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yourGuiDe topreventinG type 2 Diabetes

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Diabetes preventionstarts with you.

If you are at risk for type 2 diabetes, you can try to delay or prevent developing it. Type 2 diabetes changes the way you live each day and can cause many other health problems.

If you’re an adult, especially 40 years of age or over, and overweight, you are at risk of developing type 2 diabetes. Type 2 diabetes increases your risk of:

• Heartdiseaseandstroke

• kidneydisease

• eyediseaseorblindness

• nervedamageandtHepossibility ofamputation

• erectiledysfunction(impotence)

You may not be aware you have these symptoms until it is too late.

you can stop or slow down these problems by making small, positive changes to your daily routine.

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It’s never too early or too late to make a few healthy changes. Acting now can make a difference!

here are six steps you can take to get started today:step 1: knowifyou’reatrisk.Find out if you have pre-diabetes or are at risk for type 2 diabetes.

step 2: eat well! What, when and how much you eat all play an important role in regulating blood sugar levels.

step 3: Get moving! Every bit of activity counts! Try to get at least 150 minutes of activity each week. Regular physical activity helps your body lower blood sugar levels, achieve a healthy weight, reduce stress and improve overall fitness.

step 4: achieve a healthy weight that is right foryou!Eating well and being active is an excellent start to achieving a healthy weight that is right for you. Talk to a health care professional to determine a healthy body weight for you.

step 5: record your progress.Writing down what you eat and how much activity you do can help you achieve your goals.

step 6: Get help. There are resources to help you prevent diabetes. Get support from family and friends. Discover some of the services in your neighbourhood.

takesmallsteps toabetterlife.

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what is type 2 diabetes?type 2 diabetes happens when the body has trouble using the insulin it makes or when the body does not make enough of it. About 90 percent of people with diabetes have type 2.

Insulin is a hormone that helps your body control the level of glucose (sugar) in your blood and helps the body to use the food you eat for energy.

Type 2 diabetes can be prevented by making some healthy changes to your everyday life.

what is pre-diabetes?Pre-diabetes refers to blood glucose levels that are higher than normal, but not high enough to be diagnosed as type 2 diabetes. Although not everyone with pre-diabetes will develop type 2 diabetes, many people will.

amiatriskfortype2diabetes?Factors that contribute to the development of type 2 diabetes include:

• what you weigh: Being overweight makes it harder for your body to control your blood sugar levels. It can also lead to high blood pressure and high blood fat levels.

• what you eat: Eating a healthy diet according to Canada’s Food Guide and watching your portion sizes can help you achieve a healthy weight.

• what you do: Being inactive makes it harder for insulin to deal with sugar in the blood.

• who you are: Your genes contribute to the risk of developing pre-diabetes.

You can’t change your genes, but you can do something about your eating habits and physical activity. It is important to understand that the risk of pre-diabetes and diabetes can be lowered by making some changes every day.

Find out if you have pre-diabetes or are at risk for type 2 diabetes.

step 1:

knowifyou’reatrisk.

Information in this brochure deals with type 2 diabetes only. Type 1 diabetes and gestational diabetes are also serious conditions. To learn more, visit:

• Stand Up to Diabetes www.ontario.ca/diabetes

• Canadian Diabetes Association www.diabetes.ca1-800-BANTING (226-8464)

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whatarethesignsoftype 2 diabetes?At fi rst, you may not show symptoms of diabetes. But as the disease progresses more symptoms may develop. You should take early signs of type 2 diabetes seriously.

Signs that you may have diabetes or high blood glucose levels include:

• Unusualthirst

• Frequenturination

• Weightchange(gainorloss)

• Extremefatigueorlackofenergy

• Blurredvision

• Frequentorrecurringinfections

• Cutsandbruisesthatareslowtoheal

• Tinglingornumbnessinyourhandsorfeet

• Troublegettingandmaintaininganerection

Keep in mind that many people who have type 2 diabetes show none of these symptoms. Talk to your health care provider about your risk of developing type 2 diabetes. Get tested!

If you answered “yes” to any of these risk factors, talk to your health care providerand get tested.

