorder could be related to underlying conditions, such as iron-deficiency anemia.

A sleep study, or polysomnogram, may be warranted if the sleep doctor cannot diagnose your condition from an exam and interviews with you and your sleep partner. A sleep study can also help your sleep disorder specialist make a definitive diagnosis, and possibly rule out other causes of your symptoms. A typical sleep study takes one night.

·         You arrive at the center with an overnight bag, as though you were going to stay at a hotel.

·         Follow your doctor’s instructions about whether to take your medications as usual.

·         You can relax and follow your usual evening/pre-bed routine.

·         Technicians will place electrodes on your head to pick up brain activity.

·         Your sleep is monitored overnight and you get the results later.

Sleep Disorder Treatments

Sleep-wake disorders can be overwhelming, make life more difficult, and interfere with your health, but sleep disorder treatments can often effectively relieve symptoms or manage or even cure the condition. You may need medications, but an inability to sleep does not always require medication. Often, sleeping problems can go away or become much less severe when you make simple changes.

Medicine for Sleep Disorders

There are many medications for sleep disorders. A doctor may prescribe them based on your particular symptoms and diagnosis. These are some common sleeping pills.

·         Melatonin (also available over the counter) to induce sleep and help you stay asleep.

·         Benzodiazepine and non-benzodiazepine hypnotics for parasomnia and insomnia.

·         Orexin receptor antagonists to counter the wakening effect of the chemical orexin.

·         Anti-narcoleptics to increase daytime wakefulness.

Over-the-counter medications are also commonly used. They also can have side effects, interactions with other medications that you take, or a risk of dependency, so it is best to ask your doctor before taking them.

Better Sleep Hygiene

Sleep hygiene refers to sleep habits. Good sleep hygiene can help you fall asleep faster and stay asleep, as well as get better quality sleep. The CDC offers several tips to achieve or maintain good sleep hygiene.

·         Stick to a consistent bedtime and waking time, including on weekends.

·         Try to get enough sleep during the week so you can avoid sleeping in on weekends.

·         Keep your room cool.

·         Sleep in a dark, quiet room.

·         Use your bed only for sleeping and sex, and not for other activities such as watching TV or reading.

·         Avoid electronic devices within 30 minutes of bedtime. This includes phones, televisions, and computers.

A health coaching app, such as Lark, can help you with sleep hygiene by tracking your sleep patterns and reminding you of healthy sleep behaviors.

Healthier Lifestyle Choices

Your lifestyle choices can greatly affect your sleep quality and quantity, too. In general, choices that are good for overall health are also good for sleep.

·         Diets higher in healthy foods, such as fish, vegetables, and high-fiber foods, have been linked to better sleep quality.

·         Diets higher in saturated fat, low-fiber carbohydrates, and sugary foods and beverages have been linked to poorer sleep quality.

·         Regular exercise, but not too close to bedtime, can improve sleep.

·         Avoid caffeine within 6 hours of bedtime. Sources include coffee, green and black tea, chocolate, some soft drinks, and some energy and sports drinks.

·         Avoid a large meal or alcohol right before bedtime.

·         Losing weight if you are obese is a good way to lower risk for obstructive sleep apnea, or manage it if you have it.

The Best Sleep App

The best sleep app supports you in achieving the healthiest sleep you can. It encourages you to adapt healthy sleep behaviors as well as to follow any doctor’s orders that you have for improving sleep. Lark is an app that supports a comprehensive healthy lifestyle that includes smart sleep habits.

The app should monitor and track sleep, providing you with the chance to see your sleep history over recent weeks, as well as pointing out certain patterns. This increases your awareness of your sleep habits. You might, for example, notice how short you are on sleep during the week and therefore you might start to try to get to bed earlier each night. You might discover patterns for times when you feel tired during the day or have trouble falling asleep at night.

The best sleep app does not just track sleep. It also coaches you on improving your sleep. Lark Health Coach, for example, offers advice for getting better sleep on a consistent basis. Your coach reminds you that you are worth it – so getting enough sleep is worth it. And for those times when you just need a sympathetic ear, Lark has empathy for you to help you feel better and get through the day.

Be good to yourself, and get enough sleep. Work through any sleep disorders as much as you can, and get the help you need, whether from a doctor or from a health app. The payoff can be well worth it.

References

https://www.sleepassociation.org/sleep-disorders/snoring/is-snoring-dangerous/

https://www.sleepassociation.org/about-sleep/sleep-statistics/

https://www.cdc.gov/sleep/about_sleep/key_disorders.html

https://www.cdc.gov/sleep/index.html

https://sleepfoundation.org/sleep-disorders-problems/rem-behavior-disorder

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6008a3.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723045/

https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/sleep-and-obesity/

https://www.sleepassociation.org/about-sleep/sleep-statistics/

https://www.cdc.gov/sleep/data_statistics.html

https://www.cdc.gov/sleep/about_sleep/drowsy_driving.html

https://www.sleepassociation.org/about-sleep/sleep-statistics/

https://journals.lww.com/joem/Abstract/2010/01000/The_Cost_of_Poor_Sleep__Workplace_Productivity.13.aspx

https://hbr.org/2011/01/sleep-deprivations-true-workpl.html

https://www.webmd.com/sleep-disorders/guide/rem-sleep-behavior-disorder

https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/diagnosis-treatment/drc-20352925

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523094/

https://www.webmd.com/sleep-disorders/guide/circadian-rhythm-disorders-cause#1

https://www.sleepassociation.org/sleep-disorders/insomnia/

https://www.cdc.gov/sleep/about_sleep/key_disorders.html

https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

https://www.webmd.com/sleep-disorders/periodic-limb-movement-disorder#1

https://www.webmd.com/brain/restless-legs-syndrome/restless-legs-syndrome-rls#1

https://www.uclahealth.org/sleepcenter/preparing-for-a-sleep-study

https://www.webmd.com/sleep-disorders/drug-treatments

https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015038/

Diabetes Prevention Program Guide

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Lark’s Diabetes Prevention Program Guide

A diagnosis of prediabetes can fill you with worry, since it means that you are at higher risk for developing type 2 diabetes. You may have memories of a grandparent or parent who struggled with it, or you may even have a sibling or friend who is currently managing diabetes.

