The 7-minute exercise plan for diabetes prevention

The 7-minute exercise plan for diabetes prevention

Exercise is overrated. I'm always reading more proof that says you don't need to run a marathon to receive the benefits of a little exercise. Like this British study that claims you can control or prevent diabetes with as little as seven minutes of exercise… per week.

The study's leader, University of Edinburgh biologist James Timmons, says that you can get the same benefits from minimal amounts of exercise as you can from workouts that last for hours. "This is such a brief amount of exercise you can do it without breaking a sweat," Timmons said.

In the study, out-of-shape men in their 20s were asked to ride an exercise bike four times each day – in 30 second bursts of pedaling – two days a week. After just two weeks, the all of the men were 23 percent more effective at processing insulin.

I've warned you many times about the potential dangers of over-rigorous exercise, so this minimalist approach appeals to me – and it should to you, too! Like I always say, skip the gym membership and just go for a walk.

Always providing your brain with vigorous exercise,

William Campbell Douglass II, M.D.
The Normal A1C Level

You want to control your diabetes as much as possible. You wouldn't be reading
this if you didn't.

So you regularly check your A1C level. This is the best measurement of our blood
glucose control that we have now. It tells us what percentage of our hemoglobin
-- the protein in our red blood cells that carry oxygen -- has glucose sticking to it.
The less glucose that remains in our bloodstream rather than going to work in the cells
that need it the better we feel now and the better our health will continue to be.

As we are able to control our diabetes better and better, the reasonable goal is
to bring our A1C levels down to normal -- the A1C level that people who don't have
diabetes have. But before we can even set that goal, we have to know what the target is.

The trouble with setting that target is that different experts tell us that
quite different A1C levels are "normal." They tell us that different levels are
normal -- but I have never heard of actual studies of normal A1C levels among
people without diabetes -- until now.

The major laboratories that test our levels often say that the normal range is
4.0 to 6.0.
They base that range on an old standard chemistry text, Tietz Fundamentals of
Clinical Chemistry.

The Diabetes Control and Complications Trial or DCCT, one of the two largest and
most
important studies of people with diabetes, said that 6.0 was a normal level. But
the
other key study, the United Kingdom Prospective Diabetes Study or UKPDS, which
compared conventional and intensive therapy in more than 5,000 newly diagnosed
people with type 2 diabetes, said that 6.2 is the normal level.

Those levels, while unsubstantiated, are close. But they comes along one of my
heroes,
Dr. Richard K. Bernstein, the author of the key text of very low-carb eating for
people
with diabetes, Dr. Bernstein's Diabetes Solution. Dr. Bernstein himself
developed
type 1 diabetes in 1946 at the age of 12.

"For my patients...a truly normal HgbA1C ranges from 4.2 percent to 4.6
percent," he
writes on page 54 of the third edition of that book. "Mine is consistently 4.5
percent."
Then in his July 30, 2008, telecast he reiterated that as far as he has been
able to
determine, a normal A1C is 4.2 to 4.6.

What Dr. Bernstein says is normal is so at odds with the other experts that at
least a
year ago I determined to find scientific proof of what a normal A1C level
actually is. It
turned out to be a lot more difficult to find than I ever imagined.

My personal quest for a normal A1C level and that of my favorite Certified
Diabetes
Educator drove that search.

When I learned in 1994 that I had diabetes and that my A1C level was 14.4, I was
gradually able to bring it way down. Lately I have been doing everything I can
think of to
try to get my A1C down to normal. But in 2008 my level in nine separate A1C
tests
always ranged from 5.2 to 5.6. That's far from normal, according to Dr.
Bernstein.

My favorite Certified Diabetes Educator is also doing everything she can to get
a normal
A1C level. And she doesn't even have diabetes -- which she double-checked by
taking
a glucose tolerance test -- but her most recent A1C was 5.4.

What could we be doing that is so wrong? Each of us is thin, eat a very healthy
diet, exercise a lot, take care of our teeth and gums, which is a major source
of infection. Could we have other infections or stresses that prevent us from
getting our A1C levels down to "normal"?

It turns out that my favorite Certified Diabetes Educator and I have normal A1C
levels after all. I learned this just yesterday when I finally tracked down
actual research determining what normal levels are.

A friend suggested that I contact the people who run the standardization program
for A1C testing. This organization affiliated with the University of Missouri is
the NGSP. Those initial used to stand for the National Glycohemoglobin
Standardization Program. But now that the NGSP is international, they changed
the name.

So I called Curt Rohlfing, the NGSP data manager and technical writer/research
analyst at the University of Missouri. And finally hit pay dirt in my quest for
learning what a normal A1C is.

Curt told me that every three or four years his lab at the university studies a
group of people who don't have diabetes to scientifically determine what a
normal A1C level is. The results from one study to the next are always close,
Curt told me. In their most recent study they tested 29 people who lived nearby
in central Missouri.

I asked how they knew if the people they tested didn't have diabetes. "Because
we did fasting glucose tests on them, they had no prior history of diabetes, and
none of them were obese," Curt replied.

So what were their levels? They ranged from 4.5 to 6, Curt replied. That's at
plus or minus 3 standard deviations.

I am certainly no statistician. But Curt tells me that it includes about 99
percent of the values.

The range is narrower -- 4.7 to 5.7 -- at plus or minus 2 standard deviations.
This includes about 95 percent of the values.

"The upper limit is the more important one," Curt explained further. "The lower
limit doesn't convey as much meaning."

They also see "a little skew toward the high end of the range, a bit of tailing
at the high side," Curt continued. In fact, levels below 4.5 are "quite
unusual," and usually are only when people have anemia or other abnormalities of
the red blood cells.

Remember these are the ranges obtained by the people who set the standards for
A1C tests. Sadly, however, not every laboratory or home test kit meets those
standards. Maybe the lab that Dr. Bernstein uses doesn't. Does yours? Curt
suggests that you ask your doctor if the lab running the test uses a method that
is certified by the NGSP.

The first conclusion of the research for me is that we need to shoot for a
normal A1C level of no more than 6.0 instead of trying what may be impossible, a
level of 4.2 to 4.6.

However, an A1C level of 6.0 can cause people who take insulin injections or one
of the
sulfonylureas to go hypo. That's why the American Diabetes Associations sets the
goal
conservatively at 7.0.

Still, a lower A1C level among people who take those medications is possible
without hypos. Dr. Bernstein has amply shown that both in his own life and that
of thousands of his patients.

And certainly, for those of us who don't take insulin injections or one of the
sulfonylureas we can set our goal even lower.

That's because we have to understand the different between normal and optimal.
For example, two-thirds of all American adults are overweight. Thus it has
become normal in our culture to be overweight. Likewise, the average American
gets little exercise, and that is also normal. We know that being a chubby couch
potato isn't optimal.

"I'm going to aim to be in the lower end of the normal A1C range," my favorite
CDE tells me, "because that is what I believe is optimal for human health." And
now that I know my A1C is in the normal range I am still going to do my best to
bring it down as much as possible. Are you?