Half a billion people have diabetes, do you?

DIABETES is one of the biggest epidemics sweeping the world. By 2020, there will be more than 480 million diabetics with another 280m prediabetics (who will get the disease in the future).

China, India and the US have the highest numbers of diabetics.

Diabetes is a lifestyle disease brought on by the excessive intake of carbohydrates and sugar and a sedentary lifestyle (lacking exercise).

Indians in South Africa have the highest incidence of diabetes of all race groups. The genetic factor is critical and if you come from a family with diabetes, get screened to establish whether you are prone to the disease.

Diabetes occurs when your body is unable to use the glucose obtained from your meal. Insulin is a hormone produced in your pancreas (an organ near your stomach). Beta cells in the pancreas produce the insulin.

Insulin enables your cells to transport glucose from your blood to your cells. Every cell needs glucose to make energy it uses to function.

When your pancreas fails to make enough insulin or the cells cannot use it effectively (insulin resistance), the glucose cannot be transported effectively to the cells.

A sustained high level of blood glucose results in diabetes symptoms.

There are two main types of diabetes, each caused by a different mechanism. Type 1 occurs in childhood or teen years and is due to the beta cells failing to make insulin. This type requires life-saving insulin replacement a few times a day. Someone with this type has to be on insulin for life.

Type 2 occurs when the body has a glucose overload – usually from eating too much food that releases glucose into the bloodstream rapidly (high glycemic index food).

Being overweight, not exercising and eating large amounts of starchy or carbohydrate-rich foods can cause or aggravate diabetes.

Genetic patterns predispose people to developing diabetes, but lifestyle and food selection hasten the onset.

A third type of diabetes results from the immune system destroying beta cells. This autoimmune type has to be managed with insulin.

The first step in managing diabetes easily is to know what type you have. For Type 1 you will need insulin to survive. Your doctor will guide you as to how much to take and how often.

Insulin is injected, usually in the abdominal wall or thigh. Diet and exercise are crucial in Type 1 diabetes.

For Type 2, a low carbohydrate/ no sugar diet is essential.

Two types of medication are available to take orally, if your doctor recommends them.

The first class of drug (Metformin) improves insulin resistance in cells.

Excessive fat accumulated around the organs in the abdomen is one of the biggest causes of insulin resistance and diabetes not improving.

The second class of drug (Sulphonylureas) helps increase the secretion of insulin from the pancreas.

Some need both drugs. Your doctor will know what you need.

As you age, you lose beta cells in the pancreas (apoptosis or natural cell death). Oral drug treatment may no longer suffice. You need not fear starting insulin treatment as it can improve control.

When blood sugar levels are persistently high, the excessive blood glucose behaves like a toxin and begins to damage the inner lining (endothelium) of the arterial blood vessels, causing plaque formation and a blockage to the oxygen-bearing circulation.

The tissue in the end-organs these blood vessels supply become deprived of oxygen, degenerate and malfunction.

The organs most affected by diabetes in this process are the kidneys, heart, eyes, brain and nerves.

When these are damaged by a lack of oxygen, due to blockage of the small blood vessels as a result of uncontrolled diabetes, serious, life-threatening complications arise. Avoid these by learning how to control your blood glucose levels.

Intense stress can cause your blood sugar levels to get out of control. Infections can also cause your diabetes to spike.

A tooth or gum infection could drastically affect diabetes.

Be aware that your blood sugar levels can dive (hypoglycaemia). This often happens in Type 1 diabetes, but can happen in Type 2. Very high blood sugar levels are known as hyperglycaemia.

Excessive intake of carbohydrates is the main cause of poor diabetes control.

Carbohydrates are starches such as bread, rice, potatoes, pasta, cereal, biscuits, pumpkin, squash and butternut.

Beer is high in carbohydrates, as is all alcohol.

Food or drink high in glucose – such as drinks with a lot of sugar (fizzy drinks), fruit juice, cooked carrots and beetroot – can cause blood sugar levels to rise rapidly.

A low-carbohydrate (avoiding refined carbohydrates) and medium-fat (olive oil, coconut oil, butter, ghee) diet is the starting point for gaining control of diabetes. Non-grain bread (cauliflower bread) helps.

To control diabetes, take the time to understand what and why you must do certain things, in lifestyle, diet and exercise.

Just knowing what to do in managing your diabetes, with the assistance of your doctor, will help bring your diabetes under control.

Uncontrolled diabetes causes massive inflammation, especially in the lining of blood vessels.

Cholesterol is deposited in these injured areas, leading to a narrowing of the arteries. Organs are damaged through the narrowing and eventual occlusion of the small blood vessels.

There are nutrients available that can stem the destruction while you get your blood sugar levels under control.

Lipotropic nutrients such as choline and inositol regulate the cholesterol metabolism. They are available in a formula called Lipotropic Adjunct.

Lipotropic nutrients prevent the narrowing of small blood vessels by cholesterol.

Carotenoid complexes (found in coloured fruit and vegetables – carrots; red, yellow and green bell peppers; peaches and apricots) prevent the oxidation of cholesterol in the blood and the damaged cholesterol from becoming plaque in the arteries.

Omega 3 salmon oil (there are eight types of omega 3 molecules) behaves as a powerful antiinflammatory nutrient.

These nutrients can be safely added to a management routine to vastly improve the quality of life of a diabetic.

It is crucial that diabetics (and pre-diabetics) know what diabetes is about and how to manage it. – Dr Rajen Cooppan (MBChB, MD).