Don’t ignore the risk factors. Finding out early gives you a head start to staying well — now and in the future!

lookatthelistofriskfactorsandcheckoffthosethat apply to you:

I am 40 years of age or older.

I have a parent, sister or brother with diabetes.

MyfamilybackgroundisAfrican,Caribbean,Hispanic, Asian, South Asian or Aboriginal.

I gave birth to a baby that weighed over 4 kg (9 lb).

I had diabetes when I was pregnant.

I am overweight, especially around my waist.

I am physically active less than three times a week.

a health care provider has told me:

I have high blood pressure.

I have high cholesterol or other fats in my blood.

I have blood vessel problems affecting my circulation.

I live with polycystic ovary syndrome,acanthosis nigricans or schizophrenia.

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Find out if you have pre-diabetes or are at-risk for type 2 diabetes.

step 1:

knowifyou’reat-risk.

step 2:

eatwell!You can visit EatRight Ontario (ontario.ca/eatright) or call 1-877-510-5102 to speak to a Registered Dietitian for trusted, nutrition advice on healthy eating for you and your family.

When you call EatRight Ontario, Registered Dietitians can offer you help in more than 100 different languages. And it’s free to residents of Ontario.

Or you can ask your health care provider to refer you to a Registered Dietitian.

here are five changes you can make to improve your eating. Just one or two small changes are a beginning to give you long-term health rewards.

1. eat at the right timeEat meals and healthy snacks at regular times. Avoid going longer than four to six hours without eating. Regular eating can help control your appetite and avoid unhealthy snacking.

EatRight Ontario has an online menu planner designed for people who want to eat better and prevent diabetes. Learn more at ontario.ca/eatright.

2. eat smaller portions Big portions of any food can lead to weight gain. Serve your meals on smaller plates. Research shows that serving food on smaller plates can make you feel like you are eating a larger portion. Remember, portions today are often much bigger than they were in the past.

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wHat’saservingsiZe?

Handy Portion Guide©CanadianDiabetesAssociation,2005.Reproducedwithpermission.

FRUITS/GRAINS & STARCHESChooseanamountthesizeof your fi st.

VEGETABLESChooseasmuchasyoucan hold in both hands.

MEAT & ALTERNATIVESChooseanamountuptothesizeof the palm of your hand and the thickness of your little fi nger.

FATSLimit fat to an amountthe size of the tip ofyour thumb.

VEGETABLES(at least 2 kinds)

GRAINS & STARCHES

(potato, rice, corn, pasta)

MEAT &ALTERNATIVES(fi sh, lean meat, chicken, beans, lentils) FRUITS

The Plate Method ©CanadianDiabetesAssociation,2005.Reproducedwithpermission.

MILK &ALTERNATIVES

wHat’saHealtHyportionsiZe? 4.enjoyavarietyoffoodsEat a variety of foods such as, brightly-colouredvegetables and fruit, whole grain breads and cereals, lower-fat milk and milk alternatives, lean meat, poul-try, fi sh; and a variety of meat alternatives, such as beans, lentils and tofu.

5.limitthefollowing:• Foodshighinsaturatedandtransfats(andread

product labels)

• High-fatmilk,cheeseandyogurt

• Sweetenedfruitdrinks,cocktails,punchesandregular soft drinks

• Foodsthatareprocessed,deep-fried,sugary,salty or high in fat

• Alcohol3. take your timeTake the time to enjoy your meals. Wait at least 20 minutes before deciding to have a second helping. You might not want it.

• focusonfruit: Eat a variety of fruit rather than juice for most of your fruit choices.

• eat your veggies: Eat at least one dark green and one orange vegetable each day. The more colour, the better.

• selectlower-fatmilkandalternatives: Chooselow-fat/fat-freemilk,yogurtandcheese or fortifi ed soy beverage.

• makeyourgrainswhole: At least half of your daily grain servings should be whole grain.

• Go lean with protein:Chooseleanmeatsandpoultry.

• vary your protein choices: Include fi sh, beans, peas, nuts and seeds.

