Diabetes screening and Pre-Diabetes
Ms Chan: Good morning, Doctor
Doctor: Good morning, Ms Chan You're back for your annual check up today
Your record shows that you are 50 years old
Your body mass index, or BMI, is over 23 which means you're overweight
And your waist circumference is over 80 cm
which means you're centrally obese
Your age and obesity increase your risk of Diabetes
I recommend that you have a blood test to check for Diabetes
Ms Chan: You mean I may have Diabetes? Who may be at risk of this disease?
Doctor: Diabetes is a common metabolic disease
People at risk include
those who are over 45 years old
and are overweight or obese
those who lead a sedentary lifestyle
those with a family history of Diabetes
for example, those with a parent or sibling who has Diabetes
women with a history of Gestational Diabetes
or who have given birth to a baby over 4 kg
and women with a history of heart disease, stroke
hypertension or polycystic ovarian syndrome
I would recommend that people with these risk factors have a blood test to check for Diabetes
Ms Chan: I don't feel sick, so I should be healthy, right?
Doctor: Many Diabetes patients may show no symptoms at all
Blood tests can help us diagnose and control this disease as early as possible
Diabetes is a common chronic disease
Persistently elevated blood sugar levels may lead to serious complications
which may damage our eyes, kidneys, nerves, heart or blood vessels
Ms Chan: I'm afraid of blood tests. Can I just do a urine test?
Doctor: The urine of Diabetes patients may not contain sugar
so having only a urine test is not reliable
We'll first arrange a fasting blood test for you
In the case of any abnormal readings, we'll arrange a second blood test
which is an oral glucose tolerance test
Hence, a blood test is necessary to check if you have Diabetes or not
The nurse will explain the details to you later
Ms Chan: OK, then. Please arrange the blood test
Pre-Diabetes
Ms Chan: Hi, Doctor
Doctor: Hello, Ms Chan
Let's go over the report of your blood tests
Neither the fasting blood test
nor the oral glucose tolerance test
shows that you have Diabetes
However
your blood sugar level is higher than normal
which means you have Pre-Diabetes
Pre-Diabetes patients can delay or prevent Diabetes by improving their diet
and increasing their level of physical activity
Otherwise, 15 to 30 percent of Pre-Diabetes patients
will progress to Diabetes within 5 years
Ms Chan: I don't even eat that much sugar
Why is my blood sugar level so high?
Doctor: Usually our endocrine system can keep our blood sugar level stable
The pancreas secretes insulin, which controls our blood sugar level
and prevents drastic fluctuations caused by our diet
However, if insulin secretion is insufficient
or if sensitivity of the body's cells to insulin decreases
our blood sugar level may increase and even remain at a high level
Being overweight or obese will decrease the sensitivity of the body's cells to insulin
so eating too much sugar is not the only cause of elevated blood sugar levels
Ms Chan: I see
So are there many people like me?
Doctor: According to the Department of Health Population Health Survey 2014/2015
8 out of 100 Hong Kong people over 15 had Diabetes
In a mainland survey about the prevalence rate of Diabetes
it was found that 36 out of 100 people were Pre-Diabetic
These show that Pre-Diabetes and Diabetes are very prevalent
Ms Chan: My blood sugar level is just slightly higher than normal
It hasn't reached Diabetes-level yet
So it should not affect my health a lot, right?
Doctor: Not really!
Persistently elevated blood sugar levels can gradually cause damage to small blood vessels
and are particularly harmful to the eyes, kidneys, nerves, heart and blood vessels
In severe cases, it can lead to hypertension, kidney impairment, neuropathy and retinopathy
If you don't manage your condition properly
you may develop Diabetes
which in turn increases the risks of heart disease, stroke and even death
Ms Chan: Then how can I prevent Pre-Diabetes from becoming Diabetes?
Doctor: There are ways to do that
You can lose weight, increase your level of physical activity and improve your diet
Research shows that, with an improved lifestyle
the number of Pre-Diabetes patients who develop Diabetes
can be reduced by more than 50% after 2 years
Ms Chan: Then what should I do in my daily life
Doctor: Start by improving your diet
Control the size and timing of your meals
Having small but frequent meals can prevent blood sugar levels from becoming drastically elevated
When you feel thirsty, you should drink water, tea or sugar-free beverages
Avoid sugary and soft drinks
To maintain a balanced diet
you should eat at regular hours and abide by the proportions indicated on the Healthy Eating Food Pyramid
You should also control your intake of carbohydrates
such as rice, noodles and bread at each meal
Your diet should be low in fat, salt and sugar
Ms Chan: Can I drink fruit juice?
