How to Find a Good Diabetes Coach, Consultant, and Counselor

How to Find a Good Diabetes Coach

Good diabetes management includes a range of strategies, from taking medications and monitoring blood sugar to eating healthy and exercising smartly. It is not just your doctor who is responsible for your blood sugar; in fact, your own actions on a daily basis affect your blood sugar levels far more. Finding a good diabetes consultant, coach, and counselor can help you keep blood sugar closer to goal levels so you can stay as healthy as possible. 

 

Why You Need a Good Diabetes Coach, Consultant, and Counselor


The short answer is that having a good diabetes coach, consultant, and counselor can help you lower blood sugar, but why is it so important to keep blood sugar under control when you have prediabetes or diabetes? Also, why do you need so many experts helping you? 

Keeping blood sugar under control is the goal of prediabetes and diabetes management. Lowering blood sugar if you have prediabetes can help you prevent or delay the onset of type 2 diabetes. If you have type 2 diabetes, keeping blood sugar within goal ranges can lower your risk for complications, such as:

  • Kidney disease.

  • Stroke and heart disease.

  • Hypertension and high cholesterol.

  • Numb and tingling hands and feet (peripheral fA1C).

  • Vision problems.

It can be helpful to have many experts helping you, since so many factors go into managing blood sugar. Your diabetes management team can offer the know-how, as well as the support, encouragement, motivation, and reminders that can all get and keep you on track. You want to find the experts who not only are knowledgeable in diabetes management strategies, but who also are able to develop customized plans for you and gain your trust over time.

 

What Are Diabetes Consultants, Coaches, and Counselors?


Together, the diabetes coach, consultant, and counselor have expertise and skills that can help you keep your blood sugar levels at or closer to goal levels. You may need these experts because the diabetes management plan can be so wide-ranging.

A consultant might be the closest to an accepted expert who helps establish goals and management plans. The consultant might assess your medical history and blood sugar, provide instructions on medication and blood sugar monitoring, and offer tools for monitoring, tracking, and record-keeping.

A counselor is your guide. Together, you and your counselor have an opportunity for introspection, or self-analysis. Your counselor might ask why you might be having trouble managing blood sugar, and how you can address obstacles that you may identify.

A coach offers more of a chance to “get things done.” You can almost think of the coach as a partnership as you both seek to discover your strengths, challenges to self-management, and wants and needs. Your interactions might include questions about how you feel and what you need to reach your goals.

 

Common Barriers to Effective Self-Management


Effective self-management for lowering blood sugar in prediabetes includes lifestyle changes such as exercising and eating right. If you have diabetes, you are also likely to have medications to take, and your doctor may suggest taking your blood glucose at least once, if not more times, each day. 

In theory, self-management is simple: take your meds, measure your blood glucose levels, work out regularly, and eat well. In practice, self-management is not so easy! While everyone’s situation is different, the barriers that you face may be common among many prediabetes and diabetes patients. 

  • Lack of knowledge about how to follow your plan.

  • Difficulties with logging or tracking food, weight, medication use, and blood glucose levels.

  • Lack of time to work out, plan and cook healthy meals, and measure blood sugar.

  • Real life situations, such as last-minute meetings at work or eating at restaurants.

A diabetes counselor and coach team can help you identify and overcome your barriers. Lark is an option for a counselor that can help you overcome obstacles at any time of the day, any day of the week. These are some ways Lark can guide you.

  • Getting active: Tracking your activity and progress towards goals, providing daily and weekly activity updates, setting goals for exercise, reminding you to get active, and giving tips on activities you can try and how to fit them into your schedule.

  • Eating right: setting and tracking weight goals, educating you on healthy eating, offering tips on planning and preparing healthy foods at home, and ordering well at restaurants.

  • Taking medications: reminding when to take them and asking if you have been taking them.

  • Monitoring blood sugar: reminding you to take it, tracking your results, offering feedback on what may have contributed to high or low values, and letting you know if your value may be out of range.

 

Motivation and Action


Motivation is an important criterion for action, especially when it comes to managing your blood sugar in prediabetes or diabetes. Your diabetes consultant can create a sensible plan for you, but you have to want to follow through with it in order to do so, since it involves daily action on your part.

How can you get motivated? A diabetes coach or counselor can be pivotal. Lark for Diabetes and Lark DPP can help increase motivation by:

  • Educating you on the why and how: why your plan will help you get healthy, what might happen if you do not follow through on the plan, how to choose healthy foods, and how to plan for including physical activity in your day.

  • Reducing the burden: making food, weight, and activity tracking easy, including glucometers that automatically sync with the app so you do not have to enter the data, and being available anytime so you never need to wait on hold or make an appointment when you need help.

  • Praising you: when you make healthy choices, such as eating well or measuring your blood sugar when you are supposed to, or hit milestones, such as a weight goal.

