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Q:I am a borderline diabetic. I have been trying to lose weight, but I just do not have the energy to exercise. Could you help me out on a diet plan or give me some options to take?
--Anonymous in King George
A:If you're a borderline diabetic, this means your body is not handling carbohydrates very well.
When a person's blood sugar rises higher than normal, but not high enough to be considered diabetic, doctors say the person has borderline diabetes. One of the best ways to improve blood-sugar levels is to increase physical activity.
Often, adults who develop diabetes have problems with insulin, the hormone that is supposed to rein in blood sugar. There are two major types of problems. If your body does not make enough insulin, blood sugar jumps out of control. It's as if a person whispered a command to her pet dog, but the dog didn't hear it.
The second type of problem happens if the body makes insulin, but the insulin is not effective.
This is called insulin resistance. This is more like the pet dog ignoring his master's shouted commands. Exercise has been shown to make the body obey insulin's command to control blood sugar.
You are wise to try to lose weight, because losing only 10 to 20 pounds helps lower blood sugar.
You asked for a diet plan, but dieting alone is not an effective way to lose weight. When you cut back on food, your body goes into starvation mode, and your metabolism slows down. This means you burn fewer calories. The best way to lose weight is
to reduce your calories and increase your physical activity, which burns more calories. This keeps your metabolism normal, sort of like keeping a furnace stoked. If you only diet, the flames die down to embers.
Physical activity does not have to mean going to a gym. You could take walks, garden, go dancing, whatever you enjoy. Being active actually makes you have more energy. If you truly "don't have the energy" there may be more wrong with you than just blood sugar, and you need your doctor to examine you for thyroid problems, depression and other causes of fatigue.
A diet plan to accompany your exercise would depend on your age, height, weight and level of physical activity. The eating plan would also need to be tailored to fit your lifestyle: whether you eat meals at home or away, how many meals you like to eat each day, what your favorite foods are, if you have special religious beliefs or other food preferences, whether you have other health problems, etc.
In other words, I can't give you a realistic eating plan without more information.
Because diabetes is a serious condition, but one that can often be controlled with diet and exercise, I urge you to make an appointment with a registered dietitian or a certified diabetes educator for more in-depth counseling than I can provide in this column.
I can give you some general advice:
Even though your body has a harder time with carbohydrates, you probably need to get at least half your calories from carbohydrates.
While you shouldn't overdo sweets, it's okay to have small portions of desserts, especially if you balance them with foods that have protein or fat.
The American Diabetes Association recommends getting 10 to 20 percent of your calories from protein and the rest from fats and carbohydrates. It also recommends limiting saturated fats--animal fats found principally in meat, regular dairy products and tropical oils.
Eat four to six small, frequent meals rather than one or two huge meals. Eating every few hours keeps your blood sugar more level.
Try to eat more than five servings of fruits and vegetables per day. A recent study showed that people who ate more fruits and vegetables had a lower risk of developing diabetes.
Be physically active for at least 30 minutes a day.
If you smoke, cut back or quit.
Limit alcohol to one drink per day if you are female, or two if you are male. More alcohol can throw your blood sugar out of whack.
Ask you doctor to refer you to a dietitian or diabetes educator for a practical plan. Good luck!