Di­a­betes: It’s Not Just Su­gar

Sun.Star Cebu Weekend - - Health -

In light of Di­a­betes Aware­ness Month, I can’t let this month pass with­out talk­ing about Di­a­betes — par­tic­u­larly Type 2 Di­a­betes mel­li­tus, which is the more com­mon type. Di­a­betes is now an epi­demic along­side obe­sity, that it would not come as a sur­prise if at least one of our par­ents have it. In fact, these two (di­a­betes and obe­sity) of­ten go hand in hand. This per­va­sive chronic life­style dis­ease has be­come among the top killers of our coun­try and con­tin­ues to rise in rank. The com­pli­ca­tions of di­a­betes is what makes it lethal. In fact, along with hy­per­ten­sion (high blood pres­sure), it is the lead­ing cause of the in­creas­ing chronic kid­ney dis­ease and dial­y­sis pop­u­la­tion rate in the coun­try as well. The first thing that comes to mind for most peo­ple when they hear of the word “di­a­betes” is un­doubt­edly su­gar; that one who has di­a­betes has high blood su­gar and that this is caused by ex­ces­sive con­sump­tion of sug­ary food or car­bo­hy­drates. How­ever, there’s more to the root cause of di­a­betes than just eat­ing too much su­gar. Di­a­betes is a dis­ease borne from years of in­sulin re­sis­tance. That means, be­fore one is di­ag­nosed with the dis­ease, in­sulin re­sis­tance has long been plagu­ing the body; it is the pre­cur­sor for di­a­betes. In­sulin is the hor­mone re­leased by the pan­creas to shut­tle glu­cose into our cells to be pro­cessed into en­ergy or stored as fat. In­sulin re­sis­tance is the in­abil­ity of cells in our body to re­spond to this hor­mone and there­fore is un­able to process and store en­ergy. Thus, this leads to a prob­lem in en­ergy me­tab­o­lism and cas­cades into fur­ther meta­bolic im­bal­ances or com­pro­mises in other sys­tems in our body. In­sulin re­sis­tance es­sen­tially de­vel­ops from ac­cu­mu­la­tion of fat in our cells and or­gans, from eat­ing a diet high in pro­cessed food, sat­u­rated fat and trans fat. As fat builds up in the cells, this dulls the cell’s sen­si­tiv­ity to in­sulin when it comes knock­ing on the cell’s door (re­cep­tors). This is why peo­ple with di­a­betes tend to have non-alco-

holic fatty liver dis­ease as well. The prob­lem with in­sulin re­sis­tance is that it causes glu­cose or su­gar to re­main in the blood and when it be­comes highly con­cen­trated, it will dam­age our nerves and blood ves­sels, caus­ing the known com­pli­ca­tions such as nerve/sen­sa­tion is­sues, vi­sion loss, high blood pres­sure, and kid­ney dam­age. And ul­ti­mately, it’s these com­pli­ca­tions that lead a pa­tient to mor­tal­ity. This is the rea­son pre­di­a­betes or im­paired fast­ing glu­cose and im­paired glu­cose tol­er­ance should be crit­i­cally ad­dressed as early as pos­si­ble. So, who is at a high risk of de­vel­op­ing this stealthy dis­ease? Since this is a life­style dis­ease, it def­i­nitely in­volves all the as­pects of one’s life­style — diet, phys­i­cal ac­tiv­ity, sleep, and stress man­age­ment. Be­ing over­weight or obese is cer­tainly an ob­vi­ous risk fac­tor but stud­ies have shown that Pa­cific Is­landers/Asians are more likely to de­velop type 2 di­a­betes de­spite hav­ing a nor­mal BMI (body mass in­dex). So, just be­cause you are within a healthy weight range, it does not com­pletely ex­empt you from the risk of de­vel­op­ing this dis­ease.


Now, we know that su­gar is not the only cul­prit to the de­vel­op­ment of di­a­betes. A diet high in trans fat and sat­u­rated fat from highly pro­cessed food (fast­food, canned goods, con­ve­nience food, in­stant noo­dles, pro­cessed meats, etc.) are what also greatly con­trib­ute to in­sulin re­sis­tance through its pro­mo­tion of vis­ceral fat or fat de­po­si­tion in the ab­dom­i­nal area, es­pe­cially in the liver as the liver is the site of en­ergy me­tab­o­lism and stor­age of fat. Eat­ing a proin­flam­ma­tory diet also causes gut dys­bio­sis or the im­bal­ance of the gut mi­cro­biome (bac­te­rial en­vi­ron­ment), which is also cru­cial for sup­port­ing the im­mune sys­tem and brain health. And when one has gut dys­bio­sis, it fu­els the in­flam­ma­tory sta­tus of an in­di­vid­ual, caus­ing fur­ther in­jury to one’s health by pro­mot­ing de­struc­tive mech­a­nisms in the body.


Ex­er­cise has long been known for its health-pro­mot­ing ef­fects, re­gard­less of weight loss. Of course, weight loss is rec­om­mended es­pe­cially for peo­ple who are over­weight and have di­a­betes, but it is also the in­sulin sen­si­tiv­ity-pro­mot­ing ef­fect of ex­er­cise that makes it among the most highly rec­om­mended in­ter­ven­tion to ad­dress this dis­ease.


Don’t ever take your sleep for granted. Re­search says that get­ting in­ad­e­quate or poor qual­ity sleep even just for a night could sig­nif­i­cantly boost in­sulin re­sis­tance as much as eat­ing high­fat foods for six months. This is most likely re­lated to the ef­fect of poor qual­ity sleep on one’s hunger hor­mones.


No mat­ter how healthy you eat and how of­ten you ex­er­cise, if you also don’t man­age your stress, this is one big fac­tor that can lead to di­a­betes. El­e­vated stress hor­mones called cor­ti­sol can trig­ger hunger hor­mones to be more ac­tive than needed, thus we ex­pe­ri­ence “stress eat­ing.”


These are al­ready all too fa­mil­iar de­struc­tive life­style habits that are top con­trib­u­tors to many dis­eases such as heart dis­ease, di­a­betes, and even cancer. So, as you have read, life­style man­age­ment plays a key role in both the pre­ven­tion and de­vel­op­ment of di­a­betes and be­ing su­gar-con­scious is re­ally just the tip of the ice­berg. Di­a­betes is ris­ing at an alarm­ing rate so early pre­ven­tion and de­tec­tion are cru­cial to curb­ing this. Eat smart!

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