Type 2 Diabetes (T2D) is reaching pandemic proportions across the world. The health consequences and cost to the global economy has reached astronomical proportions. Add to this the immense social and tragic human cost of this terrible disease and the true nature of this illness becomes apparent. In 1985 approximately 30 million people had diabetes globally. In just fifteen years by 2000 this had soared to 177 million. It is now estimated that this will increase to 300 million by 2025; ten times that of 40 years earlier. T2D probably represents the world’s biggest health threat since the communicable diseases of nineteen hundreds where tens of millions of people died.
Diabetes leads to a number of serious and life threatening conditions which are primarily brought about by the toxic levels of sugar in the blood. This long term hyperglycaemia eventually leads to tissue damage, most notably of the vascular system, nervous system, eyes and kidneys. The consequences then can be blindness, kidney failure, amputations and premature death from coronary heart disease. Most type two diabetics do not reach their 60th birthday.
It is believed that the mechanisms driving T2D are our unhealthy lifestyles and expanding waistlines. Interestingly T2D can be put into remission in 80% of cases by a 500kcal diet and this tells us that perhaps the main driver of the disease is a constant calorie overload. Further to this it is known that sensitivity to insulin in the target cells (particularly the muscles which represent 40% of the mass of the body) is blunted in people that are sedentary for long periods of time. As fat mass increases, fat cells become bloated and they too become insulin resistant. Similarly the liver in its quest to process far more food than is required also loses its ability to respond appropriately to the signal of insulin.
Against this backdrop of insulin resistance in well over 90% of the body’s target cells, the pancreas has to work overtime to constantly supply sufficient insulin. Eventually it succumbs to this burden and fails, leaving the host without a mechanism to remove sugar from the blood and a diagnosis of T2D with all the consequences that this brings.
If you are worried about T2D because you have a family member with the condition or your doctor has told you that you are pre-diabetic, or for any other reason for that matter, here are the top 8 things that you should consider doing:
- Measure your waist circumference. If it is greater than 80cm if you are female or 94cm if you are male, you should start to reduce your calorie consumption until your waist reduces to well below these levels.
- If you are currently taking less exercise than 30 minutes each day, you should start to work towards this as a minimum. This can be in three ten minute sessions each day and start light to moderate if you are new to exercise. In time you should aim to build to one hour a day of moderate intensity exercise to offer maximum protection for obesity and diabetes. This is a lifetime commitment as you cannot accrue the benefits of exercise.
- Start to monitor the amount of sugar and high glycaemic index (GI) carbohydrates (those that the body can easily turn to sugar) in your diet. Try to reduce these to a minimum. Consider calculating the Glycaemic Load (GL) of your meals (GI multiplied by grams of available carbohydrate in the food) and aim to minimize GL at every meal.
- Consider the total carbohydrate content of your diet and ensure that it is no more than 50 percent of your total calories. Increase the protein content of your diet to compensate, but don’t eat more than 20 – 25% protein.
- Reduce the fat in your diet to help with weight loss and also to reduce the build-up of fats in the organs which is a high risk factor for not only diabetes but a number of other killer conditions.
- Purchase a blood sugar monitoring kit and monitor your readings whilst you experiment with adjustments to your diet and exercise patterns. Be sure to first start testing at least three days before you undertake any changes in order that you can measure the powerful impact that this simple lifestyle changes will make.
- Be sure to get adequate sleep. It has been shown that even short durations of sleep deprivation can bring about an increase in insulin resistance and this could be a significant contributor to the development of the condition for many people. Furthermore sleep deprivation makes us tired, unable to make good lifestyle choices and an aversion to physical activity.
- If you are overweight, set yourself a target of half a kilo of weight loss each week. Think about joining a weight loss group or ask other people to join you. Weight loss is always more successful when you are part of a team or group of people all helping each other. Don’t think about crash diets or rapid weight loss as they will surely fail. Take a long term perspective and set yourself a goal for six or even twelve months.