On a day-to-day basis, diabetes often means taking medications, often including injectable insulin, and often taking more than one medication. It means testing blood sugar multiple times a day. It means going to the doctor to take blood sugar tests, and tests for cholesterol and blood pressure. It means planning your day to avoid scary bouts of hypoglycemia, or low blood sugar.

When thinking about health and medical care, diabetes means a higher risk for complications such as blindness, kidney disease, neuropathy, and heart disease. It is listed as the seventh-leading cause of death in the U.S., but it plays a role in many cases of heart disease (top cause of death), stroke (fifth), and kidney disease (ninth).

Type 2 diabetes certainly sounds like a condition you want to prevent, and the great news is that, in many cases, it is preventable. If you have prediabetes, you can lower your risk of developing diabetes by over 50%, without medications, just by following a lifestyle program that includes diet and exercise changes.  

Lark’s Diabetes Prevention Program (DPP) is a Centers for Disease Control and Prevention (CDC)-approved program to prevent or delay type 2 diabetes. It involves education and support for healthy lifestyle changes through your Lark Health Coach using your smartphone. With it, you could lower your risk for type 2 diabetes and feel healthier than ever!

History of Diabetes and Its Discovery

The recognition of diabetes has been documented for nearly 4,000 years, since the ancient Egyptians noticed a classic symptom of excessive urination, which a symptom of diabetes resulting from excessive thirst, which in turn results from a high amount of sugar in the bloodstream. The ancient Indians, ancient Greeks, and ancient Persians also recognized diabetes and its link to sugar. In fact, the term “diabetes mellitus” reflects the “sweet” nature of urine due to sugar excretion.

More recently, in 1869, Paul Langerhans identified specific cells, later termed the islets of Langerhans, in the pancreas. In 1889, scientists discovered that removing the pancreas led to diabetes in dogs. Soon after came the discovery of a substance, termed “insulin,” which was excreted from the islets of Langerhans, and required to prevent diabetes mellitus.

By the 1960s, blood sugar monitoring, including monitoring using home test strips, was common. The glycated hemoglobin, or A1c, measurement, eventually became the gold standard of monitoring. It indicated blood sugar control over the past three months, and is a good predictor of the development of complications.

Early treatment for diabetes included remedies such as rose oil, nettle flowers, and “jelly of viper’s flesh,” and some approaches still have merit today. For example, calorie restriction and exercise were prescribed before the twentieth century, and lifestyle changes are increasingly recognized as effective in improving blood sugar control and preventing diabetes.

In the twentieth century, the use of insulin as a medication immediately meant millions of lives could be saved, and improvements in delivery methods continue to improve health and satisfaction with treatment. Sulfonylureas, to increase insulin production, and metformin (Glucophage), to increase insulin sensitivity, also became standard treatments for diabetes.

Diabetes Statistics in the U.S.

Something you may realize once you start thinking about prediabetes and diabetes is how widespread they are. If it is not yourself, you are almost sure to know one or more people who are affected by diabetes or prediabetes.

Who Has Diabetes in the U.S.?

According to the National Center for Health Statistics (NCHS) within the CDC, 30 million Americans have diabetes. This is up over 50% from 1988, and includes 12.6%, or 1 out of 8, of Americans 20 years of age or older. Of those, nearly 1 out of 4 do not know it. Your chances of having diabetes are higher if you have certain characteristics.

·      16.6%, or 1 in 6, chance of diabetes if your age is 45 to 64 years.

·      26.3%, or more than 1 in 4, chance of diabetes if your age is over 65 years.

·      14.3%, or 1 in 7, if you are of Mexican origin.

·      15.1%, or over 1 in 7, if you are Asian.

·      17.5%, or more than 1 in 6, if you are black/African-American.

The risk of complications for adults with type 2 diabetes is higher for patients with poor glycemic control, defined as A1c over 9%. Overall, 15.6% of diabetes patients in the U.S. have poor control, and the following subgroups are more likely than average to have poor glycemic control:

·      Adults aged 25-44 (26.2%)

·      Hispanic or Latino (25.5%)

·      African American or Black (19.0%)

What Are the Effects of Diabetes?

Patients with diabetes have a 15% higher risk of early death than healthy adults – it is often from direct diabetes causes or from cardiovascular diseases. The risk of complications for adults with type 2 diabetes increases with poorer glycemic control. Overall:

·      18.9% have eye damage, or retinopathy.

·      22.9% have foot problems, such as numbness or amputations.

·      6.6% have a stroke.

·      9.8% have a heart attack.

·      27.8% develop chronic kidney disease.

