One of the biggest threats of gaining 20 pounds is the increased risk of developing diabetes. Twenty pounds are all it takes to go from a healthy body mass index (BMI) of 21 to an unhealthy one of 25. That is the point on the BMI chart when you are classified as overweight.
Being overweight is a risk factor for developing type 2 diabetes in both children and adults.
Why the Disconnect Between Overweight and Diabetes?
When I was in private practice, many of my new clients who had gained 20 pounds came in saying they didn't like the way they looked or how their clothes fit —- as if that was all that was at stake. When I was writing The Wedding Dress Diet, many of the brides-to-be I talked to admitted they would probably gain 20 pounds after they got married —- as if it didn't matter.
Obviously, the connection between being overweight and diabetes had not hit home because whenever I asked anyone how they felt about getting diabetes, they shuddered. Being a little pudgy was one thing, having diabetes was quite another.
Sadly, the message still has not sunk in. Nearly 26 million Americans now have diabetes and three times that many are pre-diabetic - people with elevated blood glucose levels that are not quite high enough to be diagnosed as diabetes. That's an additional 75 million people who almost have diabetes!
If you or someone you know is concerned about developing diabetes, use the checklists below to recognize the risks and warning signs, then get the help you need to prevent or treat it.
Who is At Risk of Developing Diabetes?
- Overweight or obese with a BMI of 25 or higher
- Waist circumference greater than 35 inches in men and 32 inches in women
- Woman who had gestational diabetes or gave birth to a baby weighting more than 9 pounds
- Low HDL cholesterol of 35 mg/dL or less
- High triglyceride level of 250 mg/dL or more
- High blood pressure of 140/90 mm Hg or greater
- Family history of diabetes in parents or siblings
- Low physical activity level if exercising less than 3 times a week
Early Warning Signs of Diabetes
- Blurry, clouded vision - once blood sugar is lowered, vision returns to normal
- Increased thirst and hunger - not satisfied after drinking or eating
- Frequent urination - 20 or more times a day
- Always tired or fatigued - even after sleeping since cells can't get the energy they need
- Sudden, unexplained weight loss - the body is breaking down muscle and fat for energy
Tests Used to Diagnose Diabetes
- Fasting blood glucose: 126 mg/dL or greater on 2 separate tests. Blood sample is taken after not eating or drinking anything for at least 8 hours, but not more than 16 hours
- Casual blood glucose: 200 mg/dL or greater. Blood sample used is taken at any time regardless of last meal
- Glucose tolerance test: 200 mg/dL at the 2-hour reading. Blood glucose is tested after fasting, then a sweet liquid containing a known amount of sugar is consumed and blood glucose is tested periodically for up to two hours.
- Glycated hemoglobin (A1C): 6.5% or greater. Used to tell blood glucose control over the previous 2-3 months.
Goals for Treating Diabetes
- Maintain blood glucose levels as close to normal as possible with changes in diet and exercise and, if needed, medication
- Lose at least 10% of body weight to improve symptoms, maintain a BMI of 25 or less to eliminate diabetes
Dietary Objectives for Diabetes
- Eat meals and snack at the same times every day
- Distribute total calories evenly among meals, don't skip meals or eat just one or two big meals
- Increase soluble fiber content in meals from oatmeal, oat bran, beans, lentils, barley, flax seed, nuts, apples, pears, oranges celery, and carrots.
- Control the type of carbohydrates eaten by choosing "whole grain" breads and cereals over refined grains, raw and cooked vegetables and whole fruits instead of juice.
- Limit the amount of carbohydrate to 45-60 grams per meal, including carbohydrates from added sugars
- Pay attention to all of the ingredients in "sugar free" foods and those made with sugar substitutes
- Use healthier fats and oils, such as olive and canola oil, and limit saturated fat and trans fat to reduce heart disease risk
See these related stories on diabetes.