  • Supporting you: when times are tough, such as not hitting a goal or going off your plan, unwavering support and encouragement can keep you more motivated than a scolding.

  • Keeping management in mind: responding to you and reminding you can keep your diabetes goals in mind so they stay a top priority.

 

How Can You Find a Diabetes Consultant, Counselor, or Coach?


One way to find experts in diabetes is to ask your doctor for a referral or recommendation. You can also go to a diabetes center or clinic. If you do not meet a coach or counselor while you are there, ask a consultant or a diabetes nurse if they know. You can also check websites, such as that of the American Diabetes Association (ADA) or American Association of Diabetes Educators (AADE) to see if they have directories that list providers in your area.

However, there are not that many diabetes experts in the U.S! By some estimates, there are only 15,000 certified diabetes educators (CDE) in the U.S. There are 26 million patients with diabetes, leaving an average of 1 CDE per 1,733 patients.[1] Good luck if you are a patient trying to find a CDE!

Another approach is to opt for a digital solution, such as Lark for diabetes. Since it is an app that you can use on your phone, it is available nationwide. Plus, there is no waiting list. Lark is ready for you when you are ready for it. Ask your provider!

 

What Roles Can Lark Play in Your Life?


A clear and obvious role for Lark is to provide the unlimited support that you deserve. There is enough Lark to go around for as many patients as need it. The 1 to 1 ratio of one Lark coach per patient is a lot more impressive when considering the above ratio of 1 CDE per 1,733 patients. It is even more valuable when considering another shortcoming in the medical system: an average of 7 minutes in your initial with your doctor to make your diabetes plan.[2]

Lark is a completely automated app that uses artificial intelligence to provide services to you. This means some advantages of Lark apps compared to traditional diabetes service providers can include:

  • Unlimited coaching, no holds barred. You can open the app for a customized conversation as many times as you want without being charged extra. 

  • No wait times or appointments. You can get coaching any time of the day or night, and on weekends, immediately.

  • The best of the best experts in diabetes. Lark was developed by experts in diabetes, nutrition, physical activity, and more – you get to benefit from all of their input!

  • No judgement or stigma. You can tell Lark your successes and confessions without fear of judgement. Instead, count on encouragement and suggestions for next steps.

  • No inconvenience. You do not need to drive across the city and look for parking just to meet with your diabetes expert. Just whip out your smartphone.

Lark can play many of the roles that you would expect from a diabetes counselor and coach, but Lark’s roles go beyond what you might expect.

  • Being your motivator, cheerleader, and guide.

  • Exploring any obstacles to your diabetes plan. 

  • Reminding you to carry out your plan, such as measuring blood sugar and tracking food.

  • Offering instant, responsive feedback to your food, activity, and other inputs. 

  • Giving you smart tips on eating better and adding physical activity in ways that work for your lifestyle.

A solid team can help you lower blood sugar and prevent diabetes or lower the risk for complications. A coach, consultant, and counselor can offer support as you seek to follow your plan. You can ask around or check directories to find the experts you need, or you can go with a sure bet if you are looking for accessibility and convenience: Lark.

 


Diabetes Health Center and Diabetes Clinic

Diabetes Health Center and Diabetes Clinic

A range of emotions are normal if you have an upcoming visit to a diabetes heath center or diabetes clinic. You might feel:

·      Relieved. You may have suspected for months or years that you had diabetes or were at risk, and now you have the go-ahead to get medical help for it.

·      Determined. You may be ready to do everything you can to stay healthy and prevent complications from high blood sugar.

·      Shocked. You might not have had any idea that you were at risk for high blood sugar.

·      Overwhelmed. Recognizing that you have diabetes or are at risk for diabetes can be overwhelming if you are already managing another medical condition, and/or if you are realizing that blood sugar management is a long-term and intensive responsibility.

·      Guilty. While nobody should be made to feel ashamed of their health situation, some people do feel embarrassed. They may feel that their blood sugar is their own fault or they should have done something to prevent diabetes or prediabetes.

These emotions can be confusing and powerful, and they can help you focus on your upcoming visit to a diabetes health center. A diabetes health center can help you achieve important goals such as maintaining healthier blood sugar levels, incorporating your self-management behaviors into your daily routine, and feeling confident that you have the tools, motivation, and support that you need to stay healthy as possible.

 

What are a diabetes health center and diabetes health clinic?


A diabetes health center is a facility dedicated to helping you manage or prevent diabetes. The center offers resources to achieve target blood glucose levels so you can prevent or delay type 2 diabetes or complications of diabetes.

Your diabetes health clinic may offer a team-based approach to diabetes care to provide you with expertise and support in a variety of areas. These are some likely team members.[i]

·      Primary care provider (PCP) to lead your care and see you for checkups and regular care.

·      Nurse educator (RN) to help you with daily management techniques, such as taking your medications, measuring your blood sugar, and recognizing symptoms of high or low blood sugar (hyper or hypoglycemia).

