It is both bewildering and depressing that one of the most prevalent diseases plaguing the modern world today is actually preventable, modifiable, and can even be reversed without the need for any expensive medication or surgical procedures.
In the UK today around 5% of the population (over 3 million people) have been diagnosed with type II diabetes. These figures alone seem staggeringly high but there are also potentially many more that are yet to be diagnosed. Once diagnosed you join a population with a drastically increased risk of premature death and disability. Overall the risk of early death among those diagnosed is about twice that of people without diabetes of a similar age.
Type 2 diabetes arises because of resistance to a hormone called insulin. After eating a meal, insulin is produced by the pancreas and released into the blood stream to reduce the amount of carbohydrate (sugar) in the blood. Insulin helps to transport sugar from the blood so it can be stored in one of a number of places (liver, muscles, even fat cells). Problems start in situations when the sugar content of the blood is constantly high. The body has to keep releasing insulin to clear the blood of sugar and soon the body thinks the elevated insulin levels are normal. Eventually insulin starts to be less effective at removing the sugars from blood. The body then responses by releasing more of the hormone and over time this chronic state of high sugar, high insulin is when a person eventually enters a diabetic, insulin resistant condition.
So what leads to a chronic state of elevated blood sugar in the first place? And what are the risk factors we need to be aware of when it comes to diabetes? The main thing to consider here is improper eating. Excess sugar or carbohydrates, excessively large meals or glycemically imbalanced meals will all play a major role in insulin sensitivity. When you consider that around 80% of people with type II diabetes are obese at onset, it’s clear that a poor diet is the main contributor to this disease.
The risk of developing this disease will also be higher in older populations, ethnic minority populations and in people with a sedentary lifestyle. However, despite being historically known as ‘adult onset diabetes’ due to the increased risk and appearance after the age of 45, the disease is diagnosed more and more in younger populations. This is an indication of people adopting poor dietary habits and lifestyle choices earlier in life, something reflected by the increase of childhood obesity. The bad news is that with more and more people being diagnosed with this disease there is an ever increasing rate of the health problems associated with diabetes. Heart disease and stroke, blindness, kidney disease, amputations and high blood pressure are just some of the related issues.
The good news is all this is entirely preventable. In fact the vast majority of type II cases could be prevented by the adoption of a healthy lifestyle. Although nutritional modifications should be tailored to the individual, research does seem to suggest that reducing overall carbohydrate does appear to be an effective approach in the treatment of type II diabetes. The type of carbohydrate is also relevant. The detrimental effects of a high-carbohydrate diet on blood glucose (sugar)/insulin occur only when foods with a high glycaemic index are consumed (often found in baked goods and sweetened drinks which are high in starch and refined sugar). These effects are largely abolished when carbohydrates come from high fibre, low glycaemic index foods like vegetables and whole grains. It appears that people wishing manage their insulin sensitivity and type II diabetes must consider both the amount and type of carbohydrate they eat.
It also appears that by simply losing weight and reducing body fat to within a healthy range people can significantly reduce the risk of developing the disease. This can also help to restore (or at least significantly improve) normal glucose tolerance and blood sugar levels in those who have already been diagnosed.
A key lifestyle choice that often goes hand in hand with weight loss is exercise. Many consider exercise as a cornerstone to type II diabetes care and treatment. It will help to improve blood sugar levels, insulin sensitivity, reductions in body fat, cardiovascular function and stress levels. Although an individual's needs and capabilities should always be taken into account before prescribing an exercise regime the American College of Sports Medicine (ACSM) has recently suggested the following guidelines.
- Moderatlely intense physical activity on most, if not all, days of the week.
- Exercise sessions of at least 30-60 minutes per day
- Aerobic activity expending a minimum of 1000 calories per week.
- Resistance training (at least 1 set of 10-15 repetitions for between 8-10 exercises) at least two days per week.
For some people this may sound like a lot to fit into an already busy schedule but when you consider the alternative even a small amount of exercise is often better than none. Much of the research surrounding High Intensity Interval Training (HIIT) has shown that improvements in blood glucose control can result from as little as 3 minutes of exercise a week. HIIT is simply where participants work maximally for repetitive short bursts e.g. sprints on a spin bike, for as little as 20seconds at a time. This type of training only requires a small amount of volume to exhibit an effect (as little as three repetitions or bursts, 3 times a week). This could easily fit into anybody’s busy schedule.
On the point of people’s busy life schedule there is one area of lifestyle that also needs addressing - stress. Looking healthy, having a muscular body, and exercising regularly do not always mean you have normal blood sugar management. The hormone cortisol, which is released in the body in times of stress, parasitic infection, food allergies and inflammation, will also elevate blood sugar and therefore insulin levels. In other words, you could have a perfect diet and exercise program, but if your cortisol levels are constantly elevated with an over stressed lifestyle you may also be increasing your blood sugar from the inside.
Management of blood sugar levels and keeping your body sensitive to insulin release can be a relatively straight forward process. If you are overweight, have bouts of excessive hunger or thirst, urinate excessively, feel tired after meals or have sugar craving after meals then you may be close to the onset of type II diabetes. To help bring your blood sugar back under control and potentially reverse any threat of the disease the following lifestyle guidelines should be followed:
- Eat fruit and or vegetables with every meal
- Eat protein with all meals (by replacing the some of carbohydrate)
- Avoid trans fat and processed food consumption
- Eat or supplement with foods containing omega-3 fats
- Do some regular exercise including strength training
- Consume no less than 25 grams of fibre per day (replace the sugary foods)
Some key nutrients to look out for to help with insulin resistance are chromium found in foods such as onions and tomatoes. This can increase the presence of glucose transporters on cell membranes to help reduce blood sugar. Biotin found in carrots and chicken eggs is good for controlling excessive liver glucose release and coenzyme Q(10) found in fish and liver meat can help to decrease insulin release from the pancreas.
Despite being so rife and with an ever increasing rate of diagnosis, type II diabetes is not a disease with an elusive cure. It’s simply a case of changing bad habits for good ones by eating and moving the way we were created to. It’s a modern disease with a cure hiding in fresh organic natural food and a stress free physical lifestyle.