Doctor: No, please avoid fruit juice because it contains lots of fructose
It's better to eat fruit directly because fruits are rich in vitamins and fibre
But avoid eating too much fruit in one go
Ms Chan: Must I eat very little rice from now on?
Doctor: If you restrict your rice or grain intake too severely
you may feel dizzy as your blood sugar drops too low
You should limit your intake to an appropriate amount
Blood sugar levels can be stabilised by a high-fibre diet
With the help of fibre
your body will take a longer time to absorb carbohydrates, decreasing the demand for insulin
You should eat more whole-grain food
such as wheat bread, oatmeal, brown rice and red rice
Include at least one bowl of vegetables
squashes or mushrooms at lunch and at dinner
Ms Chan: Do I need to lose weight?
Doctor: Yes
Weight loss can help improve control of your blood sugar levels
and increase sensitivity of the body to insulin
It allows the body to use insulin more effectively
lowering the pancreas's workload and the risk of Diabetes
Since you're overweight, losing weight is your prime task right now!
A weight loss of 5 to 10 percent can prevent Pre-Diabetes from developing into Diabetes
and even help you return to a normal blood sugar level
Ms Chan: Then how can I lose weight?
Doctor: In addition to maintaining a good diet, you should exercise more
For at least 5 days a week
you should take part in no less than 30 minutes of moderate-intensity physical activities
These are activities during which you can speak but not sing
such as speed walking and stair climbing
You should also exercise for at least 10 consecutive minutes at different times during the day
Don't remain sedentary all day long
Once you've adapted to a lifestyle of regular exercise
you can then increase the frequency and duration of exercise in order to lose weight
It is also a good idea to exercise with one or two family members or friends
and turn it into a habit
Exercising is helpful for maintaining blood pressure
blood lipids and cholesterol at normal levels
thus lowering the risk of ischaemic heart disease and stroke
Ms Chan: I see. Doing exercise has lots of health benefits!
Doctor: You're right. You must also remember to come back regularly for blood tests and follow-ups.
We need to monitor your blood sugar level and health condition
to see if there is any improvement or if there's progression to Diabetes
Ms Chan: OK, I've got it
Doctor: One more thing. Avoid smoking or drinking
in order to decrease the risk of developing cardiovascular diseases
including ischaemic heart disease and stroke
Doctor: I also encourage you to join a weight management workshop, which we hold regularly
You should also see a dietitian in your community
for individual consultations based on your diet and lifestyle
I have a list of dietitians here for your reference
Ms Chan: I will. Thanks, Doctor
Key points about how Pre-Diabetes patients should eat
Narrator: Following the doctor's advice
Ms Chan met with a dietitian who reviewed her diet
The dietitian also gave her some dietary tips for Pre-Diabetes patients
Let's check out their conversation
Ms Chan: My doctor said my blood sugar level is too high
which means I have Pre-Diabetes
How should I adjust my diet?
Dietitian: Pre-Diabetes patients must have regular meals
and control how much they eat in each meal
Having breakfast, lunch and dinner at regular hours every day
is important for maintaining stable blood sugar levels
This not only helps you control portion sizes
but also helps you to avoid feeling hungry
We tend to overeat when we are hungry
which may lead to drastic fluctuations in blood sugar levels
Dietitian: Apart from eating regularly, you must also control your carbohydrate intake
Carbohydrates are found in several types of food
including grains, dried beans, and starchy vegetables.
It also includes fructose found in fruits
lactose found in milk
and any sugars added to food
All of them directly affect blood sugar levels
Dietitian: So we suggest that Pre-Diabetes patients
should evenly distribute their carbohydrate intake among their three main meals and snacks
They should also avoid foods and drinks with lots of added sugar
and choose high-fibre foods to stabilise their blood sugar levels
Ms Chan: Should I stop eating rice?
Dietitian: No. Having a moderate amount of grains at each meal can stabilise blood sugar levels
You can choose grains that are high in fibre
such as brown rice and oatmeal, to help you feel full longer
Dietitian: On average, a woman needs about 1500 kilocalories per day
You can have 5 Carbohydrate Exchanges
at each main meal and 1 Carbohydrate Exchange at each between-meal snack.