·      Registered dietitian (RD) to work with you on weight loss (if necessary) and healthy diabetes diet strategies, such as portion control, food choices, label reading, and meal planning.

·      Certified diabetes educator (CDE) (may be the nurse or dietitian) to help you with the ins and outs of living with diabetes or prediabetes.

·      Endocrinologist to assist with specialized care if you run into trouble controlling blood sugar or with your hormones.

·      Pharmacist, who may be onsite or at a local pharmacy, to assist in making sure your medications are working for you and you know how to take them safely.

·      Specialists, such as eye, teeth, kidney, and foot doctors to monitor for problems and treat complications of diabetes if needed.

These professionals are trained to serve patients with prediabetes and diabetes, and they should work together with each other and with you to provide you with the best care possible.

 

Can diabetes health centers help me with prediabetes?


Yes! Many diabetes health centers recognize the value of preventing diabetes, and are ready to help if you have prediabetes. Ask the diabetes clinic to be sure that they treat prediabetes when you call for an appointment, and feel proud of yourself for taking steps to prevent or delay type 2 diabetes.

 

How do I find a diabetes health center near me?


You can find a diabetes health center near you by asking your doctor where to go. You can also look at online directories to find diabetes clinics and see ratings and reviews of nearby locations. Credible organizations such as the Centers for Medicare and Medicaid Services (CMS) and the American Diabetes Association (ADA) have search engines for finding providers.

 

How should I be prepared before going to a diabetes clinic?


A small amount of preparation can help you get as much as you can out of your first trip to a diabetes health center. Consider gathering the following before your first visit.[ii]

·      Health insurance card. Also contact the clinic beforehand to make sure they take your insurance and to see if they will need to present any other information to your insurance company.

·      Lists of food and medication allergies and any medications that you are on. This can enable your doctor, pharmacist, and other specialists to safely prescribe medication and create a treatment plan.

·      Payment. Find out how much the visit or your co-pay for the visit will cost, and be sure you bring cash or have a credit card that the diabetes clinic accepts.

·      Past test results. Your doctor will likely want to know your blood sugar test results, as well as related results such as cholesterol levels and kidney function. Ask the clinic which test results you should gather, and whether it would be best if you signed a medical records release form so the clinic can gather the records it needs.

·      Pen and paper for notes. Physical pen and paper or smartphone note-taking app, we can all use a little help with our memories. You can also prepare by listing any questions that you have.

 

How can I be sure that I have a good doctor?


Many factors help determine whether a doctor is right for you. Find out the doctor’s qualifications, such as training in diabetes management. Also check how much experience the doctor has in treating or preventing diabetes and its complications. Ask the doctor how many patients she regularly treats, and whether most of them have diabetes. A doctor who focuses on diabetes may be better equipped to manage yours than a doctor who is more generalized.

You might want to ask about:

·      Areas of research, if any, that the doctor is interested in.

·      The doctor’s approach to team care.

·      Which specialists you might be referred to if needed.

·      Recommendations from current patients.

In addition to these objective criteria, personal factors matter, too. For example, a doctor who is conveniently located, whose appointment times work for you, and whose practice has after-hours support makes care more accessible. You may be less likely to seek the care you need if it is inconvenient to do so.

You will be better able to evaluate the new doctor after your first visit. What is your gut reaction? Did you connect with the doctor? Do you feel comfortable telling her about your concerns? Did she answer your questions in terms you can understand and in a respectful manner? Was the appointment on time?

Individual considerations are important, too. Your doctor should tailor your treatment plan to your lifestyle, and ask for your input. She should be compassionate and work to understand any barriers you face when managing diabetes.

 

What happens at a diabetes clinic?


Your visit to a diabetes clinic will likely include an assessment and the development of a treatment plan.[iii]

Assessment

The assessment will probably include a review of your medical history, a physical examination, and additional tests to give the doctor any necessary information. The doctor may ask if you have a family history of diabetes, whether you have complications, and what your current treatment plan, if any, is. She should also ask how you feel about your diabetes and whether you have any barriers to managing your blood sugar.

The physical examination may include familiar measurements that you always have when you visit the doctor, and/or diabetes-specific ones that you may not have had in the past. You should also have an assessment of diabetes or prediabetes signs and symptoms.

·      Height and weight.

·      Blood pressure.

·      Palpation of your organs and thyroid gland.

·      Checking heart, lungs, and reflexes.

·      Examining your hands and feet.

If needed, your doctor may order medical tests such as your fasting blood sugar, A1C, and your cholesterol and triglyceride levels.

Developing a Treatment Plan

Your team members should work together and provide you with a treatment plan. You should be involved in the development of your plan to be sure it fits into your lifestyle and accounts for your personal circumstances such as preferred schedule, family members, and any work or school obligations.