Economically, diabetes also has a severe impact, hitting $825 billion worldwide in 2014. The disease cost the country $327 billion in 2017, up from $245 billion in 2012 and $174 billion in 2007. Direct medical costs account for $237 billion of that, while reduced productivity accounts for $90 billion. About 1 in 7 healthcare dollars pay for diabetes-related costs.

What about Prediabetes?

Prediabetes has nowhere near the visible impact of diabetes in terms of complications and direct medical costs, but it affects far more people. The CDC estimates that 84 million American adults, or 1 in 3, have prediabetes, and fewer than 1 in 10 know about it. Nearly 1 in 2, or 48.3%, of adults over 65 years have prediabetes, and only 1 in 7 know it.

Link between Prediabetes and Diabetes

Most people who are diagnosed with prediabetes develop diabetes, but that fact does not have to get you down. It could be stressful if you interpret it as a warning that diabetes is coming soon, but you can decide how to handle your diagnosis of prediabetes.

The CDC suggests looking at your “prediabetes as a fork in the road.” You can either take the fast path to diabetes by ignoring it, or you can work to delay and possibly prevent diabetes by taking charge. Since fewer than 1 out of 10 people with prediabetes know that they have it, you can consider yourself one of the lucky few who even know that they are at the fork in the road.

Consequences of Not Treating Prediabetes

Prediabetes rarely has symptoms, so it can seem easy to ignore it. People might choose not to treat their prediabetes because:

·      They do not want to act “sick.”

·      They do not believe they have a health problem.

·      They believe they cannot prevent diabetes.

·      They do not know how to treat it without medications.

The actual numbers can vary, but an article in “Lancet” estimates about 10 to 15% of people with prediabetes develop diabetes each year. That value was 11% in the follow-up to the original DPP study. Eventually, about 70% of patients with prediabetes eventually develop diabetes – but reversal is possible for many people with proper treatment. The bottom line is that not treating prediabetes is almost sure to lead to diabetes, and the timeline is about 10 years. However, treating prediabetes can prevent or delay type 2 diabetes.

Why Diabetes Should Be Prevented Now

Preventing diabetes now is urgent. The urgency on a population level comes from the high and growing number of people with prediabetes and diabetes. The epidemic is growing, and leading to more complications and lower quality of life.

On a personal level, delaying or preventing diabetes is urgent for two reasons.

1.     Because it is possible. Lifestyle changes among people with prediabetes can delay the onset of type 2 diabetes, and lower risk for diabetes by over 50%.

2.     Because your body has known about your insulin resistance for years already. Your doctor does not find out about your prediabetes until you get high blood sugar reading or your A1c is over 5.7%. By that time, your body has been developing insulin resistance for a decade or more.

Easy Step to Prevent Diabetes via Your Smartphone

The urgency is clear, and help is one click away as soon as you are ready to act to prevent diabetes. Lark Diabetes Prevention Program can be with you every step of the way to establish healthy habits, lose weight, and fight prediabetes. Your Lark coach never judges you; instead, you get support, encouragement, and smart strategies in a text messaging-based program.  

How Does Lark Help Prevent Diabetes?

Lark helps prevent diabetes by empowering you to take charge of your health. Lark DPP provides coaching on healthy behaviors that are known to reduce diabetes risk. These include:

·      Losing weight if you have extra pounds.

·      Increasing your physical activity levels.

·      Choosing healthier foods.

·      Managing stress.

·      Getting enough sleep.

Lark DPP helps prevent diabetes using the CDC curriculum. The weekly lessons are delivered to you via the app in friendly and relatable messages, so you can learn about healthy eating, physical activity, and stress management using strategies that fit into your life.

Your Lark experience may include a standardized curriculum shown to lower diabetes risk, but your program is customized for you. The app learns your habits, helps you set your own goals, and provides coaching whenever you need it – including at 11:00 p.m. when you need a quick alternative for a late-night ice cream run. Diabetes prevention starts now, and Lark is ready to journey with you.

Warning Signs of Diabetes Onset

Prediabetes has few signs, but some people may notice early signs of diabetes onset. These are related to high levels of sugar in the blood and trouble processing it.

·      Being hungrier than usual even though you are eating normally. This happens because the sugar that your body makes from food stays in your blood instead of getting to the cells where it is needed. You may feel tired, too.

·      Increased urination. Your kidneys have trouble reabsorbing the water that they filter because of the high amount of sugar in your blood. The result is that you excrete more water in the form of urine.

·      Increased thirst. This results from the water you lose from increased urination. You might have dry mouth and itchy skin.

·      Poorer vision. The changes in water retention in your body can alter pressure in your lenses.

·      Signs of nerve damage. Nerve damage can lead to tingling or pain in your feet, and to reduced blood flow and slow-healing wounds.

It is important to be aware that not everyone who develops type 2 diabetes will notice warning signs of its onset. That makes it even more important to keep checking your blood glucose and/or A1c levels as your doctor recommends, even if you have no symptoms.

How to Prevent Diabetes Naturally

While nobody actually wants prediabetes, the good news is that having it often means that you can prevent or delay diabetes naturally. Eating better, exercising, losing weight, managing stress, and sleeping well can all have a significant impact on delaying or preventing diabetes.

There is even more good news when it comes to preventing diabetes naturally. First, small changes add up, so there is no need to get discouraged or overwhelmed. Just focus on small, doable, changes. Second, help is available. Lark DPP can work with you on all of those areas.

