All About Pre-Diabetes Eating – Podcast

Written By: Gloria Tsang, RD

Title: Founding Registered Dietitian

Alumni: University of British Columbia

Last Updated on:

Susan Burke March demystifies pre-diabetes and talks about what you can do to deal with it.

Host: Gloria Tsang, RD
Guest: Susan Burke March, MS, RD

You or someone you love may have recently been diagnosed with pre-diabetes. With a name like that, you may wonder whether it means you’re already somewhat diabetic and need to be on a strict regimen. Nutritionist and certified diabetes educator Susan Burke March, author of Making Weight Control Second Nature demystifies pre-diabetes and talks about what you can do to deal with it.



Gloria Tsang, RD: You may have heard of the term, pre-diabetes. With a name like this, you may wonder whether it means you’re already somewhat diabetic and need to be on a diabetic diet. Welcome to the Nutrition Tidbits podcast. This is Gloria Tsang, Editor-in-Chief for Joining me today is nutritionist and certified diabetes educator Susan Burke March, author of the new book Making Weight Control Second Nature. She is here today to demystify pre-diabetes and talk about what you can do to deal with it. Thank you for joining me Susan.

Susan Burke March, MS, RD: Thank you.

Gloria Tsang, RD: Now first things, first. Could you explain in laymen’s terms what pre-diabetes is and how it differs from regular diabetes?

Susan Burke March, MS, RD: The term pre actually means that if you don’t do something to change what’s going on right now in your body, you will probably most likely be diagnosed with diabetes. We’re talking about Type II diabetes which is a disease that’s similar to Type I in that it has some of the same symptoms but it’s different because usually it’s a disease associated with weight and lifestyle. Eighty to ninety percent of people diagnosed with diabetes have Type II diabetes. About eighty percent or more of the people with Type II diabetes get it when they are overweight.

Gloria Tsang, RD: So what’s the criteria for diagnosis? How does a doctor know that someone has a pre-diabetes condition?

Susan Burke March, MS, RD: Pre-diabetes can be determined by blood tests; either a fasting glucose or a glucose tolerance test where you drink a sugar solution and then they test your blood. So that the diagnosis of pre-diabetes is when your blood sugar isn’t at quite the level which would be diagnosed as diabetes but it is in a level that’s not normal. It’s also called impaired glucose tolerance or insulin resistance. What happens is that it’s a notice, you are on notice that you need to make some changes because your body is not able to deal with carbohydrates. It is causing high blood sugar and this is very dangerous. This can cause all kinds of complications.

Gloria Tsang, RD: So if someone has been diagnosed with pre-diabetes, what’s the first step they should do in terms of the food side and the diet?

Susan Burke March, MS, RD: That’s the really great question because I did a lot of work with diabetes diets and creating diabetes diets when I worked with one company and I really understand that diabetes is not necessarily a prescription for a diet, but it is for a lifestyle. A balanced diet means that there is no one food that you can’t eat or foods that you must eat but what you really need to do is look at your total diet and preferably with a registered dietitian and a diabetes educator and really create your diet because what we do know for a diet is that if you are trying to go on a weight loss diet, they all work. They have done a lot of research about diets but the one that works best, the one that works to make you the healthiest is the diet that you can incorporate into your lifestyle permanently. That’s the kind of a radical notion because most people think of the word diet something like deprivation. But instead of deprivation, you need to make your diet something that you enjoy. And it might mean modifying something that you usually eat. It might mean increasing whole grains, fruits & vegetables and decreasing fried foods and refined carbohydrates. The other part of the equation that is essential and non-negotiable is increasing some activity. I’m not saying you have to go to a gym, I’m not saying you have to run a marathon, but your body needs exercise. In order to work better and get the carbohydrates absorbed into your bloodstream, it needs to have some activity. So that might mean taking a walk and then really walking and no just strolling. It might mean dancing. It might mean biking or swimming or whatever you do but you just have to do it.

Gloria Tsang, RD: So can dietary changes as well as perhaps increased activity prevent the progression of pre-diabetes to diabetes?