Your plan should include the following.

·      Appointments or future plans for making appointments with necessary specialists, such as a podiatrist, dentist, kidney doctor, or eye doctor.

·      Short-term and long-term goals that you agree with.

·      Medication prescriptions and how to use them, if necessary.

·      An eating plan for weight loss and a healthy diet, with foods that fit into your life.

·      A plan for making other changes, if needed, such as quitting smoking or increasing physical activity.

·      Education on blood sugar measuring and tracking.

·      What to do if you have high or low blood sugar values.

Following Up to Increase Success

You can take actions to improve your blood sugar management after your visit to a diabetes clinic. Building a strong support system can make diabetes management or prevention easier. In general, the more, the merrier when it comes to support. Ask your family members and friends to do whatever you think might help, from eating heathy with you, to reminding you to test blood sugar at the times you are supposed to, to helping your children with homework while you take walks in the evenings.

Since so much of your diabetes management depends on you, wouldn’t it be nice to have a personal health coach in your pocket? Lark health apps for diabetes and prediabetes enable you to do just that. Your coach is available 24/7 to help you stay on track with your treatment plan. Lark:

·      Tracks your medications, diet, weight loss, and physical activity.

·      Coaches around blood sugar management, prediabetes and diabetes, and healthy behaviors.

·      Alerts you if your blood sugar is into dangerous levels and you need to connect with a healthcare professional.

·      Asks about your doctors’ appointment to help you remember the appointments that can keep you healthy.

Lark tailors its program to you, allowing you to choose programs such as a low-carb, vegetarian, or gluten-free diet, and learning from your regular habits to further customize coaching. With Lark, you are never alone in your health journey!

 

Reduced Insulin Sensitivity & How to Increase it Naturally

Reduced Insulin Sensitivity & How to Increase it Naturally

The topic of insulin sensitivity comes up frequently nowadays, and there is good reason. Reduced insulin sensitivity leads to high blood glucose levels and is the main cause of prediabetes and type 2 diabetes, which are increasingly common in the U.S., and can have serious consequences.

It is good to become aware of what reduced insulin sensitivity, or insulin resistance, means, and, better yet, what to do about it. Advanced insulin resistance, such as in the case of type 2 diabetes, can mean that you need medications to control blood sugar. It can also mean that you have a higher risk for certain health conditions.

Luckily, lifestyle changes can help you naturally increase insulin sensitivity, even if it has been decreased greatly. Healthy behaviors such as losing extra weight and getting active are usually effective at increasing insulin sensitivity. Lark can support your healthy lifestyle changes whether you have type 2 diabetes, prediabetes, or insulin resistance that is so minor that you may not even be aware of it.

 

What is Reduced Insulin Sensitivity?


Reduced insulin sensitivity is also called insulin resistance. Let’s break it down![1]

  • Insulin is a hormone produced by your pancreas. It helps your body regulate blood sugar, or blood glucose levels.

  • Sensitivity describes how sensitive, or responsive, cells in your body are to insulin.

  • Reduced insulin sensitivity happens when cells in your body are not as responsive to the effects of insulin and have trouble taking up glucose from your blood.

Normal Insulin Sensitivity

To make it clearer, here are some more details on what happens with normal insulin sensitivity. Many of the foods you eat contain types of carbohydrates called sugars and starches. Examples include bread, pasta, potatoes, cereal, sweets, and soft drinks. During digestion, your body breaks down the carbs into a type of sugar called glucose. The glucose goes into your bloodstream, which temporarily raises blood glucose, or blood sugar, levels.

The glucose in your blood is carried to certain cells that use glucose for energy. Some of your cells, such as muscle, liver, and fat cells, use insulin to take up the glucose. During normal insulin sensitivity, these cells need a normal amount of insulin to take up glucose, which lets the level of glucose in your blood go back down to normal levels.
 

Reduced Insulin Sensitivity

Various triggers can lead to reduced insulin sensitivity. When it happens, insulin is not as effective on cells such as your liver, muscle, and fat cells. They need more insulin just to take up the same amount of glucose. Insulin levels in your blood rise. Eventually, glucose levels may rise if your pancreas can no longer produce enough insulin to keep up with the demand.
 

Who Has Reduced Insulin Sensitivity?

Lots of people have reduced insulin sensitivity – maybe even you! You have reduced insulin sensitivity if you have prediabetes or type 2 diabetes. That already includes 45% of U.S. adults, but that is not all. The truth is that insulin resistance can start to develop years or a decade before you have signs of it.

You are more likely to have reduced insulin sensitivity if you:

  • Are overweight or obese.

  • Are not physically active.

  • Have a family history of type 2 diabetes.

  • Are Hispanic American, Asian American, Native American, African American, or a Pacific Islander.

  • Are an older adult.

 

How Is Reduced Insulin Sensitivity a Problem?


