Signs you may become diabetic

A patient of mine who is over 100 pounds overweight for her height had a few blood tests abnormalities that suggest the progression to diabetes may be occurring. Her fasting blood sugar was above 100 ( hers was 150).

Fasting insulin level was 36 ( normal is less than 24). This means her body is pumping out more insulin due to resistance to insulin from overweight. This is also reflected in the high fasting blood sugar. The body is not able to metabolize the sugar in the diet

The treatment for this is to lose weight and make better food choices. High fiber in the diet will help slow down the absorption of sugar into the blood and may help decrease the blood sugar after a meal

Less processed foods is important, since they convert to blood sugar rapidly and are low in fiber as well.

The third abnormality that is seen in patients who have trouble with insulin and blood sugar is elevated liver enzymes since the body converts sugar into fat in the liver. The fat surrounds the liver, and causes inflammation around the liver as well. It can be corrected with weight loss and the good choices mentioned above

Eating fresh fruits and vegetables, and whole grains are a great way to get more fiber into the diet. Try to stick to the number of calories a day that is recommended for weight control or 500 calories less a day if you want to lose weight

500 calories less a day can be achieved by decreasing intake of sugary foods, processed foods such as buns, breads, sweet desserts.


Fatty Liver disease in overweight children and adults

Many adults and children are obese, putting them at risk for a fatty liver, the storage of large amounts of fat in liver tissue. This is associated with obesity, diabetes, and high lipid levels. The liver becomes inflamed and cirrhosis could develop. Diet and exercise changes to achieve weight loss will not only halt the progression of fatty liver, but it could even reverse it.
Among children, 10% of all children have fatty liver and more than 95% of them are obese. The risk of fatty liver disease increases in overweight children who do not have a healthy diet and/or do not have access to sports programs and in those who are hispanic or asian.
Many pediatric gastroenterologists feel the definitive diagnosis of fatty liver is best made by a liver biopsy, in addition to the clinical history of the patient. I raise the question as follows: If this is a reversible process with exercise, weight loss, and change in eating patterns- would it be best to first attempt to try to change the eating and exercise patterns of the child before doing a liver biopsy?
As an integrative physician- I would like to know the whole picture of the patients eating habits before doing an invasive procedure as a liver biopsy.