What is Type 2 Diabetes?
The early signs of type 2 diabetes are seen when one can no longer control as effectively the amount of glucose (simple sugars) which are circulating in the blood. In a properly functioning system, when we eat carbohydrates they are digested and broken down into simple sugars so that they can be taken up into our body cells and used to release energy. The hormone insulin is critical in this process. Usually we produce insulin in response to eating, "telling" the body to clear excess glucose out of the blood and into the cells for use there.
Insulin resistance is an early sign of diabetes risk and it is when we are still producing insulin but the body is no longer responding as well to the messages and is not clearing the glucose effectively. As a result, the pancreas produces more insulin in an attempt to regain control. Long term this over production is not sustainable and in the worst scenario the body stops producing insulin altogether.
It is important to regulate the amount of glucose in the blood because excessive circulating glucose can attach to heamoglobin and form harmful compounds. Also, because the cells are not receiving their usual food supply (glucose), they release free fatty acids into the bloodstream which lead to a poor blood lipids profile (commonly referred to as high cholesterol etc).
Why does Insulin resistance occur?
No one is entirely sure why insulin resistance develops but it is strongly associated with lifestyle factors. Risk factors include family history of diabetes, ageing, some medications,and more than anything else obesity and inactivity. 90% of diabetics are overweight. Carrying excess weight around the organs (around your middle) is especially dangerous. Most women develop some level of insulin resistance in the latter stages of pregnancy. This resolves after birth however.
Should I Worry?
Yes, you should. The worldwide incidence of diabetes is growing rapidly. In Australia it more than doubled between 1989/90 and 2007/8. Not only does controlling blood sugars become a daily issue but diabetes directly increases your chances of a heart attack, stroke, kidney dysfunction, nervous system damage and ulcers (sometimes resulting in amputations), and blindness.
Can Type 2 Diabetes be Prevented?
To a very great extent, yes it can. Eating a healthy diet with plenty of fibre, vegetables and fruits and wholegrains is a great prevention method. Add to this a lifestyle which involves daily movement- some as part of life (eg stair climbing, walking or cycling to work, digging in the garden) and some intentional (dancing, running, playing a sport, swimming and so on). If you choose to drink alcohol, do so very moderately. Don't smoke. Keep the weight off.
Lifestyle changes such as these can reverse the early signs of insulin resistance if they are kept up. This is not a 6 week fix, its a change for life. Impressively, lifestyle change is more effective then diabetes drugs at preventing insulin resistance from progressing to full blown diabetes. It is also a really healthy way of life in terms of reducing the risk of all kinds of other chronic diseases- heart disease, stroke, and so on.
And Can Type 2 Diabetes be Reversed?
Well, thats more complicated. In theory yes it can, but the kind of diet which is effective in achieving this is very low calorie and very low carbohydrate and most people find that too hard to maintain over time. If obese then losing a lot of weight is a very effective method of reversing diabetes. For many people this is very difficult and many resort to bariatric surgery. Dietary change is definitely a great strategy however.
Can I Diet and Not Exercise?
Exercise is a key ingredient in the mix. Muscle is a big user of glucose and muscle contraction causes glucose take-up from the blood (with no insulin necessary). So, to increase muscle means you are increasing the body's capacity to clear sugars from the blood even when the insulin mechanism isn't working properly. Both aerobic exercise (makes you pant) and resistance exercise (eg weights, using your muscles) are important but resistance will build up more muscle, which is a very positive thing.
Which Diet?
If your goal is weight loss then the answer to that is whichever diet works for you and can be maintained longterm. Low fat, low carbohydrate, low calorie...whatever you find easiest. However, its also important to give consideration to what is a balanced diet for your whole body, thus a 'grapefruit and eggs only' diet is unlikely to deliver all the nutrients that you need for life...
The Mediterranean diet is an excellent choice for a lifelong healthy diet but if weight loss is needed then reducing how much you eat and drink is going to be part of the solution.
Need Help?
A nutritionist or dietitian can hep immensely in making sense of all this and helping you to make the important changes which can prevent, slow down and control type 2 diabetes. Contact me if you'd like to talk more.