Reduced insulin sensitivity can become a health problem. As it progresses, your cells are less and less able to respond to insulin; they need more insulin to “clear” glucose from your blood. At some point, your pancreas may not be able to keep up with demand. Insulin levels may not be high enough to let your muscles, fat, and liver cells get enough glucose out of your blood.

The result is that your blood sugar levels may rise above normal levels, leading first to prediabetes, and then to type 2 diabetes. The progression can take years; in fact, you are likely to have reduced insulin sensitivity for up to a decade before you actually develop prediabetes.

If this sounds far-fetched or as though it may be something for others to worry about, consider this: prediabetes and diabetes are common. Over 45% of adults, or nearly 1 in 2, have prediabetes or diabetes, according to the Centers for Disease Control and Prevention (CDC). The number jumps to nearly 3 in 4 for adults over 65 years.[2]

Reduced insulin sensitivity is not just a problem because a lot of people have it. It is a problem because it can lead to serious health consequences. Prediabetes is not likely to cause many or any symptoms, but it does increase risk for diabetes, and diabetes has its own set of concerns.

  • Seventh-leading cause of death in the U.S.

  • Higher risk for heart disease, kidney disease, and stroke.

  • Increased risk for Alzheimer’s disease.

  • Risk of complications such as blindness and diabetic neuropathy.

  • Daily (or more) blood glucose testing and probably medications.

Most cases of type 2 diabetes are preventable, and your chance of preventing diabetes is higher if you try to reverse reduced insulin sensitivity early on.

 

Reduced Insulin Sensitivity & Correlation with Early Signs of Prediabetes


Reduced insulin sensitivity means you have trouble processing glucose normally. Your blood glucose levels can be higher than normal. While prediabetes symptoms are rare, you could have signs of high blood sugar if your blood sugar levels are consistently too high. This is likely correlated with reduced insulin sensitivity.

Signs of high blood sugar and diabetes can include:

  • Increased thirst and urination.

  • Unexplained, unintentional weight loss.

  • Lack of energy.

  • Increased hunger.

  • Blurred vision.

  • Numb or tingling hands or feet.

Compared to having lower insulin sensitivity, having higher insulin sensitivity is linked to lower levels of insulin in your blood.[3] The reason is that you do not need as much insulin to get your glucose back to baseline levels after meal. This is healthy, because it means that you can keep blood glucose levels normal when you eat carbohydrates without making your pancreas work so hard to produce and secrete extra insulin.

 

How to Increase Insulin Sensitivity Naturally


There are many ways to increase insulin sensitivity naturally.[8, 9] Unlike with medications, these strategies have no harmful side effects. Instead their side effects may include increased energy, better mood, and lower risk for other health conditions!
 

Diet for Increasing Insulin Sensitivity

What you eat, and how much, can have an immense impact on your insulin sensitivity. Losing extra pounds can increase insulin sensitivity and lower your risk for prediabetes and diabetes. In one study, overweight individuals with prediabetes who lost 5 to 7% of their body weight (that is 9 to 13 lb. for someone who weighs 180 lb.) lowered their diabetes risk by 32%.[4]

You can use this calculator to find out your body mass index (BMI) if you know your height and weight. A BMI over 25 is considered overweight, and a BMI over 30 is considered obese.

The healthiest and most sustainable way to lose weight is usually to do it gradually. Together, that means that you do not need to follow a fad diet or cut out all good-tasting foods. Instead, consider adding one or more doable steps, such as the following, into your regular routine.

  • Serve smaller portions of higher-calorie foods. That could mean ordering a small instead of regular fries or burger, or having only half a piece of cake.

  • Add more low-calorie foods. For example, stir broccoli into mac and cheese or pasta sauce so that the same size portion has fewer calories. Or, start dinner with a green salad so that you are less hungry for higher-calorie foods for the main course.

  • Choose water or decaffeinated tea or coffee instead of soft drinks, energy and sports drinks, and other sugar-sweetened beverages with calories.

  • Swap less processed foods for highly processed ones to limit added sugars and unhealthy fats. For example, choose fruit instead of desserts, or roast chicken and fish instead of fried and battered choices.

 

Healthy Eating for Increasing Insulin Sensitivity

Your diet is not just about weight loss. A lot of research has been done to check the effects of what you eat on your insulin sensitivity. Here is what the results suggest if you want to reduce insulin resistance.[5]

Eat more:

  • Whole grains, including oatmeal, popcorn, brown rice, whole wheat products, and wheat bran.

  • Fiber, which is in plant products such as whole grains, vegetables, nuts and seeds, fruit, and legumes (beans, peas, and lentils).

  • Healthy fats, including monounsaturated fats from olive oil, avocados, and peanuts, and omega-3 fats from fatty fish and flaxseed.

  • Vegetables and a variety of fruit and vegetables.[6]

Limit:

  • Trans fats, which are in fried foods, plus processed foods such as some snack pies and cakes, doughnuts, and crackers.