Diet

If you eat better, your insulin sensitivity and blood sugar control may increase, which means your risk for diabetes decrease. A good diet for prediabetes depends on unprocessed foods, with plenty of vegetables, lean proteins such as fish, legumes, and low-fat dairy products, whole grains, fruit, and water.

·      Soft drinks – having them daily can bump your diabetes risk by 26%.

·      Saturated and trans fats – They have extra calories, but worse, they can directly lower insulin sensitivity. They are in fried foods and fatty red meats. Plus, they’re often in low-nutrient foods with extra calories, such as snack cookies and crackers or processed meats.

·      Red meat – as little as a moderate 3-ounce serving per day can increase your risk by 19%. Choose fish or skinless poultry instead.

·      Fried foods – along with trans fats, they have extra calories and often extra carbs – think about doughnuts, fried potatoes, and fried breaded chicken.

·      Sugary foods – the sugar is a source of extra calories, and it bumps up blood sugar just as you might expect.

·      Alcoholic beverages – mixed drinks especially are high in calories, including frequently from sugar, and can also lower your inhibition so you eat more.

How much can dietary changes lower your risk? One review article found that a Mediterranean-style diet pattern could lower risk by 19%. The diet is flexible, but includes choosing fish, olive oil, whole grains, fruits and vegetables, beans, and low-fat dairy products more often, and limiting processed foods, sweets, and red meat.

Another study estimated that those who ate the healthiest diets had a 51% lower risk of diabetes. If that is not convincing enough, what about this finding, published in the “European Journal of Nutrition?” Eating high amounts of junk food – think chips, soft drinks, and French fries, for example – was linked to a 70% greater risk of type 2 diabetes among over 200,000 participants.

Once you decide to make healthier diet choices, you may come across periodic challenges. Lark DPP includes lessons some of the most common challenges to healthy eating, and your Lark coach can guide you. Examples include:

·      Shopping and cooking to prevent type 2 diabetes. Making a shopping list, putting the right things on it, and preparing them to have maximum nutrition can all have an impact.

·      Eating well away from home. Eating at restaurants can be hard because of oversized portions and lack of healthy menu items. Learn what you can do to reduce your restaurant meals, and what to order when you do find yourself at a restaurant.

·      Coping with triggers. Come into the Lark app when you feel a craving coming on to chat with your coach about healthier options! What about a square of unsweetened chocolate instead of a bowl of sugary chocolate ice cream? Whether you are craving a soft drink or salty snack, healthier options are possible, and can have a big impact on your diabetes risk.

Exercise

DPP: achieve or maintain 150 minutes per week of moderate physical activity

Exercise can lower your risk for diabetes independently of your body weight.  The DPP study found 44% reduction in diabetes risk for participants who achieved their exercise goals, even if they did not lose the amount of weight they had hoped.

In another study, normal-weight individuals with a normal BMI who exercised for an average of at least 1 hour per day (over 7 hours per week) had a 50% lower risk of developing diabetes compared to people whose weekly exercise totaled under 30 minutes. Among individuals who were obese in that study, the higher level of exercise was linked to a 26% lower risk. If an hour a day seems unattainable, feel better knowing the study results suggested that bumping your exercise up to 30 to 60 minutes weekly could lower your risk by 17 to 26% compared to under 30 minutes a week. That’s the amount of a single walk!

Once you decide to get active to prevent type 2 diabetes, you can take steps to make it happen. For example:

·      Set a goal. You might set your long-term goal at 150 minutes a week, or 30 minutes most days of the week, but a shorter-term goal if you have not exercised much recently might be 10 minutes most days.

·      See your doctor. If you have any health conditions or have not exercised recently, check with your doctor before starting.

·      Use a tracking program to stay motivated. Lark DPP reminds you to get active and helps you set goals, as well.

Time is often a barrier to getting active. Between work, housecleaning, taking care of the family, and all the other obligations you may have, the day can slip by before you get a change to exercise if you are not careful. These tips can help you make exercise a regular part of your life.

·      Make it a priority. Schedule it in your planner, just like you schedule other important appointments, so you are sure to block off the time.

·      Break it up. You may not have 30 minutes at once, but you could squeeze in 10 minutes here and there. If not, take a 1-minute break each half-hour to stretch, march in place, or do squats.

·      Multi-task. Integrate exercise into your life. Walk instead of drive to nearby stores, or replace your family time in front of the TV with family time outside. Or, walk around the field while your kids are at soccer practice.

Losing Weight

Losing weight if you are overweight is another impactful change you can make to lower diabetes risk. It may seem daunting if you have 30, 50, or 100 lb. to lose to achieve a “normal” body mass index (BMI), but you do not have to lose that much weight just to lower your risk for diabetes.

Losing 5 to 10% of your body weight can lower your diabetes risk quite a bit. That is 10 to 20 lb. if you weigh 200 lb., or 8 to 16 lb. if you weigh 160 lb. If that amount seems like a lot to lose, here is another statistic: each kilogram (2.2 lb.) of body weight that you lose can lower your risk by 16%. So, keep at it! The effort is worthwhile.

Weight loss plateaus are challenge that come up for many people when they are trying to lose weight. They can happen for many reasons: because your body is catching up with your weight loss, because your body needs a change, or because you have lost focus without realizing it.

These stalls, or plateaus, can be frustrating, but take heart in knowing that they are quite common, and you can overcome them. You can take this approach.

·      Track your food intake carefully. Sometimes, extra foods creep in without being noticed unless you are very careful to count every bite. Those extra foods can lead a weight loss stall.

