used in the Diabetes Prevention Program (DPP), sponsored by the National Institutes of Health. for diabetes can prevent or delay the onset of the …
YOURGAMEPLAN
FOR PREVENTING TYPE 2 DIABETES
INFORMATION FOR PATIENTS
CONTENTS
Overview of the GAME PLAN 1
Who Is at Risk for Type 2 Diabetes or Pre-diabetes?
5
WalkingA Step in the Right Direction
9
Food and Activity Tracker Copier-Ready Pages
14
Additional Resources
17
The Small Steps Big Rewards GAME PLAN is based on the lifestyle modification strategies used in the Diabetes Prevention Program DPP, sponsored by the National Institutes of Health All of the DPP resources are available on the Internet at wwwbscgwuedu/dpp/manualshtmlvdoc This booklet may be reproduced without permission, but should be acknowledged accordingly The Walking section was adapted from a brochure produced by the Weight-Control Information Network, NIH Publication No 01-4155
OVERVIEW
Congratulations By reading this you are taking your first step toward preventing diabetes and living a longer, healthier life Diabetes prevention means lowering your risk for heart disease, stroke, kidney disease, blindness, amputation, and other serious problems Thats a big reward for you and a big reward for your family and friends You may have a family member with diabetes Maybe you have to drive him to his weekly
kidney dialysis Maybe you help her cut her toenails, because she cant see and it would be dangerous to damage her feet But you are in a position to avoid these complications from diabetes You can prevent diabetes and stay healthy Diabetes prevention is possible, powerful, and proven Recent studies have proven that people at high risk for diabetes can prevent or delay the onset of the disease with 30 minutes of physical activity, 5 days a week, and losing 5 to 7 percent of their body weight In other words, you dont have to knock yourself out to prevent diabetes The key is: small steps that lead to big rewards
You dont have to knock yourself out to prevent diabetes The key is: small steps that lead to big rewards
1
One Small Step: Know your diabetes risk Work with your health care provider to find out if you are at risk for diabetes or if you have pre-diabetes The section– Who Is at Risk for Type 2 Diabetes and Pre-diabetes? –also can help Big Reward: Knowing you dont have diabetes, and that you can prevent or delay it if you are at risk, will give you peace of mind Note below why you want to prevent diabetesor who you want to do it for
Losing 5 to 7 percent of your weight is
one big step to reduce your risk of diabetes
One Small Step: Commit to your GAME PLAN Set goals, and dont forget to work with your health care provider, family, and friends For example, losing 5 to 7 percent of your weight is one big step to reduce your risk of diabetes Thats 10 to 15 pounds for a person who weighs 200 pounds When you figure out how many pounds that is for you, you will see that you can meet your goal My 5 goal will be to lose _______ pounds My 7 goal will be to lose _______ pounds My 10 goal will be to lose _______ pounds
To figure out your weight loss goal, multiply your weight by the percent you want to lose For example, if John weighs 240 pounds and wants to lose 7 percent of his weight, he would multiply 07 by 240 240 pounds x 07 7 percent 168 pounds Johns goal would be to lose about 17 pounds and bring his weight down to 223 pounds
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Try to weigh yourself every day and record your progress Research shows that this is an effective way to help you reach your goals Big Reward: Setting goals will help you stick to your GAME PLAN and help you track your success One Small Step: Track your GAME PLAN progress Use the Food and Activity Tracker to help you lose 5 to
7 percent of your weight Just jotting down what you eat and drink each day is proven to be one of the most powerful ways to lose weight and keep it off Make sure you track the number of calories and fat grams you consume each day Use the Fat and Calorie Counter included in this package Also, be sure to record how many minutes of physical activity you perform each day Check with your health care provider about what goals are best for you My goal is to consume _______ calories per day My goal is to consume _______ fat grams per day My goal is to get _______ minutes of physical activity per day Use the first page of the tracker to record the small steps you will take each week to meet your goals and follow your GAME PLAN Try dancing, swimming, biking, walking, or any activity that keeps you moving for 30 minutes most days
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Big Reward: Losing weight can help prevent diabetes, heart disease, certain cancers, and many other chronic diseases You will also look better and feel better One Small Step: Start walking Start off slowly and work up to 30 minutes of brisk walking a day Or try dancing, swimming, biking, jogging, or any activity that helps get your heart rate up a bit Walking A
Step in the Right Direction, on pages 10 to 13, can help you reach your goal Record the ways that you will become more active:
Big Reward: Even modest amounts of activity help cut the risk of obesity, high blood pressure, and diabetes Taking walks or bike rides can also be great ways to spend time with friends or family You are now on the road to a lifetime of good health Take a minute to think about why you want to start living healthier and how you plan to succeed and now go out there and take your next small step Add healthy changes every week and always try to get back on track, even if you fall off a few times Use the resources in this booklet to help you stick to your goals and succeed And remember: preventing diabetes is good for you and good for your family
4
WHO IS AT RISK FOR TYPE 2 DIABETES AND PRE-DIABETES?
