Category Archives: Diabetes Prevention

The Steep Price of Overlooking Prediabetes Risk Factors

By Hui Xie-Zukauskas

Stop Prediabetes_CPDWhen you have diabetes, self-managing this condition through a list of tasks can be very challenging in your daily life.

However, whether you live with or without diabetes, your days will be happier and your life, simpler, if you cut off or minimize, improve or prevent a few of 11 risk factors for prediabetes.

Prediabetes is a condition where blood glucose (blood sugar) levels are higher than normal, but not high enough to meet the criteria as diabetes. About 86 million of Americans adults have prediabetes, and 90 percent of people with the condition don’t know they have it, based on the CDC’s data.

So, it’s urgent to know your risk. Why? Because prediabetes may develop to type 2 diabetes, the progression can lead to several health consequences. Among these is an association of prediabetes with the development of cancer. Research reveals that prediabetes is significantly linked to an increased risk for cancer of stomach, liver, pancreas, colon, breast and endometrium.

Here I’ll help you learn 11 risk factors of prediabetes, which type 2 diabetes also shares.

  1. Overweight or obesity: Obesity is an epidemic, and of our greatest concern is that it has spread to our children. The fatty tissue makes the cells become less sensitive to glucose, leaving a higher level of sugar in the blood. One more note – overweight/obesity may cause insulin resistance, which is a condition where the cells do not respond to insulin properly; and to meet the body’s demand, the pancreatic beta cells produce more insulin to help cells absorb glucose from the blood stream. Excess insulin and insulin resistance are a hallmark of type 2 diabetes, and make weight loss more difficult.
  2. Abdominal obesity: Extra fat around your abdominal region is considered a risk. A waist size over 35 inches for women or over 40 inches for men may post a higher prevalence of prediabetes. “Belly fat” is associated with high blood pressure, hyperlipidemia, heart disease, stroke, and diabetes.
  3. “SAD” diet:Standard American Diet features high in sugar, fat, and red or processed meats, and excess carbohydrates. An inadequate diet can impair insulin sensitivity over time. Additionally, portion control is also a key player. To help manage, I’d suggest you start with a smaller-size plate, rather than a regular dinner plate.
  4.  Physical inactivity: If you are not physically active or regularly exercising, you may experience weight gain over time, and you’re more likely to develop prediabetes.
  5.  Long-term stress: Under stress, the body releases the hormone cortisol into the blood stream, raising blood glucose levels, which can cause diabetes.
  6.  Metabolic syndrome: Metabolic syndrome is a group of three or more conditions that take place together and influence metabolism. When an impact of obesity, dyslipidemia (abnormal levels of “good” and “bad” cholesterol) and high blood pressure compounds, insulin resistance can occur.
  7.  Family history: Having an immediate family member or relative with type 2 diabetes considerably increases the risk of prediabetes.
  8.  Age: After the age of 45, the risk of prediabetes goes up, despite the fact that prediabetes can develop in anyone of any age. Aging alone contributes to decline in beta cell function of the pancreas. Aging could also let one easily get into inactivity, a poor diet, and a loss of muscle mass.
  9.  Ethnicity/Race: African-American, Native American, Hispanics, Asian-Americans and Pacific Islanders have a higher risk of developing prediabetes.
  10.  Gestational diabetes: Women who give birth to babies weighing over 9 pounds may be at a higher risk for prediabetes. Women previously diagnosed with gestational diabetes during pregnancy and their children have a higher risk too.
  11.  Polycystic ovary syndrome (PCOS): Women with PCOS are more susceptible to insulin resistance, thereby leading to prediabetes or type 2 diabetes.

Furthermore, activities contributing to chronic inflammation, such as tobacco smoking, excessive alcohol, and poor sleep quality, also post an increased risk of prediabetes and diabetes.

In the end, consider this price tag – The lowest cost of prediabetes or diabetes for individual health and our healthcare system is prevention, early detection, and timely treatment.

Nobody can control age, ethnicity, race or family history. But you can control those modifiable risk factors by changing lifestyle, especially having a balanced diet, exercise and healthy weight. Lifestyle modification can not only lower your risk of prediabetes or diabetes, but also that of cancer significantly.