  • Added sugars from foods and beverages, such as soft drinks, desserts, sugar-sweetened cereal and yogurt, and other processed foods such as some baked beans, teriyaki and pasta sauces, and canned soup.

  • Saturated fats from animal foods, such as fatty meats and butter.

  • Processed meats.[7]

What about a low-carb diet? Some people try to improve insulin sensitivity by turning to a low-carb diet, which restricts high-carb foods such as bread and other grains and grain products, starchy vegetables, sugary foods, and even fruits and legumes. However, the jury is still out. A low-carb diet could lower your body’s demand for insulin, but there could be long-term harm from having too much protein or fat to make up for the low amount of carbohydrates.  

A smart-carb approach may be safest and healthiest. 

  • Spread your carb intake through the day, with one or two small servings per meal and snack.

  • Avoid excessive amounts of carbs at once, such as large plates of pasta, huge bagels or muffins, or meals with bread, a side of rice or potatoes, and a starchy and sugary dessert.

  • Look for high-fiber, less refined carbohydrate sources, such as whole grains, fruit, and starchy vegetables.

  • Limit refined grains and sugars.

  • Eat your carbohydrate with a source of fat and/or protein.

Getting Active to Increase Insulin Sensitivity

Exercise is one of the quickest and surest ways to increase insulin sensitivity naturally., The benefits last for 24 to 48 hours, so try to get in a workout at least every 1 to 2 days to keep getting the rewards.

Type of Exercise Examples How Much? Other Notes
Moderate-intensity aerobic exercise (“cardio”)
Walking, low-impact aerobics, moderate cycling and swimming
30 minutes most days, or at least 150 minutes per week.
Work hard enough to be able to talk, but not sing.
High-intensity aerobic exercise (“cardio”)
Running, fast cycling, kick-boxing, basketball
75 minutes per week.
Can be used as an alternative to moderate-intensity cardio.
Resistance training
Free weights, barbells, dumbbells, resistance bands, body weight, and weight machines.
Hit each muscle group 2 to 3 times per week. Do 8 to 10 repetitions of an exercise, then repeat.
Ask a trainer about proper form, and get excited about “toning up,” not “bulking up!”
Other activities.
Yoga, tai chi, stretching.
2 to 3 times per week or more.
Lowers injury risk and risk of falls so you can keep exercising


Another important way to increase insulin sensitivity is to stop sitting. At least, try not to sit for so long! Breaking up your “sedentary time” with a few minutes of light activity, such as walking or doing calf raises, can fight insulin resistance.[10]
 

More Ways to Naturally Increase Insulin Sensitivity

You have opportunities all day to increase insulin sensitivity naturally, and side effects can include feeling better in so many ways.

  • Get enough sleep. A single night of sleep deprivation reduces insulin sensitivity. Being chronically low on sleep, as so many adults are, can harm your health even if you are doing everything else right. You can use Lark to get a handle on your sleep patterns and work on sleeping better if you are not yet getting enough.

  • Manage stress better. Some stress is good, and too much stress is unfortunately common. The effects are not just in your head; being overly stressed alters your hormones and increases insulin resistance. Learning how to manage stress can help normalize your metabolism. Meditation, exercise, and deep breathing are some ways to manage stress. Lark can help you recognize when you are feeling stressed and remind you of ways to try to handle it.

Medications and Natural Approaches to Increasing Insulin Sensitivity

Medications can be necessary to keep blood sugar levels in check if your insulin sensitivity decreases too much. Still, even if you have diabetes, these natural support strategies can increase insulin sensitivity. They may make your medications more effective or allow you to take lower doses (of course, never change your medication dose without talking to your doctor first). 

 

Ready to Increase Insulin Sensitivity?


If you are worried about reduced insulin sensitivity and are ready to increase it naturally, Lark is ready to help. The friendly health coach is available through your smartphone 24/7 to guide you and support you as you make healthy lifestyle choices. You do not need to be alone on your health journey!

 


Prediabetes Test

Prediabetes Test

Prediabetes is one of the most common conditions in the country today. The Centers for Disease Control and Prevention (CDC) report that over one-third of Americans 18 or over had prediabetes in 2015[1]. That includes 84.1 million people, and the numbers are only increasing.

Why should you care?

  • One of those people could be you.

  • Diabetes is not just your grandmother’s disease. One in 12 Americans 44 years or younger has prediabetes, and 1 in 25 Americans in that age group have diabetes.

  • Prediabetes is a risk factor for type 2 diabetes and serious complications that can follow, and knowing that you have prediabetes can better enable you to prevent the consequences.

Do I Have Prediabetes?

The only way to find out for sure is getting tested. A prediabetes test is quick and simple. Your doctor can order one, and you can get it done where you normally get your blood drawn for cholesterol and other routine tests.