What is diabetes? About 17 million Americans have diabetes mellitus, a serious disease in which blood glucose blood sugar levels are above normal The vast majority of people with diabetes have type 2 formerly called adult onset, which usually occurs after age 45, but is occurring increasingly more often in individuals, including children and adolescents High blood
glucose levels can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage About one-third of people with diabetes dont even know they have it Many people dont find out they have diabetes until they are faced with problems such as blurry vision or heart trouble Thats why you need to know if you are at risk for diabetes What is pre-diabetes? Before people develop type 2 diabetes, they usually have pre-diabetes –a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes People with pre-diabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke
17 million Americans have diabetes– one-third dont even know it
At least 16 million Americans have pre-diabetes and are more likely to go on to develop diabetes within 10 years
5
It is important to find out early if you have type 2 diabetes or if you are at risk for developing it, because treatment can prevent the serious problems caused by high blood glucose As people get older, their risk of developing diabetes increases To find out about your risk, check each item that applies to
you
1 My weight puts me at high risk according to
the At-Risk Weight Chart on page 7 Find out if you are at risk for diabetes Talk to your health care provider
2 I have a parent, brother, or sister with diabetes 3 My family background is African American,
American Indian, Asian American, Hispanic/Latino, or Pacific Islander
4 I have had gestational diabetes or I gave birth to
at least one baby weighing 9 pounds or more
5 My blood pressure is 140/90 or higher, or I
have been told that I have high blood pressure
6 My cholesterol lipid levels are not normal
My HDL cholesterol good cholesterol is less than 40 for men or less than 50 for women, or my triglyceride level is 250 or higher
7 I am fairly inactive I exercise fewer than three
times a week
6
AT-RISK WEIGHT CHARTS
Find your height in the correct chart If your weight is equal to or greater than the weight listed, you are at increased risk for type 2 diabetes
IF YOU ARE NOT ASIAN AMERICAN OR PACIFIC ISLANDER AT RISK BMI 25 HEIGHT WEIGHT IF YOU ARE ASIAN AMERICAN AT RISK BMI 23 HEIGHT WEIGHT IF YOU ARE PACIFIC ISLANDER AT RISK BMI 26 HEIGHT WEIGHT
410 411 50 51 52 53 54 55 56 57 58 59 510 511 60 
61 62 63 64
119
124 128 132 136 141 145 150 155 159 164 169 174 179 184 189 194 200 205
410 411 50 51 52 53 54 55 56 57 58 59 510 511 60 61 62 63 64
110 114 118 122 126 130 134 138 142 146 151 155 160 165 169 174 179 184 189
410 411 50 51 52 53 54 55 56 57 58 59 510 511 60 61 62 63 64
124 128 133 137 142 146 151 156 161 166 171 176 181 186 191 197 202 208 213
Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report
7
What is the next step? Talk with your health care provider at your next visit: If you are age 45 or older and have an at-risk weight according to the charts on page 7, testing for diabetes and pre-diabetes is recommended If you are age 45 or older without any risk factors, ask about your risk for pre-diabetes or diabetes and if you should get tested It is important to find out early if you have diabetes or if you are at risk for developing it If you are an adult younger than 45 years of age, have an at-risk weight, and have checked any other items on page 6, ask about your risk for pre-diabetes or diabetes, and if you should get tested Type 2 diabetes is a serious disease, but it can be
delayed or prevented Take steps now to lower your risk of getting diabetes
8
WALKINGA STEP IN THE RIGHT DIRECTION
WALKINGA STEP IN THE RIGHT DIRECTION
Why walk? Walking is one of the easiest ways to be physically active You can do it almost anywhere and at any time Walking is also inexpensive All you need is a pair of shoes with sturdy heel support Walking will: Give you more energy Help you to relax Reduce stress Help you sleep better Tone your muscles Help control your appetite Increase the number of calories your body uses Help prevent diabetes
For all these reasons, people have started walking programs If you would like to start your own program, read and follow the information here Is it okay for me to walk? Answer the following questions before you begin a walking program Has your health care provider ever told you that you have heart trouble? When you are physically active, do you have pains in your chest or on your left side neck, shoulder, or arm? Do you feel extremely breathless after you have been physically active? Has your health care provider told you that you have high blood pressure? Has your health care provider told you that you have bone or joint
problems, like arthritis, that could get worse if you are physically active?