Dietitian: 1Carbohydrate Exchange is approximately 1 full tablespoon of cooked rice,
which contains about 10 g of carbohydrates
5 Carbohydrate Exchanges are approximately
5 full tablespoons of cooked rice, or 1 level bowl of rice
We are talking about a bowl of about 300 ml here
Dietitian: If you don't want rice at a main meal
you can have 1 level bowl of rice noodles or
1 full bowl of egg noodles instead
For an 8-slice–per-pound loaf of bread
you can eat two and a half slices of bread without the crust
Dietitian: Remember to avoid mixing gravies or sauce in rice or pasta dishes
Gravies and sauces are made with sugar or corn starch
so they'll increase our carbohydrate intake and affect blood sugar control
Baked rice, fried rice or noodles also contain lots of oil
so you'll gain weight if you have them frequently!
Ms Chan: Can I eat fruits? My favourite fruit is grapes
Dietitian: Fruits are rich in nutrients
Pre-Diabetes patients can have fruits every day, but in moderate amount
Since fruits contain fructose
eating too much in one go will affect your blood sugar level
You should also avoid fruit juice
Dietitian: You can eat whole fruits as a between-meal snack
Each portion should equal 1 Carbohydrate Exchange
which is about 10 g of carbohydrates
Dietitian: For example, 1 small orange,
either half a medium apple or pear, 1 kiwifruit
either 1 finger banana or half a small banana,
or 10 small grapes
Ms Chan: So I can eat 10 small grapes as a snack
and I should remember not to eat too much fruit in one go.
Dietitian: That's right!
Ms Chan: What other snacks can I eat?
Dietitian: You can choose a snack that contains 1 Carbohydrate Exchange
which is 10 g of carbohydrates.
Apart from fruits, you can also have half a slice of bread without crust
2 pieces of soda crackers, or one-third of a corn cob
Dietitian: Having milk or dairy products as snacks can increase your calcium intake
For example, you can have either 1 cup of 240 ml low-fat or skimmed milk
or 1 tub of 150 ml low-fat low-sugar plain yoghurt
Ms Chan: What about meat?
What do I have to keep in mind when having meat?
Dietitian: You can have 5–6 taels of meat, fish, eggs or their alternatives per day
which is the same amount recommended for an average adult
One tael of meat is about 3 to 4 slices of meat
Apart from blood sugar control
Pre-Diabetes patients must also maintain a healthy weight
This will keep your blood pressure normal and your heart and blood vessels healthy
reducing the risk of cardiovascular disease
Dietitian: When you cook meat, remember to trim off the skin and fat
You should also avoid offals
Dietitian: Choose fresh meat, fish or seafood
and avoid those that are processed or preserved, so that you don't consume too much salt
Ms Chan: You don't have to worry about that.
I seldom cook with sausage, luncheon meat or salted fish
Dietitian: That's great. You should keep it up!
Dietitian: Talking about fish
remember that fish and seafood should also be included
in your daily quota of 5–6 taels of meat
You should choose more fish, especially oily fish
which contains more omega-3 fatty acids and is good for your heart
Ms Chan: I usually steam or stew my meat and fish
Can I keep on doing that?
Dietitian: Absolutely!
You can also stew and boil your food more often
because these are low-fat cooking methods
Whether you are cooking your own food or dining out
you should avoid high-fat and high-sugar cooking methods
which include pan-frying, deep-frying
frying with sauce, cooking in sweet and sour sauce, and braising in oil
Ms Chan: What should I drink when I dine out? Is water my only choice?
Dietitian: Plain water is naturally the best choice
For other drinks, you should opt for 'no sugar'
Suitable drinks also included plain tea, lemon water or tea without sugar
lime soda without sugar, and sparkling mineral water
Ms Chan: What about packaged drinks?
Dietitian: Pay attention to the food ingredients list on the package before you buy drinks
Don't buy drinks that contain sugar
for example granulated or cane sugar or syrup
because such high-sugar drinks will affect your blood sugar levels!
Also, don't overdrink even if the products claim to be 'low-sugar', 'sugar-free' or 'artificially sweetened'
It is because those drinks still contain carbohydrates
Absorbing a lot of carbohydrates will increase your blood sugar levels!
Ms Chan: I see. So, I should avoid any drinks with sugar
Dietitian: That's right
Ms Chan: I have soup with my family every night. What should I keep in mind regarding soup?
Dietitian: Generally speaking, squashes, and leafy vegetables don't increase the soup's carbohydrate content
so you can prepare soup with hairy gourd, loofah, spinach, tomato, or winter melon, for example
Dietitian: Ingredients with higher sugar content such as dried dates
preserved dates, figs and longans increase the soup's carbohydrate content
so you should use them sparingly
Ms Chan: Can I eat the soup ingredients?