 

Why Test for Prediabetes?


Why should you test for prediabetes? Wouldn’t you know if you have it? Actually, not necessarily. In fact, you are unlikely to notice any symptoms of prediabetes, although a minority of prediabetes patients do notice a darkening of skin on the back of their neck, in the groin area, or under their armpits. The condition is called acanthosis nigricans[2].

The only way to know for sure if you have prediabetes is to get tested. While 1 in 3 American adults has prediabetes, only 11.6%, or 1 in 9, of people with prediabetes, report that their doctor has told them that they have prediabetes. The other 74 million prediabetes patients are unaware that they have it.

You may be worried about your test result, but getting tested for prediabetes is better than not being tested. If you know you have prediabetes, you can take steps to manage your condition and prevent or delay type 2 diabetes and complications.

 

Prediabetes Testing 101


Prediabetes Test and Lark Diabetes Pro

Prediabetes is a condition in which your body has trouble keeping your blood sugar, or blood glucose, within normal ranges. It happens as the cells in your body become resistant to the effects of a hormone called insulin. 

Your pancreas release insulin when you eat foods with carbohydrates and your blood sugar levels rise. The insulin helps cells in your body remove glucose from your bloodstream and take it into the cells. If you develop insulin resistance, you need more insulin to keep your blood glucose levels normal. Eventually, your insulin production cannot meet the increasing demands for insulin, and your blood sugar levels rise – that is when prediabetes can be diagnosed.

With prediabetes, your blood glucose is higher than normal, and lower than in diabetes. These are the tests that your doctor can use to diagnose prediabetes or type 2 diabetes[3].

  • Fasting blood glucose (FBG)

  • Glycated hemoglobin (A1C)

  • Oral glucose tolerance test (OGTT)

  • (for diabetes only) random blood glucose (RBG)

The National Institute for Diabetes and Digestive and Kidney Disorders (NIDDK) explains that your doctor may ask you to repeat the test if the first one suggests that you have prediabetes or diabetes. Testing a second time can confirm the results of your first prediabetes test.

 

Prediabetes Test 1: Fasting Blood Glucose (FBG)[4]


Principle

Fasting blood glucose is a test to determine “impaired fasting glucose” (IFG) as a sign of prediabetes.[5]  After you eat a meal or snack with carbohydrates or calories, your blood sugar levels rise. In response, your pancreas secrete insulin, which should help the fat, liver, and muscle cells in your body take up sugar from the blood. The result is that your blood sugar levels should then fall, fairly quickly, back to baseline, or fasting, levels. The FBG test measures your blood glucose at these low points, long after a meal.
 

How to Take It

You need to fast for at least 8 hours. That means you cannot have any food or drink with calories. Water is fine. Usually, your doctor will suggest that you fast overnight and go to the lab in the morning, before you eat anything. The nurse or lab technician will draw your blood. 


Results of the FBG Test

If your value is… Then…
Under 100 mg/dl
Your result is considered normal.
100-125 mg/dl
You may have prediabetes.
Over 125 mg/dl
You may have diabetes.

 

Pros and Cons

You can get a fasting blood sugar test pretty much anywhere that you can get your blood drawn – it is a common test. This test is relatively inexpensive, which is great if your insurance is less than comprehensive.

Some people have trouble with this test because they are hungry in the morning and want breakfast. Even more difficult can be your doctor’s order to abstain from drinking coffee or having another source of caffeine until you take your test.

Another caveat with an FBG is that your blood glucose levels can fluctuate day to day, and even minute to minute. The single blood draw only shows what is happening in your blood at that one point in time, whereas in reality, your levels could change for a variety of reasons, such as if you exercised intensely the evening before, or if you are a little bit ill.

 

Prediabetes Test 2: Glycated Hemoglobin (A1C) [6]


Principle

You always have at least some glucose in your bloodstream. Because glucose is always in contact with your red blood cells, it can sometimes bind with, or attach to, them. More specifically, glucose binds with a component of your red blood cells called hemoglobin. The product is called “glycated hemoglobin,” or “hemoglobin A1c.”

The more glucose you have in your bloodstream, the more glucose binds with your hemoglobin. A higher percentage of your hemoglobin becomes glycated. While some glycated hemoglobin is normal, too much is a sign of a problem such as prediabetes or diabetes. High amounts of glycated hemoglobin can be a sign that other cells in your body, such as kidney cells, are becoming glycated. This can destroy them.

Glycated hemoglobin, hemoglobin A1c, HbA1c, and A1c all refer to the same test. The results are given in terms of percent (%) hemoglobin in your blood that has glucose molecules attached to it.
 

How to Take It

The A1c test is a blood test. You can go at any time of the day, and it does not matter whether you are fasting or not.
 

Results of the A1c Test

If your value is… Then…
Under 5.7%
Your result is considered normal.
5.7-6.4%
You may have prediabetes.
6.5% or higher
You may have diabetes.

