“Pre-diabetes, such as impaired glucose tolerance, is important to manage in advance”
Chuseok is expected for a rich Mid-Autumn Festival and delicious food, but it is not just enjoyable for people with high blood sugar. This is because you need to be careful about high-calorie holiday foods. According to one study, blood sugar in diabetic patients rises by about 12% on average before and after Chuseok. In the case of diabetic patients, blood sugar rise may come as a diabetic complication due to poor blood sugar control. If so, should people diagnosed with pre-diabetes such as impaired glucose tolerance need to be managed?
Impaired glucose tolerance is classified as pre-diabetes along with impaired fasting glucose. Endocrinologist Lee Wan-gu explained the difference between impaired glucose tolerance and impaired fasting glucose.
Can pre-diabetes be managed as little as non-diabetes? In this regard, Pil-hoon Song, an internal medicine doctor, explained the importance of pre-diabetes management, and Sang-wook Lee, a family medicine doctor, explained how to manage impaired glucose tolerance.
Lastly, Dr. Lee Wan-koo and Dr. Lee Sang-wook expressed their opinions on food intake during Chuseok holidays.
◇ What is impaired glucose tolerance?
It means ‘a state in which glucose tolerance develops and does not function properly’. The postprandial blood sugar level is out of the normal range but does not reach the diabetic level. Impaired glucose tolerance can be diagnosed when the blood glucose level is between 140 and 199 mg/dL in an oral glucose tolerance test or 2 hours after a meal.
◇ What is the difference between impaired glucose tolerance and impaired fasting glucose?
“Endocrinologist Lee Wan-gu”
When blood sugar is normal 2 hours after a meal, but only fasting blood sugar is high, it is called fasting blood sugar disorder. Conversely, when fasting blood sugar is normal but only high blood sugar after a meal is called impaired glucose tolerance. Some people have high both fasting and postprandial glucose, that is, both impaired fasting glucose and impaired glucose tolerance. Together, these two are called prediabetes.
The American Diabetes Association and the Korean Diabetes Association recommend that high-risk groups, including those with a family history, perform glycated hemoglobin, fasting blood glucose, and glucose tolerance tests once a year from the age of 30. But even before that, if you have symptoms or have blood sugar levels that suggest you have diabetes, you may need to be tested.
◇ Pre-diabetes, such as impaired glucose tolerance, is it dangerous?
“Physician Song Pil-hoon”
It is important to know that prediabetes can progress to diabetes if mismanaged. Usually we get a lot of press and TV about diagnosing diabetes or about its complications, but not so much about these pre-diabetes.
Even at national check-ups, there are cases where people look at fasting blood sugar and say “there is a possibility of diabetes”. About 50% of prediabetes lead to diabetes, and complications may already begin in prediabetes. In addition, the risk of cardiovascular complications increases by 50% compared to normal, so management is absolutely necessary.
At this stage, exercise, proper weight management, and diet can prevent diabetes from progressing, so it is important to manage it diligently from the pre-diabetes stage.
◇ When I have impaired glucose tolerance, can I adjust my diet a little less if I just exercise?
“Family Medicine Doctor Lee Sang-wook”
There are many reasons to exercise. Since muscles are the space that consumes and stores energy, it is partly for the purpose of building that muscle, and also to prevent blood sugar from rising by taking a light walk after meals to regularly consume energy. However, in diabetes, it is not important that blood sugar simply rises.
Originally, ‘sugar’ is the energy source that we need to live, but if only ‘sugar’ in the blood vessels is high, it is not used as an energy source for me to live, but just disappears without being used by my body. However, high sugar in blood vessels itself is also a problem, so it is necessary to lower the sugar through exercise or diet control.
It is also important to make the ‘sugar’ in the blood vessels, which is essential, be used as an energy source for each organ in the body. In other words, it is not simply a matter of high or low blood sugar.
Therefore, it is important to control diet along with exercise. Since the main source of blood sugar eventually comes from the food we eat, poorly controlling this diet and controlling it with exercise alone can be out of balance. Therefore, rather than exercise or diet, one of the two is more important, it is better to check the parts you need and then make a balanced adjustment together.
◇ Should a person diagnosed with impaired glucose tolerance be careful about food during Chuseok holidays? Should I not eat holiday food at all?
“Endocrinologist Lee Wan-gu”
Diabetics or pre-diabetic patients should be careful about Chuseok foods.
Delicious Chuseok foods such as rice cakes, jeon, songpyeon, sikhye, Hangwa, and japchae are not only high in carbohydrates but also high in calories. Pre-diabetes patients are not yet diabetic, so they can eat relatively freely compared to diabetic patients in terms of eating, but if they eat too much Chuseok food, blood sugar rises and the possibility of developing diabetes increases, so be careful.
It is necessary to eat food but not to overeat, and to consume it by taking a walk after eating. Drinking a glass of water before a meal or eating slowly can make you feel full faster, so you can avoid overeating.
“Family Medicine Doctor Lee Sang-wook”
If you are diabetic, you should of course be careful about Chuseok food. However, people with impaired glucose tolerance do not need to eat unconditionally or be overly cautious. However, I think that knowing what I eat and eating it will help me stay healthy.
Carbohydrates are the main ingredient in most holiday foods, such as rice cakes, pancakes, fried rice, and japchae. This in turn can directly affect blood sugar elevation and weight gain. Therefore, when eating these foods, it may be helpful to reduce the amount of food by half or a third of the usual amount.
In addition, if you eat foods rich in fiber such as vegetables before eating these carbohydrate foods, you can increase the feeling of satiety and reduce the intake of excessive holiday foods. In addition, if you think you have eaten excessively, you can induce the effect of intermittent fasting by fasting for at least 16 hours afterward, and you can reduce the effects of sudden weight gain and excessive calorie intake due to holiday food.
Above all, there is no need to be afraid because you have impaired glucose tolerance, but if you eat the same amount of food as before, or if you eat more than usual because of a holiday, it can affect postprandial blood sugar rise and weight gain, so make a plan to eat a certain amount in advance. One way is to consume it after standing up.
Help = Hidak Counseling Doctor Lee Wan-gu (endocrinologist), Hidak Counseling Doctor Lee Sang-wook (family medicine specialist), Internal Medicine Director Song Pil-hoon
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