Eat more plants The health costs

A resounding message from nutrition research is that eating a plant-based diet is best for us all, whether or not you also eat meat. Plant food includes vegies, fruit, legumes (chickpeas, beans and lentils), wholegrains, nuts and seeds. Aim for at least 5-6 serves of different vegies and 2 serves of fruit each day.

From chronic kidney disease to heart failure, vision loss to amputation, the impacts of type 2 diabetes can be life-changing. “Silent undiagnosed type 2 diabetes is a problem because if you don’t know you have it, you can’t do anything about it,” says the Chief Executive Officer of Diabetes Tasmania, Caroline Wells.

“People can live with type 2 diabetes for up to seven years before they show any signs or symptoms – it’s insidious. But by the time they are diagnosed they may already have complications, which is why it’s so important for people to understand their level of risk for type 2 diabetes.”

Associate Professor Neale Cohen, the Head of Diabetes Clinical Research at the Baker Heart & Diabetes Institute, says type 2 diabetes is similar to having high blood pressure or high cholesterol in terms of people not realising they have a health problem until it is more advanced. “Like high blood pressure or cholesterol, people with type 2 diabetes often don’t feel sick but it does cause damage. We know there are a significant number of people with type 2 diabetes who simply don’t know they have the condition – and that is concerning,” he says.

How the harm occurs

Of the 250,000 Kiwis with diabetes the majority of people have type 2, which occurs when our body becomes resistant to a hormone called insulin, or when the pancreas can’t produce enough insulin.

Insulin is key in helping our body convert glucose or sugar from the food we eat into energy. When we don’t have enough insulin or our body doesn’t respond to insulin as it should, glucose stays in our blood and causes high blood glucose levels. Over time, high glucose damages nerves and blood vessels and can lead to serious health complications for our heart, kidneys, eyes and feet.

More than 600 amputations occur each year in New Zealand as a result of type 2 diabetes and the number of Kiwis with the disease is expected to increase by 70% -90% in 20 years.

Knowing your risk

Associate Professor Emily Hibbert, an endocrinologist at the Nepean Clinical School, The University of Sydney, says while type 2 diabetes can be ‘silent’, there are known risk factors for diabetes or pre-diabetes. It’s well known that being overweight or obese increases your diabetes risk, but it’s a mistake to think that’s the only risk factor, she says. Genes, ethnicity, lack of activity and age also play a role.

“If you have a parent or other first degree relative with type 2 diabetes, your risk of getting it is more than doubled – and the risk rises fivefold for people of European heritage if both parents have diabetes.”

People with Aboriginal or Torres Strait Islander background or with Pacific Island, Indian subcontinent or Chinese cultural backgrounds are also at greater risk. Women with polycystic ovarian syndrome are also at increased risk, as are women diagnosed with gestational diabetes during pregnancy.

They have up to 50 per cent risk of developing type 2 diabetes within 10 to 20 years.

“Pregnancy is a stress test for the pancreas,” says Associate Professor Hibbert. “Women who’ve had gestational diabetes who are planning another baby should be tested for diabetes before they become pregnant again. If it isn’t well controlled, there is a risk of congenital abnormality. Pregnancy is a key time to intervene for future generations.”

“Like high blood pressure ... people with type 2 often don’t feel sick but it does cause damage.”

– Neale Cohen