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Lisa Ranes

Lisa Ranes, manager of the Billings Clinic Diabetes and Endocrinology program, discusses diabetes prevention in her office.

TAILYR IRVINE Billings Gazette

People at risk for diabetes can take steps to decrease their chance of developing the disease.

According to the American Diabetes Association, nine out of 10 Americans who are most at risk for type 2 don’t know they are at risk.

In Montana, 279,000 people, or 36.4 percent of the adult population, have pre-diabetes, the ADA said, meaning their blood glucose levels are higher than normal.

On top of that, an estimated 26,000 Montanans have diabetes but don’t know it.

Often people in the category find out only when they go to their physician and a simple blood test reveals they have type 2 diabetes, said Lisa Ranes, manager of Diabetes and Endocrinology at Billings Clinic.

“If you truly have high glucose there are classic symptoms like increased thirst, increased urination, blurry vision, fatigue and weight loss,” she said.

A number of elements can go into boosting the risk for diabetes. Family history is one factor. Others include being overweight or inactive, having uncontrolled blood pressure and getting older.

A couple of websites, the American Diabetes Association and the Centers for Disease Control and Prevention, have simple assessment tools that let people know if they are at risk for the disease.

“What’s great about that tool is there are certain modifying risk factors,” Ranes said.

Back in the early 2000s, a diabetes prevention study revealed that lifestyle intervention such as increased activity and weight loss can reduce the risk of diabetes by about 58 percent, she said.

Aiming at 150 minutes a week of moderate activity is a good goal, she said. Walking 2 miles in a half hour would be considered moderate activity, she said, encouraging people just starting out to consider even a 10-minute walk every day.

Losing 5 percent of body weight is another positive step. That goes hand-in-hand with healthier eating habits.

“Eat a rainbow of more colorful foods that are more nutrient-dense,” Ranes said.

Include whole grains, non-starchy vegetables, whole fruits and lean protein, and focus on portion control. On a nine-inch plate, fill half of it with 50 percent greens and non-starchy vegetables and fill 25 percent with protein and 25 percent with whole grain.

Since 2008, grants provided through the Montana Department of Public Health and Human Services have helped establish 19 diabetes prevention programs around the state.

That's been shown to reduce the incidence of type 2 diabetes by 28 percent, according to the DPHHS.

“Montana is leading the nation in diabetes prevention,” Ranes said.

In Billings, diabetes prevention programs are available through Billings Clinic, St. Vincent Healthcare and RiverStone Health. The course includes 16 weeks of once-a-week meetings and then monthly meetings for eight more months for support and maintenance.

In addition to a curriculum that focuses on nutrition, activity, accountability and behavior modification to help participants achieve a 7 percent weight loss, people in the class find support from others in the group.

“When we’re making changes, we need that support and accountability,” Ranes said.

People with type 2 diabetes are smart to surround themselves with a team of professionals, she said, including a medical provider, diabetes educator, dietitian and pharmacist who can help a patient make good decisions about managing the chronic disease. That’s crucial for a disease that can lead to many serious side effects.

“It’s one thing to have knowledge of diabetes management, but knowledge should convert to self-management skills,” Ranes said.

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General Assignment and Health Care Reporter

General assignment and healthcare reporter at The Billings Gazette.