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try to keep these healthy eating tips in mind:at home:

• Trytogrillorbakeyourfoodsratherthanfry

• Lightenyourrecipesbyusinglower-fatingredients

• Usefreshherbsandseasoningstoaddflavour

• Freezeportionssothatyouhavemealsreadyforwhen you’re too tired or busy

• Packyourlunchthenightbeforesothat it’s ready to go

in-between meals:

• Eatvegetablesandfruit

• Drinklotsofwater

• Chewsugar-freegumbetweenmealstohelpcutdown on snacking

shopping:

• Makealistofwhatyouneedaheadoftimeandstick to it

• Trynottogoshoppingwhenyou’rehungry

• Readandcomparefoodlabels

• Fillyourcartwithfoodsthatarenotprocessed

For more tips, visit ontario.ca/diabetes, or call EatRight Ontario at 1-877-510-5102 and talk to a Registered Dietitian. It’s free and available in more than 100 languages.

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why is physical activity so important? Being physically active can reduce your risk of type 2 diabetes, heart disease and some cancers.

Additional benefits of regular physical activity include:

• Lowerbloodsugar

• Lowerbloodpressure

• Improvedhearthealth

• Weightloss

• Strongerbones

• Reducedstressandanxiety

• Increasedenergylevels

how much is enough?Adults should do a minimum of 150 minutes of moderate to vigorous aerobic physical activity each week. Activity that lasts as little as 10 minutes counts. Muscle-strengthening activities two days per week are also recommended.

whattypeofactivityisright forme?There are lots of things you can do at home and at work to get more activity throughout the day.

• Gofora15-minutewalkafterlunch.

• Takethestairs,nottheelevatororescalator.

• Walk,don’tcall,tospeaktoacolleague.

Chooseactivitiesthatarefun,easyandfitintoyourschedule.VisitthePublicHealthAgencyofCanada to get more ideas on how to get active your way.

www.phac-aspc.gc.ca

Find out if you have pre-diabetes or are at-risk for type 2 diabetes.

step 1:

knowifyou’reat-risk.

step 3:

getmoving!

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use these six tips to keepyou moving. 1. set realistic goals: Set small, attainable goals.

Celebrateinahealthywaywhenyoureacheachone.

2. start slowly: Start with a goal of 10 minutes of activity per day and gradually work up to 150 minutes of aerobic activity per week.

3. build physical activity into your day: Walk and take the stairs whenever you can.

4.makeitsocial: Instead of meeting a friend for coffee, go for a walk together. When you involve others in your activities you are more likely to stay motivated.

5.Havefun: Whatever activity you choose — make it fun. Vary your activities so that you don’t get bored. You may also get better results.

6. try and try again: It often takes several attempts to change your daily routine. If you don’t succeed the fi rst time, just try again. Stick with it!

whatifihavebeeninactiveforsometimeandihavedifficultywalkingorexercising?Talk to your doctor before starting any exercise program that is more strenuous than brisk walking.

Remember, it often takes several attempts to change your daily routine. If at fi rst you don’t succeed, try to learn from the experience, fi gure out what went wrong, then plan how to do it better. Try and try again.

A great place to start is Canada’s Physical Guide to Healthy Living website. It provides useful ways to get active and build physical activity into your daily life.

healthy eating and physical activity will:

• reduceyourriskofdiabetes,heartdiseaseand stroke

• lowerbloodpressureandcholesterol

• giveyoumoreenergy

• buildstrongerbones

• reducetheriskofsomeformsofcancer

• reducestressanddepression

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being overweight puts you atriskformanyhealthproblemsand serious diseases.Some of these are:

• Diabetes: Obesity is a leading cause of type 2 diabetes.

• high blood pressure: High blood pressure causes your heart to work harder and can lead to heart disease.

• stroke: Being overweight or obese are major risk factors for heart disease and stroke.

• abnormalbloodfats: A diet high in saturated fats and trans fats increases the level of LDL (bad) cholesterol in your body. This increases your risk of heart disease.

• cancer: People who are overweight have a higher risk of developing some kinds of cancer.

Eating well and being active will help you achieve a healthy weight that is right for you. Achieving a healthy weight will lower your risk for many diseases. Talk to a health care professional to determine a healthy body weight for you.

Find out if you have pre-diabetes or are at-risk for type 2 diabetes.

step 1:

knowifyou’reat-risk.

step 4:

acHieveaHealtHyweigHtthat is riGht for you!