10
Are you over 50 years old and not used to a lot of physical activity? Do you have a health problem or physical reason not mentioned here that might keep you from starting a walking program? If you answered yes to any of these questions, please check with your health care provider How do I start a walking program? Leave time in your busy schedule to follow a walking program that will work for you Keep the following in mind: Choose a safe place to walk Find a partner or group of people to walk with you Your walking partners should be able to walk with you on the same schedule and at the same speed Wear shoes with thick flexible soles that will cushion your feet and absorb shock Wear clothes that will keep you dry and comfortable
Think of your walk in three parts Walk slowly for 5 minutes Increase your speed for the next 5 minutes Finally, to cool down, walk slowly again for 15 minutes Try to walk at least five times per week Add 2 to 3 minutes per week to the fast walk If you walk less than three times per week, increase the fast walk more slowly To avoid stiff or sore muscles or joints, start
gradually Over several weeks, begin walking faster, going further, and walking for longer periods of time
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How do I warm up? Before you start to walk, do the stretches shown here Remember not to bounce when you stretch Perform slow movements and stretch only as far as you feel comfortable
Wall Push Lean your hands on wall with your feet about 3 to 4 feet away from the wall Bend one knee and point it toward the wall Keep your back leg straight with your foot flat and your toes pointed straight ahead Hold for 10 seconds and repeat with the other leg
Side Reaches Reach one arm over your head and to the side Keep your hips steady and your shoulders straight to the side Hold for 10 seconds and repeat on the other side
Knee Pull Lean your back against a wall Keep your head, hips, and feet in a straight line Pull one knee to your chest, hold for 10 seconds, then repeat with the other leg
Leg Curl Pull your right foot to your buttocks with your right hand Keep your knee pointing straight to the ground Hold for 10 seconds and repeat with your left foot and hand
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Take the first step Walking the right way is very important: Walk with your chin up and your shoulders held slightly
back Walk so that the heel of your foot touches the ground first Roll your weight forward
Walk with your toes pointed forward Swing your arms as you walk
Over several weeks, begin walking faster, going further, and walking for longer periods of time
BUILD UP TO 30 MINUTES OF BRISK WALKING FIVE DAYS A WEEK
WARM UP TIME WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6 WEEK 7 WEEK 8 WEEK 9 walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min FAST WALK TIME walk briskly 5 min walk briskly 8 min walk briskly 11 min walk briskly 14 min walk briskly 17 min walk briskly 20 min walk briskly 23 min walk briskly 26 min walk briskly 30 min COOL DOWN TIME walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min walk slowly 5 min TOTAL TIME 15 min 18 min 21 min 24 min 27 min 30 min 33 min 36 min 40 min
13
FOOD AND ACTIVITY TRACKER COPIER-READY PAGES
Photocopy the following pages to create your own Food and Activity Tracker You also may download additional copies at wwwndepnihgov click on the Small
Steps logo
MY DAILY AND WEEKLY GOALS
MINUTES OF ACTIVITY
FAT GRAMS
CALORIES
MY GAME PLAN
FOOD AND ACTIVITY TRACKER
NAME — FROM TO
DAILY
WEEKLY
MY DAILY AND WEEKLY TOTALS
WEIGHT FOR CUTTING FAT GRAMS: MY GAME PLAN THIS WEEK
DATE
FAT GRAMS
CALORIES
MINUTES OF ACTIVITY
MONDAY FOR CUTTING CALORIES: FOR GETTING MORE PHYSICAL ACTIVITY:
FOLD HERE
TUESDAY
WEDNESDAY SAMPLE ENTRY: DAY
THURSDAY
Monday
DATE
February 3, 2003
FRIDAY
DAILY FOOD AND DRINK TRACKER
TIME 8:00 AM AMOUNT/NAME /DESCRIPTION 1/2 cup oatmeal 1 cup 2 milk POUNDS LOST TO MAKE MORE WEEKLY TRACKERS: Make one 1 copy of this page Place it on top of seven 7 copies of the next page Trim the pages and staple in the upper left-hand corner Fold to fit in your pocket or purse FAT GRAMS 1 5 CALORIES 73 121
SATURDAY
SUNDAY
WEEKLY TOTALS
DAY TIME AMOUNT/NAME /DESCRIPTION FAT GRAMS CALORIES TIME
DAILY FOOD AND DRINK TRACKER
DAILY FOOD AND DRINK TRACKER
CONTINUED
AMOUNT/NAME /DESCRIPTION
FAT GRAMS
CALORIES
FOLD HERE
TOTALS
DAILY PHYSICAL ACTIVITY
TYPE OF ACTIVITY
MINUTES
MAKE SEVEN 7 COPIES OF THIS PAGE
TOTAL
ADDITIONAL RESOURCES
National Diabetes Education Program 1-800-438-5383 or wwwndepnihgov and
click on the Small Steps logo American Association of Diabetes Educators 1-800-TEAM-UP4 or wwwaadenetorg American Diabetes Association 1-800-DIABETES or wwwdiabetesorg American Dietetic Association 1-800-877-1600 or wwweatrightorg Centers for Disease Control and Prevention 1-877-232-3422 or wwwcdcgov/diabetes Healthier US Initiative wwwhealthierusgov National Institute of Diabetes and Digestive and Kidney Diseases National Diabetes Information Clearinghouse 1-800-860-8747 or wwwniddknihgov Weight-Control Information Network wwwniddknihgov/health/nutrit/winhtm National Heart, Lung, and Blood Institute 301-592-8573 or wwwnhlbinihgov For on-line fat and calorie counters, visit these web sites: National Heart, Lung, and Blood Institute http://hinnhlbinihgov/menuplanner/menucgi United States Department of Agriculture Nutrient Data Laboratory wwwnalusdagov/fnic/cgi-bin/nut_searchpl
US Department of Health and Human Services
A joint program of the National Institutes of Health and the Centers for Disease Control and Prevention
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NIH Publication No 03-5334 February 2003
Source:nfid.org
