I have suffered from hyperglycemia for years: I follow a limited diet, both quantitatively and qualitatively; I do not smoke; transaminases, triglycerides and blood pressure are normal; cholesterol at 175 (I take statins on prescription); I’m not overweight and I walk every day. If I developed type 2 diabetes – in the family there is a precedent from an uncle -, even if the values are not very high, would it be necessary to treat it with drugs or would I only be forced to eat an even more restricted diet? A dietician some time ago, only for hyperglycemia, had indicated a regime based on legumes, vegetables and fruit. I’m scared by this prospect: food and eating well – even with due attention – is very important to me.
He replies Silvana CostaEndocrine Diseases Unit, San Bortolo Hospital, Vicenza, Association of Diabetologists (GO TO THE FORUM)
The hyperglycemia you are referring to is probably impaired fasting blood sugar (i.e. a value between 100 and 125 mg/dl) and not a diagnostic blood sugar level for diabetes (blood sugar level greater than or equal to 126 mg/dl, confirmed in two blood samples taken after at least eight hours of fasting).
Risk factors
Impaired fasting blood sugar is one of the risk factors for the onset of diabetesbut there are many others that she doesn’t have: reduced tolerance to carbohydrates (which is highlighted by the oral glucose load), first degree familiarity (in your case you have a second degree relative with diabetes), overweight, hypertension, low HDL levels, high triglyceride values.
Correct lifestyle
The results of multiple randomized clinical trials performed in patients with reduced carbohydrate tolerance have shown that Diabetes prevention is achieved with a correct lifestyle. It is reasonable to hypothesize that the proposed interventions are also effective in other categories at risk of diabetes (patients with impaired fasting glycemia). The correct lifestyle includes regular physical activity (20-30 minutes a day or 150 minutes a week) and a healthy and correct diet.
What to put on the table
There Mediterranean diet has been shown to reduce the risk of developing diabetes: it is based on the prevalent consumption of foods of plant origin (legumes, fruit and vegetables), low glycemic index carbohydrates (preferably whole grains and derivatives) and extra virgin olive oilon a reduced intake of products of animal origin (rich in saturated fats), with preference for fish over meat and cheese.
Pharmacological therapy
Processed foods should be limited as much as possible. The Mediterranean diet has been shown to have positive effects on health and is a model that we should all follow. Continue as you are doing: in the case of the development of diabetes, the possible initiation of drug therapy will be based on the results of blood tests (fasting blood sugar and glycated hemoglobin).
