GETTING OFF YOUR BACKSIDE!
It’s madness for the NHS to spend millions fighting type 2 diabetes when the simple cure is...
WHEN my father was in his 60s, he was told that he had type 2 diabetes. We didn’t know it at the time, but it would contribute to his premature death.
Diabetes can cause multiple complications and, at the relatively young age of 74, my father died, suffering from prostate cancer, heart disease and what I now suspect was early dementia.
So when I went for a routine blood test five years ago, aged 55, and discovered that my blood sugar was in the diabetic range, I was shocked and worried.
The accepted wisdom is that type 2 is incurable. My doctor told me I should start on medication.
I did not accept it. Instead, I came across research pointing to the importance of weight loss in controlling and possibly reversing diabetes. I lost 19 lb in 12 weeks, and my blood sugar and cholesterol levels returned to normal — where they have stayed since.
With the help of science and some selfdiscipline, I sorted myself out. And there is nothing unusual about that: knowing what to do and then doing it is the way to better health.
Last week, Professor Sir Muir Gray, one of Britain’s most eminent doctors, said that he didn’t consider type 2 diabetes to be a ‘real disease’. As reported in the Mail, he told a shocked audience at Oxford Literary Festival that it was a reversible illness caused by the ‘modern environment’ and our sedentary lifestyles.
He said it ought to be known as ‘walking deficiency syndrome’.
It is a controversial view and while it is certainly alarming that, according to new NHS figures, one in four people fail to manage to take even 30 minutes exercise a week, I think Professor Gray is both right
and wrong, as I will explain. Type 2 diabetes occurs when the body’s insulin-producing cells fail to produce enough of this hormone (which promotes the uptake of glucose, the energy source for the body, from the blood). It is a national epidemic. And like any epidemic it often feels as if we are powerless to stop it, but that is not true.
The biggest problem is that we have to find ways to help people help themselves, to appreciate that their future health is in their own hands.
BEING overweight or obese dramatically increases the chances of developing type 2 diabetes — and a staggering 68 per cent of men and 58 per cent of women in the UK fall into this category.
More than 8 per cent of people over 20 years old are already diabetic, and a terrifying 33 per cent are pre-diabetic — well on the way to developing the full-blown disease.
That’s a third of all British adults whose bodies are laying the groundwork for type 2. And almost none of them will be aware of it, because in the early stages there are few, if any, signs or symptoms.
Unless we tackle obesity, which is fuelling this crisis, unless we can show parents living on tight budgets that feeding their families healthy food is not just better but often cheaper than feeding them on takeaway junk and processed food, unless we can drastically reduce the amount of sugar we consume, and unless, as a whole country, we find better ways to control what we eat and how we exercise, we are heading for a national health catastrophe that could wreck the NHS.
Already the annual cost of type 2 diabetes is estimated to be as high as £25 billion — lost in sick leave, early retirement and spent on hospital treatment. And though the prevalence of the illness has spiralled upwards in the past 20 years, we are seeing just the beginning of this crisis.
As the country gets older, rates of diabetes will rise. How high could the cost to the taxpayer and the economy go? £50 billion a year? Higher?
There are things that governments can do, such as the proposed tax on sugary drinks. We also know that food manufacturers are partly to blame, having spent decades creating irresistible junk food.
Last week, ministers issued voluntary guidelines to manufacturers urging them to reduce calorie counts in sweets. It is progress — but not enough.
Britain is not alone in facing this problem. Diabetes is a global epidemic. In Saudi Arabia, 25 per cent of people have type 2. One study suggests that at least half of all adults in China are prediabetic — that’s half a billion people on their way to developing a condition that causes blindness, heart problems and nerve damage among other serious problems.
In Vietnam, a surgeon recently told me that hospitals are performing more amputations due to type 2 diabetes than they did for landmine injuries at the height of the civil war. We
must find some way to tackle this condition and its devastating consequences — which brings me back to Professor Sir Muir Gray’s claim that type 2 diabetes is not a ‘real disease’ but just a ‘walking deficiency syndrome’.
There’s not much evidence that walking alone can prevent type 2 diabetes, because in most people it seems to be mainly the product of too much fat round the waist. But Professor Gray is certainly right that it can be reversed.
