Amanda Wilde (Host): If you are at risk for diabetes, you can take steps toward never developing the disease at all. We're talking about diabetes prevention with Shelly Tang, Manager of Diabetes Initiatives at Holy Cross Health. This is Your Best Life Podcast from Holy Cross Health. I'm Amanda Wilde. Welcome, Shelly. Thank you for being here.

Shelly-Ann Tang, MPH: Thank you for having me. 

Host: I have read that one in three adults or a little more has prediabetes. Can you explain what prediabetes is and how people can know if they're at risk?

Shelly-Ann Tang, MPH: So prediabetes is a condition where your blood sugar or glucose levels are higher than normal but not high enough to be classified as Type 2 diabetes. So there are many early warning signs that may be indicative or a telltale sign that you need to pay more attention to your dietary intake and your physical activity to ensure that you're decreasing your risk of developing Type 2 diabetes.

Or even any other chronic illness such as heart disease and even a stroke. In prediabetes, the body starts to have trouble using insulin effectively, also known as insulin resistance. And so the insulin helps regulate blood sugar, and when it doesn't work well, blood sugar levels definitely will rise. Although there aren't many noticeable symptoms of prediabetes, there's definitely risks and the importance of paying attention to risk factors. Your age, being age 45 and over, increases your risk. Family history, having a parent or sibling that, has Type 2 diabetes also increases your risk.

Weight, being overweight, one of the biggest risk factors and so importance of making sure that we're staying attuned to what we're eating. Physical activity, lack of physical activity, even if it's just 30 minutes a day or 15 minutes a day, can reduce your risk of developing prediabetes as well.

Host: Now there's Type 1 and Type 2 diabetes. Can you explain the difference and would the symptoms be different? 

Shelly-Ann Tang, MPH: So Type 1 diabetes is a condition where the body can't produce insulin to help regulate sugar levels. It's usually more common in children and young adults, but it can occur at any age. Type 2 diabetes, the body still is producing insulin, but it is having difficulty using it effectively. And so almost like it's not enough of it. So over time, your pancreas starts to wear and tear from overproducing of insulin and that results in a diabetes diagnosis.

Host: So that's really hard on the body. And most people who have diabetes have Type 2, is that right?

Shelly-Ann Tang, MPH: Correct. Yes. Most individuals have Type 2, or if they've had Type 1 when they were younger, it can develop into Type 2 as they get older.

Host: So how can people at risk for Type 2 diabetes prevent or delay the onset of the disease?

Shelly-Ann Tang, MPH: So there are many steps that individuals can take and be proactive in preventing or delaying an onset of the condition. Effective strategies include maintaining a healthy weight. Again, being overweight or obese increases the risk of developing due to that insulin resistance. And so even if it's a 5 percent body weight loss, can make a very significant impact in reducing your risk.

Things that you can do, having a balanced diet that has healthy portion sizes, as much as you can, cutting down on excess calories, incorporating more fruits, vegetables, lean proteins into your meals can definitely support that. In addition, adopting a healthy diet, which is balanced, of course.

So, you know, limiting the number of sugary foods and drinks like sodas and candies and pastries and incorporating more fiber rich foods like whole grains, fruits, vegetables. Fat isn't always bad, you know, they have healthy fats and so having foods that have olive oil or that you're cooking with olive oil, nuts, avocado, and then monitoring your carbohydrate intake. A lot of foods that have that increased carbohydrates can also impact your sugar levels, as it flows into your bloodstream.

Another big piece of the puzzle is physical activity. Having regular physical activity improves your insulin sensitivity or the ability for your body to use insulin more effectively. And so aiming to do at least 150 minutes of moderate to intense exercising per week. This can include brisk walking, swimming, you know, many people like swimming, especially as the weather gets warm. But also aerobic activities, so jogging, walking, strength training, all those different opportunities can definitely maximize your benefit.

Host: Now to support people, and also particularly people who might have limited resources, do you know of some affordable, accessible options for eating healthy and getting active?

Shelly-Ann Tang, MPH: Try as best as you can to plan your meals ahead of time. So what we find is when we have those last minute food choices, they tend to be unhealthy because it's like quick, let's quick and get it. Making a shopping list when you're going grocery shopping and to prepare to make your meals because when you have a list to follow, you're more likely to stay on track with the items that you truly need, not items that you see.

Meal prepping. So, you know, as much again as you can, putting together meals in advance, storing it in the freezer, in the refrigerator, buying in bulk. And so when we buy in bulk, it is affordable, but also focusing on the healthy items oats and again, less carbs and more lean protein, and vegetables, and then buying frozen.

Frozen, is not the best option, but it is a healthier option and definitely affordable if we buy our frozen fruits to make smoothies, or other food items that can be beneficial for us in the long run. One of the big ones is cooking at home as much as we can. Oftentimes, I know, again, it's quick, it's easy, go to a restaurant, but as much as we can, cooking at home is oftentimes more affordable than eating out or ordering takeout. And so, using simple recipes, vegetable stir fries, making soups can yield an inexpensive meal as well.

Host: That is a really affordable option, cooking at home. And you just mentioned stir fries are a really good suggestion. Are there any local programs or resources available who can help people with this kind of changing diet and getting more exercise or otherwise want to prevent diabetes?

Shelly-Ann Tang, MPH: Yeah, so there's many programs in the community. Holy Cross Health has a Centers for Disease Control and Prevention Recognized Diabetes Prevention Program, and it's one of our most impactful initiatives that focuses on preventing Type 2 diabetes in at risk individuals across Montgomery County. And so through this Diabetes Prevention Program, participants gain resources and guidance that can help them make meaningful lifestyle changes, including healthier eating, increased physical activity, and better stress management.

So, these classes and programs are offered in person or online. And it's offered in English and Spanish, so we want to make sure we're reducing any barriers to individuals being able to take advantage of the opportunity. And so we kind of instill with our community, it's not just about numbers on a scale or A1C results, which is what's attached to a diabetes diagnosis, but it's about creating lasting changes and building a healthier future. So we encourage community members to give us a call 301-754-8291 or email us diabetespreventionprograms@holycrosshealth.org for more information and to sign up. 

Host: Shelly thanks for all you do as manager of diabetes initiatives at Holy Cross Health.

Shelly-Ann Tang, MPH: My pleasure. Thank you for having me.

Host: For more information, please visit holycrosshealth.org or you can email Diabetes Prevention Programs atHoly Cross Health.org. The phone number is 301- 754-8291. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you.

This is Your Best Life Podcast presented by Holy Cross Health.