·      Try something different. That could mean adding in a different kind of workout or trying six smaller meals instead of three larger ones. Sometimes, your body just needs a change.

·      Have patience. Sometimes, your body needs some time to catch up. When it is ready, you will start losing weight again.

Stress Management

Stress is a reaction to certain situations in your environment. Some stress is good, because it prepares your mind and body to rise to the challenge. However, too much stress is unhealthy, and it can raise your risk for type 2 diabetes.

The stress response in your body includes increases in the hormones epinephrine (also known as adrenaline) and cortisol, along with a reduction in insulin. The goal is to prepare your body for fight or flight, and the result is an increase in blood sugar levels – not what you are looking for when trying to prevent diabetes! Worse, cortisol increases insulin resistance. Over time, too much stress can increase diabetes risk.

Stress can come from work, home, relationships, your health, and worries about your family. While you cannot eliminate all stress, you can work to manage it better. Lark DPP coaches you on strategies for that. Examples include:

·      Accepting what you cannot change.

·      Talking to a friend.

·      Taking a walk.

·      Meditating or deep breathing.

Sleep

Sleep can make you feel so good, and it does wonders for your health. Specific to diabetes, too little sleep can have the following effects:

·      Altering hormone levels, including of leptin, cortisol and ghrelin.

·      Increasing insulin resistance.

·      Lowering daytime energy levels so you are less likely to exercise.

·      Increasing cravings for sweet foods.

Lark DPP tracks sleep and coaches you on achieving and/or maintaining healthy levels.

Getting Tested

Getting tested can help keep you motivated and on track. Get your blood glucose levels tested as often as your doctor recommends; this might be every three or six months if you have prediabetes. Your blood test could be:

·      Fasting blood glucose: 100 to 125 mg/dl for prediabetes; lower is normal, and higher means diabetes.

·      Oral glucose tolerance test: 140 to 199 mg/dl for prediabetes; lower is normal, and higher means diabetes.

·      Hemoglobin A1c: 5.7 to 6.4% if you have prediabetes; lower is normal, and higher means diabetes.

Type 1 Diabetes Prevention

Type 1 diabetes is considered to be largely genetic, and prevention is not currently possible. You are at higher risk if you have a family member with the condition. The condition may be triggered when you develop a disease that ends up leading to damage to your pancreas and a loss of ability to make insulin.

Type 2 Diabetes Prevention

Type 2 diabetes has a genetic component, but is largely related to factors that are modifiable. In many cases, you can lower your risk with certain healthy behavior changes, and that is the focus of Lark DPP. The program supports you in:

·      Eating better.

·      Losing and/or maintaining a healthy weight.

·      Exercising more.

·      Managing stress.

·      Getting enough sleep.

How to Reverse Prediabetes

Often, prediabetes is reversible. Many patients who adapt a healthier lifestyle can return their fasting blood sugar and A1c levels back to normal levels. This can often happen without any medications, although metformin can be necessary. The steps to lower are the same healthy behavior changes as described above.

Reversing prediabetes does not happen overnight. Detecting even a small change in A1c takes about 3 months. Instead of rushing it, take a long-term view for reversing prediabetes. Small but consistent changes might help you reverse it in a few years. These tips may help.

·      Work closely with your healthcare provider or team. They can help you get the blood tests you need, keep you accountable and motivated, and connect you to any resources you may need.

·      Join a DPP program, which takes a year to complete and focuses on gradual healthy changes that work for your lifestyle. A digital one, such as Lark DPP, lets you access all the material without needing to attend possibly inconvenient meetings each week.

·      Ask friends and family for support. This can include moral support, such as encouragement, and physical support, such as helping you cook healthy meals or walking with you.

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a 27-site clinical trial led by the Centers for Disease Control and Prevention (CDC) to prevent diabetes. It compared the effects of an intensive lifestyle intervention with the effects of medication with the effects of a placebo among participants with prediabetes.

·      Intensive lifestyle intervention: specific weight loss and healthy eating goals, plus a goal to exercise at least 150 minutes per week, plus 16 weekly lessons given in one-on-one sessions covering diet, exercise, and other healthy behavior change materials, with subsequent group lessons.

·      Medication: a glucose-lowering drug (metformin/Glucophage) plus standard lifestyle recommendations, such as losing weight, exercising more, and following a balanced diet.

·      Placebo: standard lifestyle recommendations plus a placebo.

The DPP study was so successful that it remains the leading program for diabetes prevention around the country. Many insurance plans cover it, and offer it to members who have prediabetes. Other eligibility criteria may include being overweight (BMI over 25, which is 164 lb. for someone who is 5’8” tall) and being over 18 years old.

Diabetes Prevention Program Results

The DPP trial results showed that lifestyle changes work! Overall, there was a 58% reduction in diabetes risk among people in the intensive lifestyle group compared to the placebo, while the metformin group had their risk of developing diabetes decrease by 31% compared to placebo. Among individuals over 60 years old, the lifestyle group had a reduced risk of 71%!

To put in another way, 11% of people in the placebo group got diabetes, while only 4.8% of the participants in the lifestyle group and 7.8% metformin did in the first 2.8 years of the study. Over 10 years, there was a 34% lower incidence of diabetes among the lifestyle participants, and an 18% lower incidence of diabetes in the metformin group.

Program Curriculum

The CDC-approved DPP curriculum has 26 modules that focus on behavior change and achieving goals of losing 5 to 7% of body weight (for perspective, that is 9 to 13 lb. for someone who weighs 180 lb.) and increasing physical activity. The program encourages weighing yourself at each session and logging your exercise and what you eat.

