Diabetes: reduce your risk
Professor Kerryn Phelps looks at the rising number of people with diabetes and advises how to reduce your risk.
In New Zealand, more than 257,000 people have diabetes and the number is increasing across all age groups. Why is this? The simple answer is that we are consuming more kilojoules and doing less exercise. Another theory is that chemicals in our environment may be disrupting our metabolism and hormone balance.
The number of people diagnosed with diabetes increases with age, with 15 to 20 per cent of people aged 65 to 74 having the disease. Yet the number of younger people being diagnosed with Type 2 is also rising alarmingly because of the increase in childhood obesity and inactivity.
Because of the long-term complications, this means a heavy burden for future generations. We know that diabetes creates other health problems such as high blood pressure, heart and blood vessel disease, stroke, non-alcoholic fatty liver disease, blindness, kidney damage, nerve damage (numbness or pain in the feet and hands), erectile difficulty and foot ulcers.
There are two main types of diabetes, Type 1 (insulin dependent) and Type 2 (non-insulin dependent). The level of blood sugar (glucose) in your body is regulated by the hormone insulin, which is produced in the pancreas. Diabetes occurs when there is a problem with the production of this hormone, or the way it works in your body. If glucose is unable to enter cells to provide energy, levels build up in your bloodstream.
What is insulin resistance? Insulin resistance is a condition where the cells of the body do not respond effectively to insulin. It is more commonly found in people who are overweight or inactive, and in women who have polycystic ovarian syndrome (PCOS).
People with insulin resistance are more likely to develop Type 2 diabetes. The treatment is a healthy diet, weight loss and regular physical activity.
What is the Glycemic Index? The Glycemic Index (GI) is a ranking of carbohydrate in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value are more slowly digested, absorbed and metabolised, and cause a lower and slower rise in blood glucose and, therefore, insulin levels.
Once I have been diagnosed, is that it? Type 1 diabetes needs lifelong insulin treatment and blood glucose monitoring, along with careful attention to diet to ensure blood sugar levels remain stable. Regular daily exercise is essential. What can I do about a diagnosis of Type 2 diabetes?
Prevention is best. The main challenge is to avoid becoming overweight. Mainstays for treatment of Type 2 diabetes are diet, exercise and weight loss, and avoiding vitamin D deficiency. Some people
resort to weight-loss surgery. Do not smoke and keep alcohol to a minimum. What is the eating advice for a
diabetic? Choose foods with a low glycaemic index and ensure you eat two pieces of fruit and five serves of different vegetables each day. Include wholegrains and legumes in your diet, and reduce saturated and trans fats. Avoid high-sugar and high-salt, low-nutrient foods.
Medication
If lifestyle measures are unsuccessful, oral medication may be prescribed. There are different classes of medication for Type 2 diabetes, usually starting with Metformin, which helps the body become more sensitive to insulin.
Supplements
Some nutritional supplements can help, but you will need professional advice and supervision of the combinations and doses. Vitamin B1: May reduce diabetic complications such as neuropathy, kidney disease and visual problems.
Vitamin B12: Metformin causes vitamin B12 malabsorption. All people on Metformin need vitamin B12 supplementation.
Vitamin D: Deficiency is associated with an increased risk of developing Type 2 diabetes.
Vitamin C and vitamin E: Improves insulin sensitivity. People with diabetes have lower levels of vitamin C. It can also improve glucose tolerance in Type 2 diabetes.
Chromium picolinate: Chromium is an essential trace mineral and a key component in glucose tolerance factor. It is essential for normal carbohydrate metabolism and insulin sensitivity, and reduces insulin resistance.
Magnesium: May be protective against the development of early-stage Type 2 diabetes in people with normal kidney function.
Zinc: Diabetes decreases zinc absorption and increases urinary excretion, decreasing total body zinc. Zinc deficiency is common in vegetarians.
Fish oil: Reduces cardiovascular complications. Can be combined with evening primrose oil.
Gymnema sylvestre: A herb which reduces sweet cravings. It also reduces intestinal absorption of glucose, inhibits active glucose transport in the small intestine and stimulates insulin secretion. Medication may need to be adjusted, as it can reduce blood glucose level.