Research by Professor Roy Taylor, of Newcastle University, has shown that an 800-calories-aday diet stuck to for eight weeks can reverse type 2 diabetes in the majority of cases.
Professor Taylor, with whom I worked on my recent book, says that when patients are given hope and clear direction, the chance to control their own lives and not simply to fall back on taking tablets, most embrace the opportunity.
Even if you are on medication, being a type 2 diabetic can have serious consequences. Already in this country, it leads to 6,000 amputations a year.
Symptoms of type 2 diabetes include being thirsty, needing to pass urine a lot and having wounds that won’t heal. But often, particularly in the early stages, there are no symptoms at all.
SPoT-chEck surveys suggest that for every three people in the Uk who know they have type 2, there is another person who has it but doesn’t realise. The longer it goes undetected, the greater the harm and the less chance you will be able to reverse it.
My wife, clare, is a GP and one of the first things she tells diabetic patients now is: ‘Sorry, but we’ve been giving you the wrong advice for 20 years.’ That advice, which was mainly to take some pills and accept your fate, removed the incentive to change. It’s hard to be positive when you’re told by your doctor that there’s nothing you can do. As Professor Taylor says, you might as well hang a sign over the door of a diabetes clinic saying: ‘Abandon hope all ye who enter here’.
But there is something you can do if you are a type 2 diabetic or pre-diabetic — and that is to lose weight, particularly fat stored around the stomach.
Personal genetics also plays its part. Not everyone who is overweight has problems with their cholesterol or blood sugar levels, and many people with type 2 diabetes have a normal Body Mass Index (BMI).
It seems that some people have a greater capacity to carry fat safely than others do. It also depends where you lay it down.
The worst sort of fat is the fat around and inside your tummy, also known as visceral fat. We each have, it seems, our own personal fat threshold. Imagine you have an internal bathtub, which is slowly filling up with fat.
At some point, it will overflow and start to infiltrate your liver and pancreas.
The pancreas is responsible for producing the hormone insulin, which helps keep your blood sugar levels within a normal range. once it starts to get infiltrated with fat, it does not work as well — and this may then lead to type 2 diabetes.
The size of that internal bathtub varies from person to person. Although you can’t measure it, a good indicator of whether you have a lot of visceral fat is your waist measurement, which should be less than half your height. For instance, if you are 6ft tall — or 72 in — your waist should measure no more than 36 in.
The best way to measure your waist is round the belly button and not to rely on your trouser size.
one study found that men routinely knock an average of four inches off their waistline, by citing their trouser size instead. Just because a man’s trousers have a 36 in waistband, that doesn’t mean his waist is within healthy limits.
Manufacturers often make their clothes bigger than the label, to flatter our vanity. And how many middle-aged men have a roll of fat flopping over their belt?
As well as waist size, BMI is useful, but it won’t give you the information you really need — which is what your blood sugar levels are doing.
If you are at particular risk (if you have a family history of diabetes, you are over 50, your waist is over 37 in if you’re male or 31 in if you are female), then you can get a test done by your doctor, or a simple finger-prick blood test is available from your local chemist.
YET what about exercise, about which Professor Gray makes a big point? humans did not evolve to go to the gym, after all. our hunter-gatherer ancestors survived by conserving energy, not burning it on treadmills.
We are sedentary by nature and, sadly, modern life makes it much easier to sit all day. In our cars, at desks and in front of video games or TVs, we rarely have a reason to walk anywhere. And it’s difficult to change that.
But it does have to change. The responsibility falls squarely on us and on society in general, too. Because all of us will have to meet the massive health bills we are inevitably facing if nothing is done.
I have a strict policy that I never drive distances less than a mile if I can walk instead, and I never take the lift if I’m climbing five flights or fewer.
Breaking a rule causes me more distress than breaking a light sweat, so I stick to my resolution.
Let’s make it harder or more inconvenient to be lazy. Studies show that 50 per cent of people waiting for a lift will take the stairs instead if the elevator arrives, but the doors stay shut for just six seconds longer than normal.
Six seconds... that’s all it takes to spur us into action. Every lift should be late by law — the benefits could be immense.
our sedentary lifestyle and junk diets are killing us. We can change that. We have to stand up to type 2 diabetes. And to stand up, we have to get off our backsides.
The eight-Week Blood Sugar Diet by Dr Michael Mosley is published by Short Books, priced at £8.99.