Lifestyle Medicine Is the Standard of Care for Prediabetes

Lifestyle Medicine Is the Standard of Care for Prediabetes

“Lifestyle Medicine Is the Standard of Care for Prediabetes” For people with prediabetes, lifestyle modification is now considered
the cornerstone of diabetes prevention. Diet-wise that means individuals
with prediabetes or diabetes diabetes should aim to reduce their intake of excess
calories, saturated fat, and trans fat. Too many of us consume a diet with too many
of these solid fats as well as added sugars. Thankfully the latest dietary guidelines aim
to shift consumption towards more plant-based foods. Lifestyle modification is now the foundation of the
American Association of Clinical Endocrinology guidelines, the European Diabetes Association guidelines, as well as the official standards of care
for the American Diabetes Association. Dietary strategies include reduced intake of fat, and increased intake of fiber, meaning
unrefined plant foods including whole grains. That’s based on research like this. We’ve known eating lots of whole grains is associated
with a reduced risk of developing type 2 diabetes. This recent study took it further,
demonstrating that whole grain consumption may also protect against
prediabetes in the first place. To help prevent diabetics from dying, recommendations should focus on the reduction of
saturated fat, cholesterol, and trans fat intake, which is basically code for meat
and dairy, eggs, and junk food, and increases in omega 3’s,
soluble fiber, and phytosterols, all of which can be found packaged
in flax seeds, for example, an efficient but still uncommon
intervention for prediabetes. They found that about 2 tablespoons
of ground flax a day decreased insulin resistance, which
is the hallmark of the disease. So if the standards of care for all
the major diabetes groups says that lifestyle is the preferred
treatment for prediabetes because it’s so safe and highly effective, why don’t more doctors do it? Unfortunately, the opportunity to treat this
disease naturally is often unrecognized. Only about 1 in 3 patients report ever
being told about diet or exercise. Possible reasons for not counseling
patients include lack of reimbursement, lack of resources, lack of time, lack of skill. We’re just not teaching doctors how. The inadequacy of clinical education is a consequence
of the failure of health care and medical education to adapt to the great transformation
of disease from acute to chronic – from broken legs to broken hearts. Chronic disease is now
the principal cause of disability, consuming three quarters
of our sickness-care system. Why has there been little academic response
to this rising prevalence of chronic disease? Maybe it’s because doctors aren’t getting paid to do it. Attempting to change to a rational chronic
care model is practically unthinkable in the absence of radically changed compensation. Why haven’t reimbursement policies been modified? One crucial reason may be a failure of leadership
in the medical profession and medical education to recognize and respond to this
changing nature of disease patterns. How far behind the times is the medical profession? A report by the Institute of Medicine
on medical training concluded that the fundamental approach to medical
education has not changed since 1910.


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