 

Pros and Cons

The A1c test is the most convenient test since you can take it at any time of the day, and you do not need to fast or prepare for it. It also has the advantage of giving you a three-month picture of what your blood sugar has been doing, rather than the instantaneous one-time shot that the FBG tells you. Finally, the A1c test has no daily variability, so your result will not change, for example, if you are short on sleep for a night, you are stressed, or you had a big meal the day before.

A drawback of A1c test is that it is more expensive than a FBG test. It may also be less accurate for as a prediabetes test than as a test for diabetes. In addition, A1c can be affected not only by your blood sugar levels (which is what we are interested in when talking about prediabetes), but also by factors related to your hemoglobin and red blood cells.

 

Prediabetes Test 3: Oral Glucose Tolerance Test (OGTT)


Principle

When you have a food or beverage with carbohydrates, your body breaks them down into glucose. The glucose enters your bloodstream, which raises blood glucose levels, which triggers insulin to be released from the pancreas to help lower your glucose levels back down.

In prediabetes and diabetes, you can have impaired glucose tolerance (IGT). Your body may have trouble bringing back your blood glucose levels to normal. This is what the OGTT measures.
 

How to Take It

You need to begin the OGTT while you have been fasting for at least 8 hours or overnight. Your blood will be drawn. Then you will drink a solution that contains 75 grams of glucose. Your blood will be drawn at 1 and 2 hours after you drink the solution.
 

Results of the OGTT

If your value is… Then…
Under 140 mg/dl
Your result is considered normal.
140-199 mg/dl
You may have prediabetes.
Over 200 mg/dl
You may have diabetes.

 

Pros and Cons

The OGTT is a more sensitive test than the A1c test. That means it is more likely than than the A1c test to detect prediabetes or diabetes if you have it; a “false negative” (saying you do not have prediabetes even when you actually do) is less likely.

The OGTT is more expensive than the A1c and FBG tests. Other drawbacks are that it is a bit more inconvenient and invasive.

  • You need to begin with an 8-hour or overnight fast.

  • You will need to get your blood drawn at least twice.

  • You will need to dedicate 1, 2, or more hours to the test, and your clinic or lab may require you to stay on site while waiting for each blood draw.

Some people have trouble downing the required 75 grams of glucose. They may feel sick or nauseous. This amount of glucose is equivalent to the amount of sugar in 2 cans of regular (not diet) soda, or 2.5 bags of M&Ms.

 

Type 2 Diabetes Test: Random Blood Glucose


Principle

There is one more test that could come up, but it is more of a screening test for diabetes than prediabetes. The random plasma glucose (RPG) tests your glucose at any time. It could be high if your insulin sensitivity is low enough, or if you have little enough insulin, that your blood glucose levels never get down to healthy baseline levels.
 

How to Take It

You can take the RPG at any time. You just need to go to a lab to get your blood drawn.
 

Results of the RPG

If your value is… Then…
Up to 199 mg/dl
Your blood sugar is considered normal.
Over 200 mg/dl
You may have diabetes.

 

Pros and Cons

The RPG is easy for you to take. You do not need to be fasting, and it can be done at any time of the day. It takes only one blood draw.

On the other hand, the RPG is not a good prediabetes test. It is likely to be used only when your doctor suspects that you have diabetes, or as a test to see whether you might need a FPG, A1c, or OGTT test. Your RPG can vary depending on time of day, stress level, whether you smoked or exercised, and other factors.

 

After Your Prediabetes Test


Follow up with your doctor when you get the results of your prediabetes test. Your doctor can tell you what the results mean. The likely possibilities are:

Prediabetes Test following Gestational Diabetes with Lark
  • Everything is fine for now – good job!

  • You need another prediabetes test to confirm the results of the first test.

  • You have prediabetes.

Continued Blood Sugar Testing

You will need another prediabetes test at some point. If you do not have prediabetes now, your next test may be within another 2 to 5 years, depending on your risk factors and your healthcare provider’s recommendation. 

If you do have prediabetes, your healthcare provider will tell you how often to retest your blood sugar. The ongoing tests will let you know how well your prediabetes management plan is working. You may get your blood sugar tested every year or more often.
 

Consider a Diabetes Prevention Program (DPP)

If you have prediabetes, you can work to lower your blood sugar levels with healthy lifestyle changes. Losing extra weight, increasing physical activity, and improving your diet can all be effective. They can delay the onset of type 2 diabetes, prevent it altogether, or even reverse prediabetes.

The CDC-recognized Diabetes Prevention Program (DPP) is a proven strategy for implementing these changes. A DPP may be covered by your health insurance. It includes a year-long curriculum that you can cover in in-person meetings or through a digital DPP, such as Lark. Lark is available on your smartphone and it includes coaching on prediabetes and other aspects of health.