Dietitian: For soup ingredients like root vegetables, starchy vegetables,
dried beans and fruits
you should exchange their carbohydrate content with that of rice
to control and limit your carbohydrate intake at each meal
Let me show you some examples of food
that should be exchanged with 1 full tablespoon of rice
These include: 1 piece of potato equivalent to the size of an egg
2 pieces of carrots, lotus roots or pumpkin equivalent to the size of 2 eggs
one-third piece of corn cob; 2 chestnuts
4 level tablespoons of cooked dried beans
one-third bowl of soaked vermicelli or mung bean threads
Another thing: you should prepare soup with low-fat ingredients
such as tofu, dried scallops, dried octopus, chicken without skin
lean meat and fish tails
Avoid high-fat ingredients like pork bone, chicken feet, chicken with skin and fish heads
They affect your weight control
Ms Chan: My daughter sometimes takes me out for dessert
What should I do then?
Sweet soups and desserts are usually made with lots of sugar and syrup
so you should reduce the amount and frequency of eating them
Try to discuss with your daughter and maybe sharing a dessert together in order to reduce your sugar intake
Or you can enjoy some fresh fruits with your daughter as an alternative!
Ms Chan: Sometimes I ask her to take a walk with me after dinner
We have a chat and then go home to enjoy some fruits
That is even better than having sweet soup!
Dietitian: Good thinking! One more thing
Chinese sweet soups often contain high-carbohydrate ingredients such as root vegetables
fruits and dried beans
When eating, you have to exchange them with other sources of carbohydrates
Ms Chan: I know I can't eat too much sweet foods
How about artificial sweeteners?
Dietitian: Artificial sweeteners make food taste sweeter
Using a small amount of them wouldn't affect blood sugar levels under normal circumstances
However, just because you are using artificial sweetener
doesn't mean you can forget about the existing carbohydrates in the food
Overconsuming such food will still increase your blood sugar levels
Ms Chan: Your detailed explanation has taught me a lot about dietary management
Thank you!
Narrator: Let's recap how to delay or prevent Pre-Diabetes from developing into Diabetes
The most important rules are
lose weight, exercise more and improve your diet
Here are the key points about how Pre-Diabetes patients should eat
Have your meals: breakfast, lunch and dinner at regular hours
Have between-meal snacks in moderate amounts
Control the carbohydrate content in meals and snacks
Opt for high-fibre whole grains
Eat more vegetables
When eating soup ingredients like root vegetables
starchy vegetables and dried beans
exchange their carbohydrate content
with that of rice to control your carbohydrate intake at that meal
Avoid mixing gravies or sauce in rice or pasta dishes
Avoid food and drinks with added sugar
Have fruits, dairy products or their alternatives daily
but control portion sizes properly and avoid fruit juice
Have 5–6 taels of meat
fish, eggs or their alternatives daily
If possible, opt for fish more often and avoid fatty meat
Pre-Diabetes patients can live a healthy and joyous life!
All you need is an improved lifestyle and a good diet
For more infomation >> 실무자도 인정하는 창업다마고치 - 돈버는방법 신사임당 - Duration: 11:05. 
For more infomation >> Double RC Car 1:18 Dual Motors Rechargeable Remote Control Truck 4WD Off Road RC Truck Rock Crawler
For more infomation >> Autoboy Blackbox : Dashcam App - 12-23-2018 16:31:36 4005 S Easy Ln, Spokane, WA 99223, USA - Duration: 2:23. 
For more infomation >> Hyunda Tucson 1.6 Dizel-Otomatik Test Sürüşü ve İncelemesi - Duration: 6:42. 
For more infomation >> 20181224 And so this is Christmas - Duration: 4:37. 
For more infomation >> Le visage d'Macron en dit long affirme un proche... - Duration: 3:22. 
For more infomation >> 梁洛施患肺炎高燒！吊點滴露「皮包骨手臂」網驚呆 - 藝人故事 - Duration: 3:33. 
For more infomation >> 糖尿病筛查与前期糖尿病 - Duration: 23:27. 
For more infomation >> 糖尿病篩查與前期糖尿病 - Duration: 21:54. 
For more infomation >> GARRY'S MOD: DARKRP ► ЧИТЕРСКИЕ БУДНИ ► ХАКЕРСКАЯ ДУЭЛЬ - Duration: 10:09. 
For more infomation >> Christmas Eve service in Huntsville with fireworks show - Duration: 0:23. 
No comments:
Post a Comment