Image credit: Clipart and CPD

Links between Obesity, Diabetes, and Colon Cancer

By Hui Xie-Zukauskas

Links 3 conditions_CPDColorectal cancer remains the 3rd most common cancer and is the 2nd leading cause of cancer-related deaths in the United States.

The causes of colon cancer are multi-factorial. They include cellular, molecular, and genetic factors, as well as dietary and lifestyle factors. Today, I’m going to focus on one significant yet modifiable risk factor, obesity.

We start with a glimpse at the numbers.

The incidence rate of obesity is alarmingly high among U.S. adults based on CDC data. Rates for different age groups include middle-aged (40.2%), older (37.0%), and younger (32.3%). Also, about 17% of children and adolescents (age 2-19) are obese.

More than 29 million adults and children in the U.S. have diabetes. 86 million Americans have pre-diabetes, a condition that can lead to type-2 diabetes. Note that an estimated one in two seniors has pre-diabetes.

Obesity may be a factor in approximately 300,000 deaths each year. Diabetes will cause an estimated 75,578 deaths and colorectal cancer, an expected 49,190 deaths in 2016.

A look beyond the numbers

Obesity is a leading cause of diabetes, a disease for which the body fails to control blood sugar levels. High blood sugar levels are characteristic of both obesity and diabetes. What is less well known is that diabetes and obesity are also linked to an increase in cancer risk.

In fact, obesity is linked to many types of cancer (colon, esophageal, thyroid, breast, prostate, uterine, kidney, pancreas, gallbladder and non-Hodgkins lymphoma) and, needless to say, heart disease, stroke, and other chronic illnesses.

Research shows that obesity and diabetes are associated with an increased risk of developing colon cancer.

Intrinsic links between obesity, diabetes, and colon cancer are vastly complicated. One clear tie is sugar. High levels of blood sugar are a characteristic in both obesity and diabetes. High blood sugar also makes us predisposed to cancer by increasing the activity of a gene involved in cancer progression. Apparently, dietary sugar is a link tying together obesity, diabetes, and colon cancer, and thus excess sugar has an impact on our risk for cancer.

Certainly, other links play a causal role. For instance, chronic inflammation is a central process that likely leads obese individuals to an elevated risk of diabetes and colon cancer, which all three conditions share a common inflammatory loop participated by multiple cell signaling molecules, growth and nuclear factors.

Highlighted Call for Actions

1. Colon Cancer screening

If you or your loved ones turn 50, you all should begin screening for colorectal cancer and then continue getting screened at regular intervals. This is because colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal polyps can be found by screening and then removed before they develop into cancers. Plus, any developing cancer can be found earlier by screening when treatment works best.

2. Diabetes Control

Early intervention is critical to preventing or delaying the onset of type-2 diabetes. Good news for our nation’s seniors is that Medicare will extend coverage for pre-diabetes care. Check out the National Diabetes Prevention Program, a preventive health initiative via the Center for Medicare & Medicaid Innovation.

3. Healthy Weight Management

Nutrition and balance diet, weight loss, daily physical activity and healthy lifestyle are all beneficial for keeping weight down. Look for further details in CancerPreventionDaily earlier posts.

In brief, obese people are at a higher risk for developing cancer. Also, an obese condition is often resistant to chemotherapy regimens. The bottom line is that obesity prevention is a key life-saving approach.


Image source: CancerPreventionDaily

How do you integrate vascular health and cancer prevention?

PAD_leg artery_by CDCBy Hui Xie-Zukauskas

For those who may be unaware of what cancer and heart disease share in common, today I wish to remind you of why I talk about cardiovascular diseases. When I started this website, with its focus on cancer prevention, I had a well thought-out approach to maximize your benefits for heart health as well. To put it simply, there are many practices that will help you “kill two birds with one stone”—both cancer and heart disease.

So today, let me elaborate on cardiovascular risk factors that a cancer-prevention lifestyle can help allay.

First, let me ask you, Do you know if you have peripheral vascular diseases (PVD) or not? About 20 million of people in the United States are suffering from PVD, yet they don’t even know it. What does that have to do with cancer prevention? Please read on.

What is PVD, and what is PAD?

