Over two million Britons have diabetes. That’s a
worrying statistic, but perhaps even more frightening is that there
are at least ¾ million people in the UK today with diabetes
who don’t yet know and many more whose lifestyles are putting
them at high risk.
What is diabetes?
Diabetes is a chronic condition that occurs when the pancreas
doesn’t produce enough insulin (the hormone that regulates
blood sugar levels), or when the body cannot effectively use the
insulin that it produces.
There are two types of diabetes, type 1 and type 2.
Type 1 is due to insufficient insulin production and tends to
occur in young people. It accounts for between 5 and 15% of all
cases and whether or not you develop the disease is a bit of a
lottery based on your genetics more than anything else.
Type 2 is characterized by the body’s ineffective use of
insulin, which occurs as a result of weight gain. It accounts for
the other 85 - 95% of cases and it is this form that we can and
should prevent. When I was at medical school, type 2 diabetes was
known as maturity onset diabetes because it occurred in older
people, but today, with obesity rates soaring, we are seeing
children as young as eight with the disease and experts believe
that obesity and diabetes could mean that this generation will not
outlive their parents.
Why is it important to diagnose and treat
diabetes?
I often hear people refer to type 2 diabetes as "mild diabetes"
or "a touch of diabetes" but don’t be lulled into a false
sense of security. There is a misapprehension out there that as
long as the condition is managed with diet or pills, it can’t
be too serious and it’s only the folk needing to use insulin
that are really at risk. Wrong! Type 2 diabetes develops slowly and
symptoms, like fatigue may be vague or even absent so it can take a
long time to make the diagnosis. In fact 50% of people have
evidence of complications by the time they are diagnosed. You may
feel completely well with type 2 diabetes and working hard to keep
sugar levels in the blood normal may seem a real bore but it is
time and effort well spent. Untreated, diabetes can reduce life
expectancy by ten years. Diabetics are five times more likely to
have heart disease and three times more likely to have a stroke.
Diabetes is the leading cause of blindness in people of working age
and dialysis units are full of diabetics. Convinced?
What is my risk of developing diabetes?
There is no doubt that the more diabetic relatives you have, the
greater your risk and unfortunately there is nothing you can do
about your genetics or indeed about advancing years which also
increases the risk, but thereafter the excuses stop! The single
greatest risk factor for developing type 2 diabetes is weight gain
and specifically weight gain around your midriff. To assess your
risk you need to take three measurements - your height, your weight
and your waist circumference. (No cheating - I have met far too
many men in 34 inch waist trousers which sit neatly on the hips
below an impressive beer belly!) You can calculate your body mass
index (BMI) by dividing your weight in kilos by the square of your
height in metres. A BMI greater than 25 is associated with an
increased risk so get yourself checked. The correlation between
waist circumference and risk is so close that some doctors use this
measurement alone. Any woman with a waist greater than 80cms and
any man whose waist is larger than 94Kg is at significant risk.
How can I reduce my risks?
If you are overweight, losing weight really does make a huge
difference and I’m not talking size zero here. If a 100Kg
individual loses 10Kg he or she can expect to reduce fasting blood
sugar levels by between 30 and 50% and that may mean the difference
between needing medication or not. The same 10% reduction in weight
is associated with a 10% fall in cholesterol and a drop of 10mmHg
in blood pressure.
Nutrition and exercise are the best defense you have against
developing diabetes. Just 30 minutes of moderate exercise each day
(a brisk walk will do as long as it gets you puffed) will boost
your metabolism and help weight loss. When it comes to diet,
following a few simple rules will keep you on track.
- Carbohydrates - keep these to 55-60% of total calories try to
stick to complex carbs, (bread, potatoes and pasta), not simple
sugars like cakes and biscuits.
- Fat - limit fats to a third of total calories of which less
than a third should be saturated fats
- Protein - aim for around 10 - 20 % of total calories
- Fibre - 30g/day
What about supplements?
A balanced diet provides all the minerals and vitamins most of
us need but there are some instances where supplementation helps
and diabetes could be one of them. Biotin works with insulin to
control blood sugar and diabetics use up biotin more rapidly so may
need to supplement dietary biotin. Chromium is an essential mineral
that has been shown to improve sugar metabolism in type 2
diabetics, but check with your doctor before taking it. It’s
not suitable for anyone who suffers with depression or mental
illness. Magnesium levels are often low in diabetic patients,
especially those with diabetic eye disease and zinc deficiency has
been associated with the development of diabetes. Maintaining
adequate levels of vitamin A, B and E will help keep diabetic
complications at bay.
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