Diabetes: “I’ve just got a touch of the sugar, doc.” – the epidemic sweeping the nation.
Within 2 years, the number of people in Australia with type 2 diabetes is expected to reach more than 2.5 million. This will be close to 10% of the population. It is a concern that underdiagnosed or poorly managed type 2 diabetes can result in coronary artery disease, stroke, kidney failure, limb amputation and blindness. Early diagnosis and weight loss is critical to reducing complications and mortality.
What is diabetes?
Diabetes is a progressive condition. We often hear the term “Touch of sugar” which is an inaccurate phase as you either have impaired sugars or you don’t. There is no ”just a touch” about it and if untreated, the disease will progress to affect multiple organs if the body. The most common early are symptoms:
- Tired after sleep – unrefreshing sleep
- Frequent urination
Diabetes initially is treated with lifestyle changes to diet and exercise. Weight Loss can have an immediate and effective impact on disease progression and in some early cases can reverse diabetes altogether. However, despite lifestyle changes and oral medication for diabetes, the harsh reality is that 50% of people diagnosed with diabetes, will need insulin within 10 year. These needs will change over time as generally our body’s insulin needs will increase over time. Our body manages the increase in blood sugars by instructing our pancreas to make more insulin. But at some point the beta cells of the pancreas fail and the pancreas cannot make it anymore. This is when diabetes develops.
Living with Diabetes
Diabetes is a difficult condition to live with. Some people are more motivated than others to make the lifestyle changes that are needed to stop the progression of diabetes. Even if we cannot reverse diabetes completely with weight loss and lifestyle changes, we know that good sugar control (called glycaemic control) in the 1st 10 years makes a difference to disease progression and complications. Good control of diabetes means that most of the rise in the blood sugar levels comes from eating (post prandial). This is like that large sugar rush we get after a Mars bar. Poor control means that the blood sugar levels are high even when fasting meaning that we do not have enough effective insulin to reduce the sugar levels in our blood even when we are not eating.
How can we help reduce the burden of diabetes on the individual.
Diabetes is a hard journey for the patient. It is so important to involve the entire family especially the food preparer and partners. The role of dietitians, exercise physiologists, podiatrists, diabetes educators and medical specialists are essential. If the weight loss can occur early, then the progression of diabetes and the burden on the pancreas will be reduced.
Lifestyle changes in Diabetes
Eating a low GI diet and reducing refined carbohydrates are the key to keeping fasting sugars down. Most of the glucose comes in our diet comes from carbohydrates, so it is important to look closely at what % of our diet is carbohydrates. There is good evidence that the Mediterranean diet has a large impact on reducing the progression of diabetes. But it is important we don’t blame carbohydrates on everything and anything including climate change. The key message is that we should be eating healthy, reducing your refined sugars (sweet treats) and focus on getting fresh ingredients into our diet. . A good way to simplify this is to eat a low “HI” diet. That means a low “human interference” diet. We spend a lot of time learning how to eat food labels, but there is an argument, that if we have to read the food label, should we be eating it at all?
Regular exercise is also essential to keep the blood sugar running at a good level. But the key is finding something that is enjoyable and sustainable. If we ask people who exercise regularly, why they do it. They will not say, “because my doctor told me to”. Find exercises you enjoy doing. Do it in groups. Do it with friends. Have goals and aims to drive you even if it is, to go that extra 100 meters more each time. If exercise makes sense to you, it has meaning to you.
How do we keep up the motivation?
Most importantly, as this may be a lifelong disease, motivation and psychological help is critical for support and mental health. Look for support in friends and family. The Diabetes Association has some excellent resources. If you need some psychological support, our CBT Weight Loss Program may be useful to you. Diabetes and obesity are the two most worrying health trends of this century and they go hand in hand. If you have a “touch of the sugar”, please do go and see your doctor and seek some help.
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