Almost everyone knows about atherosclerosis. Well, PVD is one of the major clinical complications of atherosclerosis. It affects blood vessels outside of the heart and brain, e.g. those of your body’s extremities.

When PVD only develops in the arteries, it is usually called peripheral arterial disease (PAD), which results in reduced blood flow to the lower extremities. PAD is predominantly caused by the buildup of fatty plaque in small arteries, resulting in the narrowing of those arteries, blocking blood flow from the heart to the legs. Consequently, the hallmark of PAD is extreme pain or painful cramping in the legs.

However, many folks with PAD experience no symptoms. That is why it is important to raise public awareness.

PAD and aging

PAD is neither a men’s nor a women’s disease—it is more of an aging disease. According to the NIH and CDC, one in every 20 Americans over age 50 has PAD, and approximately 12-20% of people older than age 60 have it. By age 80, 20-25% of Americans have PAD.

What are the risk factors for PAD?

So far, we have covered two already:

  •      Atherosclerosis
  •      Aging

Other risk factors include:

  •     Smoking
  •     Diabetes
  •     High blood pressure
  •     High cholesterol or abnormal cholesterol – too much “bad” LDL cholesterol and too little “good” HDL cholesterol
  •     Being overweight or obese
  •     Family history of high cholesterol, high blood pressure, or cardiovascular disease (stroke, coronary artery disease, or PVD).
  •     Stress

What does learning about PAD have to do with cancer prevention?

The table below shows the risk factors that cancer and PAD have in common.

Risk Factors




 Tobacco use / Smoking


 Being physically inactive


indirectly, because it’s linked to atherosclerosis



 Junk diet (high fats, high sugar, excessive salt)

may lead to other risk factors above

 Hormonal imbalance

Without distracting from today’s focus, I have addressed each of risk factors in previous CancerPreventionDaily Summer Health Education Series, and you can learn more by visiting

What’s the take-away message?

  1. PAD is under-diagnosed and lacking in public awareness, yet its incidence increases with age disturbingly.
  2. Make a cancer-prevention lifestyle your priority. Lifestyle modification is one of the keys to controlling and preventing PAD as well as cancer.
  3. Take action using the “Five Seconds Rule”—meaning that whether you consult with your physician or change one unhealthy lifestyle habit, take one small step at a time and do it now!


Image credit: CDC

Cutting Sugar for Cancer Prevention

By Hui Xie-Zukauskas

Sugar in a teaspoon_DreamstimeIt’s easy to say “Sugar is bad for you,” but just how bad is it?

In 2015, the World Health Organization (WHO) is reducing its sugar intake recommendations from 10 percent of your daily calorie intake to 5 percent. To put this in a more measurable way, consuming 5% daily would be about 25 grams of sugar intake. This recommendation refers to all sugar – manually added and naturally occurring.

So, what does this translate for you? Adults with a healthy weight (a normal body mass index or BMI) are recommended to have less than 6 teaspoons of sugar per day from added or natural sources, given that 1 teaspoon = 4 grams.

The WHO warned the public that much of the sugar consumed today is “hidden” in processed foods that are not usually seen as sweets. This is alarming. Sure, you probably know a can of regular soda contains 40 grams of sugar, equivalent to 10 teaspoons. However, do you realize that a tablespoon of ketchup contains 1 teaspoon of sugar (4 grams)?

How about your frozen pizza? Or cereal, bread, soup, yogurt, and even mayonnaise? They all contain sugar. So it’s not just soft drinks, juice drinks, desserts, and other foods we think of as “sweet,” but many other common food items, especially processed ones.

Why is cutting sugar crucial to fighting cancer?

Candies in stop-sign -1025007-mEvery cell in our bodies needs sugar to promote a positive energy balance. Cancer cells are no exception, and they love sugar because it feeds them. Growing research evidence has shown how, though complicated mechanisms, increased blood sugar plays a significant role in cancer development.

Cancer hallmarks include accumulated mutations of DNA, increased proliferation, and the invasion and migration of cancerous cells. Higher blood sugar has both direct effects on cancer’s cellular events and indirect effects on rewiring cancer-related signaling pathways through other factors. This may also provide insight into the extensive findings that the diabetic population is at higher risk of site-specific cancers (e.g., breast, colorectal, pancreatic, and stomach cancer).

