Prof Jennie Brand-Miller answers your questions about pre-diabetes. 
How do I know if I have pre-diabetes? You don’t. There are no specific signs and symptoms. But, carrying extra body fat (especially around the middle) tends to go hand in hand with pre-diabetes. There are also a number of risk factors such as a family history of diabetes; having diabetes in pregnancy or giving birth to a big (more than 4kg) baby; having PCOS; having heart disease or high blood pressure or high cholesterol; and smoking. To diagnose it, you need to have either a fasting blood glucose test or an oral glucose tolerance test. The American Diabetes Association recommends adults who are overweight or obese and have one or more additional risk factors for diabetes consider having regular testing. So, make an appointment to see your doctor.
Is pre-diabetes doing my body harm? Probably. The underlying metabolic problem in pre-diabetes (as with type 2 diabetes) is insulin resistance. This means that your body’s cells are resistant to the action of insulin. They don’t let the insulin in as easily, so blood glucose levels tend to rise. To compensate, your pancreas has to work extra hard to make more and more insulin. This eventually moves the glucose into the cells, but now your blood insulin levels stay high. Having high insulin levels all the time spells trouble. Why? Research shows that prolonged exposure to elevated levels of insulin can cause weight gain (insulin promotes the storage of fat); high blood pressure; a reduction in HDL cholesterol, an increase in LDL cholesterol, and an increase in triglycerides (all of which increase your risk for heart disease); and a higher risk for some cancers as insulin can contribute to cell proliferation.
Can pre-diabetes be reversed? Yes. The Diabetes Prevention Program (DPP) was a (US) federally funded study of 3,234 people at high risk for diabetes. It showed that people with pre-diabetes can often prevent or delay diabetes if they lose a modest amount of weight and increase physical activity – for example, walking 30 minutes a day, 5 days a week. If you think you may have pre-diabetes, visit your doctor for a check-up.
For more on pre-diabetes see Watch Out for Weight Creep in this issue's Food for Thought.
GI Product News.
Black Rice is relatively new to supermarket and health food stores. There are a range of products, some of which are glutinous rices. The one we picked off the shelf here in Australia, Forbidden Black Rice, was labelled “low GI” – so how could we resist? It is parboiled, medium-grain black paddy rice from Heilongjiang Province in north-eastern China. Parboiling speeds up lengthy cooking times. The three basic parboiling steps are soaking the grain to soften the husk; pressure steaming the grain to drive the husks vitamins and minerals into the grain; and then drying and milling of the husk. Black rice is a popular side dish on its own and can be used as a substitute for other rices, noodles, quinoa and chia seeds in many recipes, especially in salads where it adds colour and texture. However, black rice pudding is probably the most common of black rice dishes. It is also used to make porridge. On the GI Database at the University of Sydney, we have a GI value for black rice porridge from China (42). We believe that this is where the “low GI” claim comes from. Here at GI News we would like to see these new parboiled black rice products tested – and we have asked the team at SUGiRS to put them on the list along with other brands of black rice. So, watch this space. Organic black rice from north-eastern China’s Heilongjiang Province is also available in the USA through Lotus Foods.
Lower GI flours may be on the way.
New Zealand’s Farmers Mill is working with Lincoln University to investigate ways refine and improve their milled grain processes to develop a nutritional product range using specific grain and flour-based products, especially to mill flours with a low GI value. For more information contact Farmers Mill CEO Grant Bunting. We are often asked by readers about where to buy lower GI flour products, so we will keep you posted on developments.
