November is National Diabetes Awareness Month, and that’s a great time to review the risk factors. You can’t change your family history or your heritage, but you can watch your weight and exercise regularly. The people at highest risk are African-Americans, Hispanic and Latino Americans, Native Americans and Alaska Natives, Asian-Americans and Pacific Islanders, and older adults (over 45) and overweight.

Other risk factors include having a parent or sibling with diabetes, having had gestational diabetes or at least one baby over 9 pounds at birth, having high blood pressure or abnormal cholesterol or triglyceride levels. Some of these factors can be modified through lifestyle changes. If you see something you could change in your life, start working on it now!

• Diagnosis and risk factors. Many people with pre-diabetes have no symptoms, which makes diagnosis very challenging. The American Diabetes Association recommends that if you are overweight and age 45 or older, you should be checked for pre-diabetes during your next routine medical office visit. For adults younger than 45 and overweight, your doctor may recommend testing if you have any other risk factors for diabetes or pre-diabetes.

• Prevention and treatment. If your doctor has diagnosed you with pre-diabetes, take action to prevent or delay the onset of Type 2 diabetes. The Diabetes Prevention Program has shown that diet and exercise work. Just 30 minutes a day of moderate physical activity and a 5 to 10 percent reduction in body weight produce a 58 percent reduction in the risk of developing Type 2 diabetes.

• Do it the right “weigh.” Set small weight-loss goals. If you have pre-diabetes, a modest amount of weight loss will make a huge difference. For example, if you weigh 200 pounds, set a goal to lose 10 to 15 pounds, or if you weigh 150 pounds, set a goal to lose 5 to 10 pounds.

• Get moving toward your goals. You don’t have to join an expensive gym to start an exercise program. It’s as simple as putting one foot in front of the other and moving. Walking is one of the cheapest and easiest forms of exercise.

Set a goal to walk 30 minutes per day. If you can’t fit it all in at once, split up your activity for the day and try a brisk 10-minute walk after each meal until you reach a total of 30 minutes.

Other fun activities include aerobics, biking, tennis, swimming or dancing. Pick whatever activity fits your lifestyle and enjoy those 30 minutes of healthy moving.

• Highlight healthy food. Picking the right foods will help you reach your goals of weight loss and normal blood sugars. Enjoy a diet filled with fiber and protein. Fiber comes from plants and may help to lower blood glucose.

Protein also helps to steady blood glucose levels. Always start your day with a nutritious breakfast, enjoy a light lunch and end the day with a dinner highlighting lean meats and vegetables and watching your carbohydrate foods such as dairy, grains and fruit.

Moderation is key. It’s also important to watch portion sizes and the amount of carbohydrates you eat. Read food labels to identify serving sizes of the foods you like to eat. The most important thing to remember is that good nutrition means eating a variety of foods.

Try spaghetti squash in place of pasta to lower your carbohydrate intake.

Roasted spaghetti squash

Prep: 20 minutes

Roast: 40-50 minutes plus 10 minutes

Stand: 10 minutes

Serves: 4


1 small spaghetti squash (about 1 ½ pound)

Desired toppings, below


Preheat oven to 350°F.

Cut squash in half lengthwise and remove seeds. Place squash halves, cut sides down, in a shallow roasting pan.

Roast for 40 to 50 minutes or until tender. Let stand for 10 minutes. Turn squash halves cut sides up.

Loosen the squash with a fork to form spaghetti-like strands.

Add desired toppings. Roast 10 minutes more or until toppings are heated through.

Top it!

• Soft mozzarella cheese, fresh baby spinach, pasta sauce, crushed red pepper flakes.

• Deli chicken breast slices, purchased pesto, fresh basil leaves, toasted pine nuts, grated parmesan cheese, drizzle of extra virgin olive oil

Per serving:

• 45 calories.

• 11 milligrams of cholesterol.

• 30 milligrams of sodium.

• 11 grams of carbohydrates.

• 2 grams of fiber.

• 4 grams of sugar.

• 1 grams of protein.

• No fat, saturated fat or trans fat.

Tracey Shaffer, RD, LD, is a Hy-Vee dietitian at the Blue Springs location The information provided should not be construed as professional medical advice. Email her at