One of several modifiable risk factors for cancer is poor diet, which is also a risk factor for obesity. What’s more, obesity is an independent risk factor for cancer and for many other common chronic diseases. There is a variety of ways to lower your sugar intake, including:

  •     Keep a healthy, nutritious diet.
  •     Eat a plenty of fresh vegetables and fruits.
  •     Avoid processed foods.
  •     Avoid artificial sweeteners.
  •     Drink water instead of sugar-loaded soft drinks.
  •     Read food labels attentively.

For more strategies and tips, see our cancer prevention blog.

The bottom line:

Cutting back sugar will help you maintain a healthy weight and lower your risk for diabetes, cardiovascular disease, obesity-related health problems, and cancer.


Image credits: By and nazreth

Why It Is Critical to Prevent Diabetes: Association with Pancreatic Cancer

By Hui Xie-Zukauskas

Stop diabetes logoHere are a couple of sobering statistics: A total of 25.8 million children and adults in the United States and 347 million worldwide have diabetes. These figures demonstrate clearly that diabetes has become a pandemic in today’s world.

Preventing diabetes in our own and our families’ lives should be of great concern to us for several reasons. One reason is that a diagnosis of diabetes can result in life-altering changes needed to manage the disease. But there is another big reason such a diagnosis is troubling, and today I’m going to focus on that reason. I’m going to talk about the urgent need for diabetes prevention because diabetes is a known risk factor of pancreatic cancer.

What is diabetes?

Diabetes is a chronic disease in which the body either cannot make enough insulin (Type 1) or cannot effectively uses its own insulin (Type 2). Insulin is a pancreatic hormone that regulates blood sugar by facilitating glucose (sugar) storage in the cells for energy. When insulin fails to do its job, blood sugar levels rise.

Type 2 diabetes affects 90% of people with diabetes around the world and results largely from being overweight and physical inactivity. High blood sugar levels can lead to long-term damage to cells and organs, as seen in complications like high blood pressure, blindness, kidney disease, and nerve disorders.

What is pancreatic cancer?

Pancreatic cancer is a deadly disease in which cancerous cells develop inside the pancreas, an organ that produces hormones such as insulin and digestive juices. (See more on “The Rule of Three for Pancreatic Cancer Prevention”).

What is the relationship between the two?

Accumulated studies have revealed a positive association between diabetes and pancreatic malignancy, although the details of what is the exact causal relationship are complex and controversial. Diabetes may be either a symptom or a risk factor of pancreatic cancer. Here are some facts showing why it has been concluded that the two maladies are connected:

-          Pancreatic cancer occurs two times more in people who have diabetes than in those without diabetes.

-          Approximately 80% of patients diagnosed with pancreatic cancer, when diabetes co-exists, often have a progressive malignancy.

-          Patients with new-onset Type 2 diabetes are at a higher risk of developing pancreatic cancer. When suffering from cancer, they have a worse rate of long-term survival and a higher rate of post-surgical complications.

-          45% of pancreatic cancer patients have diabetes and more than half of diabetes cases are newly developed. Thus diabetes has been proposed to be a clue for early cancer diagnosis.

In summary, diabetes is considered to be a risk factor of pancreatic cancer and has a negative impact on the prognosis and outcome of this deadly form of cancer. That is one excellent reason why it is so important to prevent diabetes.

To help in that prevention, here are a couple of small, easy, and effective dietary practices that can be achieved on a daily basis:

  • To help keep your blood glucose under control, avoid foods high in sugar. High sugar-containing foods include rich desserts, candies, ice cream, sweetened drinks and fruits packed in syrup. Furthermore, many processed foods hold excessive sugar.
  • Drink plenty of water, which benefits your body in many ways, especially helping remove metabolic by-products when hyperglycemia occurs.

Following these two suggestions daily can go a long way toward helping keep you free of the plague of diabetes… And oh yes, don’t forget to include an appropriate measure of exercise in your lifestyle!

Until my next cancer prevention blog, I wish you Good Health, Good Living and Happy Thanksgiving!


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