2023-11-14 08:07:36
It is one of the most common chronic diseases. To date in France, more than 3.5 million people live with treatment for diabetes, more than 90% of whom suffer from type 2 diabetes, which mainly affects adults. But the disease does not appear overnight; it is preceded by a more or less long and silent phase of blood sugar dysregulation, called prediabetes.
A crucial moment to delay or even avoid the switch to diabetes. This state of prediabetes – or moderate hyperglycemia – is reversible, provided you adopt an appropriate lifestyle. Balanced diet and physical activity are the prescription. On the occasion of World Diabetes Day this Tuesday, 20 Minutes gives you the details.
An intermediate and silent stage
But prediabetes, kézako? ” Glycemia [taux de sucre dans le sang] Normal is below 1.06 grams of glucose per liter of blood (g/l) on an empty stomach. Diabetes appears with blood sugar above 1.26 g/l, checked twice. The area in between constitutes prediabetes, explains Dr Pascal Goncalves, aka Dr Food, general practitioner and author of Better to prevent (ed. Thierry Souccar). The problem with prediabetes is that it is silent: it can be asymptomatic for years, but if we do nothing, it is a risk factor for the development of type 2 diabetes and pathologies. cardiovascular, heart attack and stroke. Hence the importance of prevention.”
In his office, Raphaël Gruman, nutritionist, sees “many patients with prediabetes but who don’t necessarily know it because there are no suggestive signs. Most of the time, it is men aged 40 and over with inadequate dietary habits, and women approaching menopause who consult me, because they would like to lose weight but cannot. If prediabetes is suspected, I prescribe two tests, the Quicki index and the Homa index.
Once the diagnosis has been made, “it’s time to ‘take advantage’ of this moderate hyperglycemia to raise patients’ awareness of the two essential pillars for delaying or even avoiding diabetes: eating a healthy diet and practicing regular physical activity,” explains Dr. Goncalves. In general, the message is well received. “Diabetes scares patients: they all say: ‘I don’t want to become diabetic’, because they all have someone around them who is, or even who has to receive daily insulin injections. The announcement of prediabetes has the effect of an electric shock.”
No diet, but a dietary rebalancing
First step, therefore: review the diet. “At 50, my glucose readings went up,” says Guillaume, 54 years old. But after three yoyo effect diets, I said stop! And now I have treatment. I’m a little careful, but not too much.” The problem “is that he talks about restrictive diets, which never work in the long term,” emphasizes Dr. Goncalves. On the other hand, the Mediterranean diet, as a dietary model, is effective. It favors plants, whole grains, legumes and nuts and olive oil, limited consumption of animal products (fish, poultry, eggs, dairy products). And avoid red meat and cold meats, he explains. Its modernized version, the 3V “diet”, for “eating real, plant-based and varied foods”, with the least amount of ultra-processed products – full of sugar, salt, fats and chemical additives – is what’s right. better “.
In practice, “I initially prescribe total withdrawal from sugar,” explains Raphaël Gruman. I cut out all intakes: simple sugars, added to the diet (chocolate, jam, desserts, pastries, etc.), but also complex sugars contained in starchy foods, pasta, rice and bread. This protocol lasts a few weeks, then we gradually reintroduce complex sugars: starches and whole grains, with the lowest glycemic index, and no more than one serving per day. Patients generally observe this phase well because they do not want to become diabetic with lifelong treatment. Especially since initially, they mainly consult me to lose weight, and the very rapid result is motivating.”
Simple sugars “are reintroduced much later and under conditions: they must not be eaten in isolation, insists Raphaël Gruman. If you eat a pastry in the middle of the day, as it is not mixed with the food, the sugar will very quickly rise in the blood and generate hyperglycemia. On the other hand, associated with other non-sweet foods, the passage of sugar into the blood is much more gradual. This is common food sense, valid for everyone, (pre)diabetic or not.” “Many associate pleasure with junk food, as if we cannot enjoy ourselves by eating healthily,” adds Dr. Goncalves. “I changed my diet by removing what was harmful, without any feeling of lack,” confirms a reader. In one year, I lost 9 kg without effort or frustration, and regained impeccable blood sugar levels.”
“Not sitting”
Second component: physical activity. “The starting point is not to sit,” says Dr. Goncalves. It’s not a question of jogging three times a week or cycling two hours overnight, but of fighting against a sedentary lifestyle. This can be walking, gardening, doing crafts or walking the children to school, everything as long as you are not sitting and you feel pleasure doing it, to last over time. Because the point of changing your lifestyle is to maintain it for life. And to be regular: it’s better to walk 10 minutes every day than an hour on Sunday. This is why I write about the prescription to take the dog out for 10 minutes three times a day. It makes them laugh at first, but they do it and derive well-being from it on a daily basis.”
If they are sedentary, “brisk walking is a good start, as are flexibility exercises, yoga and core strength: simple and quick activities to incorporate into daily life,” explains Raphaël Gruman. And those who are athletic, I offer them hiit-type exercises, shorter and at high intensity, to counter insulin resistance.” Measures that work. “More than 90% of my prediabetes patients escape diabetes with a balanced diet and regular physical activity,” reassures the nutritionist. Especially since “this lifestyle modification prevents the worsening of diabetes and its therapeutic escalation in the long term, and also limits the risks of stroke, heart attack, depression, certain cancers or osteoporosis,” adds Dr. Goncalves. And if you become diabetic, you must not stop your efforts, warns the doctor. Otherwise, instead of needing one medication per day, you will need two. And instead of two, you will have to receive insulin shots! »
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