The curriculum is designed to take a year to complete. The first 16 modules are presented during the first six months of the program. These are the topics that you will cover in any CDC-approved DPP, along with the description provided by the CDC.

Module

Description

Program Overview

This module provides an overview of the PreventT2 Lifestyle program, background, goals, explanation of the course structure, and your role as a coach.

Introduction to the Program

This module sets the stage for the entire Prevent T2 course.

Get Active to Prevent T2

This module provides the core principles of getting active.

Track Your Activity

This module provides the core principles of tracking activity.

Eat Well to Prevent T2

This module provides the core principles of healthy eating.

Track Your Food

This module provides the core principles of tracking food.

Get More Active

This module provides the core principles of increasing activity level.

Burn More Calories Than You Take In

This module provides the core principles of caloric balance.

Shop and Cook to Prevent T2

This module teaches participants how to buy and cook healthy food.

Manage Stress

This module teaches participants how to reduce and deal with stress

Find Time for Fitness

This module teaches participants how to find time to be active.

Cope with Triggers

This module teaches participants how to cope with triggers of unhealthy behaviors.

Keep Your Heart Healthy

This module teaches participants how to keep their heart healthy.

Take Charge of Your Thoughts

This module teaches participants how to replace harmful thoughts with helpful thoughts.

Get Support

This module teaches participants how to get support for their healthy lifestyle.

Eat Well Away from Home

This module teaches participants how to stay on track with their eating goals at restaurants and social events.

Stay Motivated to Prevent T2

This module helps participants reflect on their progress and keep making positive changes over the next six months.

 

During the final six months of the program, you will complete at least 6 of these 10 modules.

Module

Description

When Weight Loss Stalls

This module teaches participants how to start losing weight again when their weight loss slows down or stops.

Take a Fitness Break

This module teaches participants how to overcome barriers to taking a 2-minute fitness break every 30 minutes.

Stay Active to Prevent T2

This module teaches participants how to cope with some challenges of staying active.

Stay Active Away from Home

This module teaches participants how to stay on track with their fitness goals when they travel for work or pleasure.

More About T2

This module gives participants a deeper understanding of type 2 diabetes.

More About Carbs

This module gives participants a deeper understanding of carbohydrates.

Have Healthy Food You Enjoy

This module teaches participants how to have healthy food that they enjoy.

Get Enough Sleep

This module teaches participants how to cope with the challenges of getting enough sleep.

Get Back on Track

This module teaches participants what to do when they get off track with their eating or fitness goals.

Prevent T2—for Life!

This module helps participants reflect on their progress and keep making positive changes over the long term.

Diabetes Prevention Program Options

You can check the CDC’s website for a list of programs. There are in-person options, as well as virtual or online possibilities. As you choose, consider a variety of factors.

·      Your own preferences and personality – do you want to meet in a large group or complete the curriculum in private?

·      Your availability – does your schedule allow for in-person meetings each week at a specific time, or are you best off completing the program at times you can choose, which may or may not change with your schedule?

·      Your hopes for the program – are you there just for the CDC-developed curriculum, or do you want extra support, such as for dealing with cravings or setting activity goals?

Comparison of In-Person and Lark DPP Options

In-Person Program

Lark Program

·      Potential opportunity to meet new people who are in the same boat as you.

·      Physically attend weekly classes, often after work.

·      May teach only the CDC curriculum.

·      Contact with your DPP lifestyle coach may be limited to classroom time.

·      Chat with Lark coach anytime, anywhere via your smartphone.

·      Offers coaching beyond the CDC curriculum.

·      No judgement from your Lark coach – just compassion and understanding.

·      Daily reminders and check-ins about logging food, getting active, and talking about your progress and goals.

·      Check your activity, weight, or diet history anytime to see your progress.

Are You Ready to Prevent Type 2 Diabetes?

So you’ve decided you want to prevent type 2 diabetes. Congratulations on taking charge of your health! What’s next?

·      Make a commitment to yourself, preferably in writing. That means you are all in!

·      Talk to your healthcare provider about your goals, and ask how your provider can help and what resources are available. Specifically ask about DPP options.

·      Find out about Lark if you want a lifestyle program that has been clinically shown to help with weight loss and healthier behavior change.

Taking charge of your health can lead to better blood sugar control, and so much more in every aspect of your life. You will be glad you did.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749019/

https://www.nejm.org/doi/full/10.1056/NEJMoa1504347

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870323/

http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html

https://www.cdc.gov/nchs/fastats/diabetes.htm

https://www.cdc.gov/diabetes/data/statistics-report/prevalence.html

https://www.cdc.gov/features/diabetesprevention/index.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891203/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135022/

http://care.diabetesjournals.org/content/32/suppl_2/S151/

https://www.webmd.com/diabetes/guide/understanding-diabetes-symptoms#1

http://care.diabetesjournals.org/content/33/11/2477

https://academic.oup.com/ajcn/article/94/4/1088/4598110

https://link.springer.com/article/10.1007/s00394-012-0423-4

https://www.cambridge.org/core/journals/public-health-nutrition/article/adherence-to-a-mediterranean-diet-and-risk-of-diabetes-a-systematic-review-and-meta-analysis/39DAAE3F1BFD53B5A1123DBFBE40D3E1

https://www.nejm.org/doi/full/10.1056/NEJMoa010492http://care.diabetesjournals.org/content/29/9/2102

http://jech.bmj.com/content/53/6/359?ijkey=b2b4e43dcaf8bb330d4775df24f11bfa0a74789f&keytype2=tf_ipsecsha

http://europepmc.org/articles/PMC2976532

https://www.nejm.org/doi/full/10.1056/NEJMoa012512

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135022/

http://care.diabetesjournals.org/content/25/12/2165

 

 

Prediabetic Diet

The DPP Diet and Coaching for Prediabetes

The Centers for Disease Control and Prevention, or CDC, have developed a program with diet and lifestyle changes that has been shown among prediabetes patients to reduce the risk of developing diabetes by over 50%. This program is the Diabetes Prevention Program, or DPP.

