Category Archives: borderline diabetes

May 2017 Awareness Topic: The Difference Between Overweight and Obesity

In the May 2017 Health Awareness Topic, I’ll discuss the difference between what it is to be obese and how this differs from being overweight. In my years of clinical practice, I have found that people do not like to describe themselves as obese. Somehow the word obese has become ‘politically incorrect’ and offensive. So people, even healthcare professionals, choose to use the word ‘overweight’ even when they really mean that a person is obese.

I recall once when I was educating a patient about the fact that her CT scan showed that she had fat in her liver and this put her at a higher risk of diabetes. She later reported me that I said she was fat!

My assertion is that if we continue to tiptoe around this issue and not address obesity for what it is we will never be able to take control of the rising obesity or type 2 diabetes and borderline diabetes epidemic. Our patients look to us to tell them the truth. Being told the truth does not have to be offensive, but it may require an uncomfortable conversation that more healthcare professionals need to get comfortable having.

The similar statistics between obesity and type 2 diabetes

If you look closely at the statistics that I started this article with you will notice that they are similar over 100 million of adult Americans are either obese or overweight. Over 100 million adult Americans have either type 2 or borderline diabetes

Body Mass Index- BMI

The body mass index (BMI) is used to define normal weight, underweight, overweight and obese conditions. For the most part, BMI correlates with the amount of fat a person has. So a higher BMI correlates with a higher risk for obesity. There are some exceptions to using the BMI exclusively. For instance a person who is muscular may have a high BMI but they are not obese.

The BMI is calculated by dividing the weight in kilograms by the height. There are many BMI calculators online. All you need to know is your height and your weight (in kilograms) and then you can plug those numbers in. For an example of a BMI calculator, click here.

Categories of BMI:

Underweight -BMI less than 18.5

Normal weight- BMI 18.5- 24.9

Overweight- BMI 25-29.9

Obesity class I 30-34.9

Obesity class II 35- 39.9

Obesity class III greater than 40

Over two-thirds of the adult population in America is either overweight or obese. Currently there are over 29 million Americans living with type 2 diabetes. There are an additional 86 million are living with borderline diabetes. The common denominator for both of these conditions is the rising obesity epidemic.

Consider this, if you have been diagnosed with borderline diabetes and commit to losing just 10% of your body weight, you can reduce your chance of developing type 2 diabetes.

The goal is to maintain a healthy and normal BMI of between 18.5 and 24.9

For people who are overweight or obese I usually get a lot of rebuttal telling me they have not had BMI in that range since they were in high school or middle school.

That’s OK. Just as it took some time to gain weight, it will also take some time to lose weight. So let’s start with that statement. You are OK.  Accept that you are overweight or obese. This statement should not be seen as  someone making a derogatory statement about you. It simply means that if you want to live a long and healthy life there is work to do. You are not alone in this obesity epidemic.  There are close to 200 million people in the United States alone. Start by developing a support system. Work closely with your healthcare professional.

Changing old habits is never easy. There are several stages to change. One thing you can start today is to start taking simple small steps every day. Taking simple small steps helps to reduce the sense of overwhelm that making big changes can cause. And because the changes seem so small in the beginning you are more likely to stick with them.

Here’s an example of a simple small step you can take on. Purchase a fitness tracker. What is the common step goal everyone says when you start counting steps? 10,000 steps! Look at that number, doesn’t ten thousand sound like a whole lot to start with? Consider this. Set a goal to walk 1000 steps on your first day. And then when you reach that goal (or exceed it) slowly increase your daily goal. Eventually you’ll reach your goal without feeling overwhelmed and along the way you’ll discover ways to increase the amount of steps you take every day.

It all starts with what I call the ABCs – Acceptance, Belief and Commitment.

For more information about the ABCs and how you can use these to start making changes in your life, you can download a free copy of the first three chapters of my upcoming book, ‘Dr Eno’s A-Z Guide to Living Powerfully with Type 2 Diabetes’ by clicking here.

To your health and wellbeing,


Can You Reverse Borderline Diabetes?

prediabetes_xsPerhaps you have read articles on how in to reverse borderline diabetes. Borderline diabetes is also known as pre-diabetes. Borderline diabetes is diagnosed when the blood sugars are out of the normal healthy blood sugar range but not as high as the range used to diagnose diabetes.

Normal blood glucose levels are between 70-99 mg/dl. Essentially less than 100 mg/dl

When the blood glucose level is between 100-125 mg/dl, this is pre-diabetes or borderline diabetes.

Borderline diabetes can lead to type 2 diabetes. The common thread linking borderline diabetes and type 2 diabetes is a condition called Insulin resistance. I explain this in detail in my award-winning book ‘Dr. Eno’s A-to-Z Guide to THRIVING with Type 2 Diabetes’.  I compare the effects of insulin resistance to when a landlord changes the locks on a tenant that he no longer wants in his building. When the body’s cells become resistant to insulin, it is not able to pass into the cell to carry out its functions. So insulin gets stuck in the bloodstream where it is of no use. The cells need sugar for energy. Persistently high blood sugars in the bloodstream eventually lead to borderline or type 2 diabetes.

Strategies to reversing borderline diabetes

Diet and exercise

Research has shown that by losing just 5-7% of your current body weight can help to reverse the effects of insulin resistance and diabetes up to 60%.

Think about this- what if you were to commit to losing just 10% of your current bodyweight? You could potentially reverse the effects of living with type 2 diabetes.

In the first three chapters of my book, I write about having the right mindset. I call this the ABCs of living with type 2 diabetes.

The ABCs stand for- the Acceptance that they have diabetes (or in this case pre-diabetes); the Belief that they can make the changes that they need to make in their lives; and finally the Commitment to creating a permanent shift in their way of being.

What happens if diet and exercise do not work in reversing type 2 diabetes?

There is a medication that can help. This medication is called Metformin. Metformin is the only drug approved by the FDA for diabetes prevention.

Metformin acts in two ways to help with blood sugar control:

  1. It acts to reduce the output of stored sugar from the liver
  2. It helps to improve the sensitivity of the cells to insulin. In other words it helps to reduce insulin resistance.

Metformin can also help with weight loss.

Metformin is not without it’s side effects. One serious side effect is called lactic acidosis. This is a condition where there is a build up of a poisonous acid in the blood stream. This condition is potentially fatal.

If you are placed on metformin, it is important to have your liver and kidney function checked with blood tests at least every three months. So check with your healthcare practitioner about this. If you have any form of kidney disease then you should not be on metformin.

I am not enthusiastic about placing people with borderline diabetes on medications. I sincerely believe it is possible to reverse and even prevent borderline diabetes from progressing to type 2 diabetes.

This can be accomplished by making intensive lifestyle changes, which includes not only diet and exercise but also a change in mindset.

It starts with the ABCs of diabetes (Acceptance-Belief-Commitment).

To download a free e-book that includes the first three chapters of my book, click here.

Until next week, here’s to your health and wellbeing