DO YOU HAVE PRE-DIABETES?
There’s a chance you don’t even know you’re on the path to developing type 2 diabetes. Friday explains why by 2020, one in three adults in the UAE could be a diabetes statistic – and how you can stop it
Tabitha* was well aware that she should have been addressing her weight problem and doing more to curb her unhealthy diet, but she was a busy active teaching assistant, with no obvious health problems. “I’ve always assumed that if there was something wrong, my body would let me know and send me warning signals,” Tabitha admits. It wasn’t until she had an unrelated blood test after suffering from a virus that her doctor delivered the blow: she had pre-diabetes. “When I heard the word diabetes, I was terrified,” Tabitha explains. “My aunt has Type 1 diabetes and is insulin dependent. I conjured up awful images of needles – not to mention a lifetime of checking my sugar levels.”
Tabitha’s doctor went on to explain that pre-diabetes is a relatively new term to describe someone showing the early signs of developing type 2 diabetes. There was even a chance to stop it progressing.
According to the International Diabetes Federation (IDF), there are almost 750,000 diabetics in the UAE – and potentially 300,000 of them have not been diagnosed. It’s a problem that’s causing escalating costs for the government. Type 2 diabetes is the most common form of diabetes worldwide, accounting for an estimated 90 per cent of cases, and according to the United Health Group, the UAE is among the top five countries with the highest rate of type 2 cases.
It’s important to note that although type 1 diabetes can be managed with medication and a careful lifestyle, it has no lifestyle links when it develops. It’s believed to be caused by a fault in the immune system, which leads to insulinproducing cells being destroyed.
With type 2 diabetes, insulinproducing cells are still present but are no longer producing enough insulin, or the insulin isn’t working properly, wreaking havoc with the blood’s glucose levels. Type 2 diabetes can be linked to your lifestyle – if you’re overweight, don’t exercise and have a poor diet, these factors could lead you to develop the condition.
This is something you want to avoid, as both types are dangerous and, as Dr Satyendra Kumar Multani, an endocrinologist at Prime Medical Centre in Dubai explains, can cause long-term health risks. “Diabetes can cause cardiovascular complications such as heart attacks and strokes. It can cause nerve damage, kidney damage and even eye disease, which could lead to blindness.” Tabitha, was lucky. Like many, she hadn’t heard of pre-diabetes, but it meant that her blood-glucose levels had increased, however not quite enough so that she officially had full-blown type 2 diabetes – there was still time to stop it.
“In about 80 per cent of cases, we can prevent or delay type 2 diabetes,” says Libby Bowling, clinical adviser at the charity Diabetes UK (www. diabetes.org.uk). “A key message to get across is that we’ve coined the phrase ‘pre-diabetes’ because it’s easy to understand, but it’s unfortunate that it gives the impression that developing type 2 diabetes is inevitable – that’s not the case.”
For Tabitha, pre-diabetes was a wake-up call and according to Dr Kumar, a very important one. “It’s believed that by 2020, one in three adults in the UAE will have diabetes or pre-diabetes,” Dr Kumar says. “The progression from prediabetes to diabetes can be prevented or postponed in most patients by addressing weight, exercise and diet issues. “Pre-diabetes develops in genetically predisposed individuals if they become overweight and follow a sedentary lifestyle with unhealthy eating habits. I consider diabetes as a disease of discipline – the more
the patient is disciplined, the less harm will be caused.”
The shock of Tabitha’s diagnosis gave her the motivation to take a long hard look at her health. “I was surprised that I was taking all these health risks, and because I wasn’t feeling ill, I assumed everything was fine,” she explains. “I couldn’t believe I had put myself on the path to having such a dangerous condition – now I have changed my daily habits and I’m looking after my body. My BMI is now out of obesity rating and down to over-weight, and I’m not stopping there.”
So, what can you do to avoid being a statistic in this potentially preventable disease?
Understanding is the first step. This means being aware if you’re at risk, taking steps to prevent it, and knowing how to manage it. “Type 2 diabetes and its complications are readily preventable,” says Professor Merlin Thomas, author of new book Understanding Type 2 Diabetes. “It just takes clear understanding, good support, commitment and management, but it is possible.”
While it mostly occurs in overweight people aged over 40, type 2 can sometimes develop in younger age groups, particularly among South Asian people, who are at higher risk. Symptoms can include increased thirst, increased need to urinate, blurred vision, extreme tiredness and itching. But the condition can have zero symptoms, so if in doubt ask your GP for a test.
EAT A SENSIBLE, BALANCED DIET
“If you have pre-diabetes, you are about 10 times more likely to get type 2 diabetes in the next five years,” notes Prof Thomas. “But although your risk is increased, this means the benefits of lifestyle and diet interventions are much greater.”
In fact, the same lifestyle adjustments that can prevent type 2 are also crucial to managing it. While some cases may require medication, even insulin injections, sometimes lifestyle changes alone are enough – and may get rid of it altogether.
Eating well is crucial. “It really is as simple as following a healthy, balanced diet, and by that we mean a diet that’s low in fat, salt and sugar, and having at least five portions of fruit and vegetables a day,” Libby explains. “The other thing, of course, is portion sizes, because that’s a key part of managing your weight.”
Eat regular meals throughout the day, rather than fasting and then having one big meal, as this will help balance out your energy levels.
And remember, you can still enjoy the occasional treat. “The key is that we say ‘low’ fat and sugar, not ‘no’ fat and sugar. So that doesn’t mean you can never eat treat foods, you just need to be careful about how much and how regularly you’re having them,” says Libby.
Allowing yourself an occasional treat may help you achieve a healthy diet rather than being stuck in the all-or-nothing trap. There are plenty of tips and meal ideas on the Diabetes UAE website (www.diabetesuae.ae).
Being overweight or obese is one of the primary risk factors for type 2 diabetes. “Keeping physically active can help in either maintaining your weight, or losing weight,” says Libby. And according to the latest global figures, more than 66 per cent of men and 60 per cent of women in the UAE are overweight or obese.
Weight control is a vital factor in preventing and managing type 2, but being active plays a role, too. Moving your limbs, getting your heart pumping and your blood flowing all help keep the body in good working order, preventing complications and generally bringing about a sense of motivation to look after yourself and control your condition.
But don’t be put off by thinking that you’re not capable of exercise – it doesn’t have to be a full on gym workout. Diabetes UAE recommends 30 minutes of moderate exercise each day, five days a week. Even walking briskly for 30 minutes a day can be effective in preventing diabetes.
ASSESS YOUR HEALTH
Generally, we could all benefit from looking at our overall lifestyles and consider how things might be impacting on our health. This includes prioritising sleep, reducing stress and factoring in time for relaxation and leisure to keep our batteries charged.
Factors like smoking are not directly linked with type 2 diabetes, but it’s still worth taking a sensible approach. “Smoking is linked with high blood pressure, and having high blood pressure increases your risk of type 2,” explains Libby. “It could also lead to problems such as impaired circulation, which won’t do you any favours if you do develop diabetes.”
Get a tape measure out and slip it round your waist. According to studies, women who have a waistline over 80cm and men with a waist over 90cm are at greater risk of developing type 2 diabetes. So check out your number – and start changing your life.
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