Each DPP program includes a year-long lifestyle change curriculum delivered via lessons put together by the CDC. Lesson topics include nutrition, physical activity, managing stress, and fitting your healthy choices into your and your family’s lifestyle.

You can find an in-person DPP program to attend, or see whether you are eligible for a digital program. Lark Health Coach, for example, is a CDC DPP program that delivers the program via your smartphone, on your time. Lark also helps with tracking weight, food, and exercise, and customizes the program according to preferences such as low-carb, gluten-free, or vegan.

Lark’s prediabetes diet recommendations are consistent with the DPP and include recommendations based off evidence from diets such as the DASH diet and Mediterranean patterns. Your Lark coach, for example, might suggest:

·      Choosing fruit instead of dessert.

·      Steaming, baking, or grilling instead of frying.

·      Using olive oil instead of butter or shortening.

·      Trying plant-based proteins or fish sometimes instead of red meat.

·      Enjoying your meals and having them in a pleasant environment.

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Balanced DPP Healthy Diet for Prediabetes

Foods to Emphasize

Pros

·  Vegetables

·  Fish and shellfish

·  Plant-based proteins, such as beans, peas, lentils, tofu, and nuts

·  Whole grains and whole-grain products

·  Healthy fats such as olive oil and avocado

·  Fresh fruit

·  Spices and herbs

(In Moderation)

·  Starchy vegetables (e.g., peas, winter squash, corn, and sweet potatoes)

·  Lean animal proteins, such as skinless poultry and eggs.

·  Reduced-fat dairy products, such as low-fat cheese and fat-free cottage cheese and plain yogurt.

·  Water and other low-calorie, hydrating beverages such as decaffeinated green tea.

·  Has been shown to lower insulin resistance and blood glucose levels (A1c) among individuals with diabetes and prediabetes.

·  Based on eating patterns shown to have health benefits such as lowering blood pressure, improving cholesterol levels, and

·  Can aid in weight loss due to:

o   Reminding you to weigh in.

o   Calorie reduction by swapping low-calorie foods such as lean proteins and vegetables, and having smaller portions

o   Swapping empty calories for high-fiber choices such as fruit and whole grains.

· Simplifies your diet with reminders, tracking, and suggestions for small changes.

· Better potential for long-term success due to allowances for special occasions and cravings.

Foods to Limit or Avoid

Cons

·  Processed meats

·  Fried foods

·  Fatty red meat and poultry with skin

·  Solid fats (e.g., lard and butter)

·  Refined grains (e.g., white bread, pasta, rice, and crackers, and refined cereals)

·  Sweets (e.g., candy, cake, ice cream, pie, pastries, and cookies)

·  Sugar-sweetened beverages, (e.g., soft drinks, energy drinks, sports drinks, and sugar-sweetened coffee and tea beverages)

·  Alcoholic beverages and mixed drinks

·  Sugar-sweetened foods, such as flavored yogurt and oatmeal, and sugary condiments

·  Dried fruit and fruit juice

·      Is less focused on counting calories and grams of carbohydrate, fat, and protein grams – some people prefer to count.

·  Is not a prescriptive meal plan, so users must decide what to eat rather than expecting to be told what to have at each meal and snack (but you can use the meal plan on this page as a model!).

 

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Sample Diet Plans for Prediabetes

The prediabetes diet plans below are designed to help you lose weight, improve your blood sugar control and overall health, and be easy to follow. Each plan has about 1,200 to 1,400 calories per day. If you need more, you can add in one or more of the healthy snack options listed below the menus. There is are one-week menus for a low-carb ketogenic diet and for a balanced, DPP-based prediabetes diet, and snacks listed for both types of diets.

Be sure to:

·      Drink plenty of water.

·      Check with your doctor before starting the plan.

·      Modify the plan to meet your dietary needs and preferences.

Low-Carb Ketogenic Prediabetes Menu

..

 

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Breakfast

½ recipe of Egg Bake with 2 eggs and 4 egg whites, 1 cup cooked, spinach, 4 oz. blue cheese, 2 oz. all-natural turkey bacon, and Italian seasoning.

Tofu scramble with ½ diced bell pepper and onion cooked in 2 tsp. olive oil. Add cumin, paprika, and pepper, plus ½ block firm tofu, pressed. Serve with ½ avocado.

Omelet with 1 egg and 2 egg whites, 2 oz. swiss cheese, 2 oz. natural turkey, ½ cup kale, and 1 sliced Roma tomato.

½ cup of cottage cheese with 1 oz. sunflower seeds and ½ cup of sliced strawberries.

Cauliflower Turkey Hash (Recipe)

Crustless Fritatta (Recipe)

Scrambled eggs with 4 egg whites, 2 T. milk, 2 tsp. olive oil, 1 cup mushrooms, 2 oz. feta cheese, and ¼ cup sliced olives.