Susan Burke March, MS, RD: That is a very good question. Yes, lifestyle changes can prevent advancing to Type II diabetes. The diabetes prevention program is a really good study with a large number of people. And they did find that people with pre-diabetes can often prevent or delay diabetes if they lose a modest amount of weight. Maybe just five to seven percent of their body weight. If they incorporate some physical activity with the dietary changes, they could prevent the advancement to Type II diabetes in a lot of cases. Over sixty percent of people in this study did prevent it.

Gloria Tsang, RD: The topic of sugar always comes up when we talk about diabetes. What’s your take on cutting sugar completely and also what’s your take on artificial sweeteners?

Susan Burke March, MS, RD: I think that sugar is made out to be the cause of diabetes. Certainly, that was historically the understanding but, sugar is a carbohydrate. And just like any carbohydrate, it needs to be monitored and measured to a certain extent in your diet. So sugar has no nutritional value but it sure tastes good. So you want to make sure that it is in the right portion size. Occasionally, sugar in a cookie is not a food you have to avoid forever; you just have to work it in at the right portion size. Again, that is how a registered dietitian can help you. Because if you are really looking for that sweet treat, you might be able to put it in your diet in a way that that you could enjoy it without it hurting your blood sugar. Like choosing something in a small amount and accompanying it with exercise might really be able to balance it out. Artificial sweeteners, I think, play an important role in managing diabetes. The ones that are approved by the Food and Drug Administration here in America for example, in the right portion size again can really be helpful; it can allow you to have something sweet without you to have to worry about the amount of carbohydrates in it. I think they can play an important role but not overdoing it of course.

Gloria Tsang, RD: So what about those natural sugars like stevia that has been really hot in the last few months. What do you think of that?

Susan Burke March, MS, RD: They are now approved and naturally sweet. They are not non-caloric for example like Splenda versus their new Sun Crystals, they are both options and they taste different. They are sweet but they taste different. I have tried them both. I think they play a place in your diet. I don’t think anything that comes in a package is purely natural. That’s my opinion. I think if you are totally looking for something natural, you can find it in the produce section of your grocer. If you want sugar, even white sugar or honey, these are things that are processed to a certain extent. They are all either caloric or non-caloric. I don’t demonize foods and I don’t say that one food can make you healthy and one food will make you sick, it’s all in the concert of a healthy program. So using these products can be fine but you are using them in small amounts and they really shouldn’t make a difference in your health, whether or not you choose Splenda or your choose Sun Crystals. They are both used to enhance your diet to make it taste better maybe for a treat. Use it in that sense.

Gloria Tsang, RD: Susan, tell us more about your new book, Making Weight Control Second Nature.

Susan Burke March, MS, RD: Making Weight Control Second Nature subtitle living thin naturally is a live it book and not a diet book. It stems from my experience as a member of a dietetic practice group called the Weight Management Dietetic Practice Group. Where we are talking to clients or people, or even friends, say to me, you are naturally thin, you don’t have to watch out for what you eat. In fact, that is kind of telling me what they think about me. It’s not telling me a lot about what they think about them but it is. They are saying they are looking at me and looking at me and saying I have a skinny gene. And since they don’t have that gene, they won’t be able to lose weight and keep it off permanently. I found that it’s kind of a misconception but when I describe my lifestyle, I realized that this is something that other people could benefit from. So the book takes you from understanding what it is to think naturally thin, making healthy choices and then going through the whole process of understanding wherever you go, whatever you do, you could make healthy choices. And I take you through all the scenarios whether it’s working, vacationing or dining out, it’s got a lot of resources and references on how to take control of your lifestyle. And it shows you what other people do to remain thin naturally.

Gloria Tsang, RD: Great information. To find out more about Susan’s book, you can go to her website and we will have a link on our website too. Thank you again for joining me Susan.

Susan Burke March, MS, RD: You are welcome.

Gloria Tsang, RD: We have been talking to nutritionist Susan Burke March, author of Making Weight Control Second Nature. For more healthy eating tidbits and information about this show, go to


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