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Keep a diary of your goals and progress. This will help keep you on track and will motivate you to be healthier for yourself and your family.

Createasimplecharttotrackyourgoalsandresults.See an example on the next page.

Be realistic. It is not always easy to make changes. If one goal is right for you, list only one.

At the end of each day, if you are successful, give yourself a check mark on the daily tracking form.

Remember, it often takes several attempts to change eating and activity patterns. Don’t be discouraged if at first you don’t succeed — every small step can make a big difference in preventing type 2 diabetes.

step 5:

recordyourproGress.

mytype2diabetespreventionplan

eating Goals:

consumeless

1. White bread2. White rice3. White chapatti, roti or tortilla4. Sweetened soft drinks 5. High-fat salad dressing6. White pasta7. Higher-fat milk products8. Creamypastasauces9. Fried foods

10. Lard, ghee, butter or hydrogenated margarine 11. Whiteflour12. Fruit drinks, cocktails and punches13. High-sodium, high-fat, pre-packaged meats

cHooseinstead

1. Whole grain bread2. Brown or basmati rice 3. Whole wheat pasta, chapatti, roti or tortilla4. Water and other unsweetened beverages5. Low-fat salad dressing6. Whole wheat pasta7. Lower-fat milk and alternatives8. Tomato or marinara sauces9. Steamed, grilled or baked food

10. Moderate amounts of canola, olive, corn, soybean,orsunfloweroil

11. Wholewheatflour12. Vegetables and fruit 13. Lean meats, skinless poultry and fish14. Meat alternatives such as beans, lentils

and tofu

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mon tues wed thurs fri sat sun

Walk 15 mins. X X X X X

Take stairs X X X

One less sugar drink today

X X X X

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activity Goals:

effectiveactivitygoals

1. At least 150 minutes of aerobic activity per week.2. Walk rather than take the car. 3. Get off the bus a stop or two early.4. Go for walk breaks during the day.5. Park further from the store entrance.6. Walk to work, school or for errands.7. Try an activity you loved doing and want to start

again, like cycling. 8. Have a walking date with a friend or

family member. 9. Go to your nearest recreation centre and get

information on activities right for you.10. Take 15 minutes each day to stretch and

relax with no distractions.11. Take the stairs even when there is an elevator

or escalator.

step 1:

knowifyou’reat-risk.

step 6:

getHelp.

where i can learn more and get help about:

Diabetes

• standuptodiabetes www.ontario.ca/diabetes

• canadiandiabetesassociation www.diabetes.ca 1-800-BANTING (226-8464)

• Visitontario.ca/healthcareoptionsformoreinformation on your health care options close to home.

Healthy Eating

• eatrightontario www.ontario.ca/eatright 1-877-510-5102 Easy healthy eating tips from Registered Dietitians at EatRight Ontario.

• Healthcanada www.hc-sc.gc.ca 1-866-225-0709 CreateapersonalizedCanada’s Food Guide.considerusingasimplecalendartotrack

your success.You are more likely to succeed if you set achievable goals and track yourresults.TIP:Choosethenumberofgoalsthatarerightforyou.New behaviours usually take at least 30 days before they become natural to you.

Here is what a simple calendar looks like after one week.

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Physical Activity

• publicHealthagencyofcanada www.phac-aspc.gc.ca 1-866-225-0709 Build exercise into your day every day. Find tips for home, work, school and more.

• Findmanyphysicalactivitiesavailableinyourneighbourhood. www.mhp.gov.on.ca/en/active-living/about/tools/wotfy.asp

More Information

ministryofHealthpromotionandsport www.ontario.ca/healthy Discover more information about healthy living at Ministry of Health Promotion and Sport. Search in “Active Living” for physical activities available where you live.

public health units OntarioPublicHealthUnitsofferawidevarietyofprogramsthat can help you learn to eat healthier, be more active and prevent chronic diseases. Visit www.ontario.ca/healthcareoptions and searchfor“PublicHealthUnits”tofindoutmore.

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La brochure est aussi disponible en français.

For more information, visit ontario.ca/diabetes