Lunch

Hummus Chicken Salad with 3 ounces baked chicken breast, ¼ cup of hummus, diced celery, bell pepper, and green onion, black pepper, and lemon juice, in a lettuce wrap.

1 oz. nuts

Chopped salad with 2 cups lettuce, 1 sliced hard-boiled egg, 3 oz. cooked ground turkey, 1 oz. cheddar cheese cubes, ½ cup diced cucumber, 2 tsp. olive oil, balsamic vinegar.

Portabello Tuna Melts with 2 portabello mushrooms for bread, topped with ½ cup of tuna, ½ cup sliced red peppers, and 2 oz. (1 oz. per mushroom) of cheese.

Chicken salad with 3 oz. of cooked chicken breast, 3 cups of spinach or romaine lettuce, ½ cup sliced mushrooms, 1 oz. sliced almonds, and 2 T. low-carb dressing.

Avocado Soup: ½ recipe made by blending 2 avocados with 2 cups of chicken broth and ¼ cup lime juice. Add 1 diced tomato, red pepper flakes, cilantro, and pepper to taste, and top each serving with 1 oz. shredded cheddar.

1 cup of celery sticks with 2 tablespoons of peanut butter; 1 hard-boiled egg; ½ cup of strawberries

4 oz. of cooked, shredded chicken breast mixed with ¼ cup fat-free yogurt, 2 tablespoons sliced celery, 1 oz. shredded cheddar, and 1 cup of cooked, cubed cauliflower.

Dinner

“Naked” burger with 4 oz. ground turkey, 1 oz. swiss cheese, lettuce, sliced tomato, and ¼ sliced avocado.

1 cup baked zucchini “fries” with drizzle of olive oil.

4 oz. baked salmon topped with a mixture of 1 oz. parmesan cheese, 2 tsp. olive oil, and 2 tablespoons ground almonds.

1 cup broccoli florets.

Chicken Chili

(Recipe)

Meatballs with Zoodles

Spiralize or grate a large zucchini. Cook in a pan. Toss with ½ cup tomato sauce, mix with 3 ounces cooked ground turkey formed into meatballs, and top with 1 oz. parmesan cheese.

Chicken Stir Fry

½ recipe of 8 ounces skinless chicken breast strips stir fried in 1 T. sesame oil with sliced ginger and low-sodium soy sauce, 1 cup bell pepper strips, ½ cup each sliced carrots, bean sprouts, and bok choy, and 2 oz. of cashews

1 cup cooked broccoli florets mixed with 1 egg, 2 ounces of natural turkey, and 2 ounces of cheddar cheese, all baked until the egg is set.

 

½ recipe of eggplant lasagna with 1 sliced eggplant layered with tomatoes, basil leaves, Italian spices, 2 ounces of mozzarella cheese, and 6 ounces of ground turkey.

Add snacks as needed

Best Ketogenic Snacks

Low-Carb Ketogenic Recipes

Cauliflower Turkey Hash

(Serves 4)

Ingredients

1 lb. cooked fresh or frozen cauliflower, chopped

1 lb. lean ground turkey

1 tablespoon olive oil

1 onion, chopped

½ teaspoon dried thyme

¼ teaspoon pepper

4 eggs

Directions

Heat the oil in a pan. Add the onion and ground turkey; stir until the turkey is browned. Add the spices and cauliflower. Add the eggs and stir until the eggs are cooked.

Spinach Cheddar Frittata

(Serves 4)

Ingredients

1 tablespoon of olive oil

10 oz. frozen cooked or fresh spinach

8 oz. sliced zucchini

4 eggs plus 8 egg whites

4 oz. cheddar cheese

Directions

Cook the vegetables in a hot pan with oil. Mix with the eggs and cheese. Pour into a greased pan, and bake at 400 degrees until the eggs are set, or about 25 minutes.

Chicken Chili

(Serves 4)

Ingredients

1 lb. chicken breast, cubed or shredded

1 T. olive oil

1 onion, diced

1 clove garlic, chopped

1 jalapeno pepper, seeded and chopped

1 cup low-sodium chicken broth

1 cup low-sodium canned white beans

½ teaspoon cumin

½ cup fresh cilantro

2 oz. shredded cheese

1 avocado, sliced

Directions

Heat the oil in a pan and add the chicken, garlic, onion, and jalapeno. Cook. Add the broth, beans, and cumin, bring to a boil, then simmer for 15 minutes. Stir in the cilantro. Serve, topped with cheese and avocado.

Low-Carb Ketogenic Snacks

¼ cup cantaloupe and 1 string cheese stick

1 cup cucumber sticks and ½ cup plain Greek yogurt

1 oz. almonds

1 cup bell pepper strips and 2 tablespoons hummus

1 string cheese stick or 1 oz. other cheese

1 hard-boiled egg

1 cup cooked broccoli florets with 1 oz. cheese melted on top

1 oz. unsweetened 100% dark chocolate

Caprese salad with 1 oz. mozzarella cheese in small cubes, plus ½ cup cherry tomatoes, fresh basil, and 1 teaspoon of olive oil

½ can tuna mixed with 2 tablespoons of yogurt and 1 tablespoon of diced celery, spread on hollowed-out cucumber halves or hard-boiled egg white halves.

1 small avocado

Mini skewers with 2 oz. of skinless cooked chicken breast and 1 oz. of mozzarella cheese, both cubed, and button mushrooms.