CIC Blog

HEALTH NUGGET- DIABETES

Question:

Hello Doc,

Thank you for these nuggets.  As usual, they are not only enlightening but also provide a moment for self-evaluation and reflection. Kindly do share on Diabetes. We have recently seen a surge in patients suffering from diabetes in their adult life. How do we prevent this? How do we manage and support so as not to get to a point where one requires dialysis.

Many thanks.

Be blessed……..XYZ

Answer:

Thank you XYZ for your request. This month we shall share on Diabetes. This disease usually occurs in two common forms. Type 1 (we call childhood) or youth onset) starts quite early, often due to diseases of the pancreas, such as infections. The patients tend to use Insulin for the rest of their lives. Approximately 25% of Diabetic patients are Type 1.

The second form, which you are asking, is the Type 2 (we call maturity or adult onset variety) which starts in adulthood. 75% of diabetics fall in this group. Patients tend to use anti-Diabetic pills, with many moving on to the use of Insulin injections. The basic problem in Type 2 Diabetes is the inability of the pancreas to handle sugar control adequately. As a result, the sugar is not utilized by the body well enough, and hence it increases in the blood. As a result, the sugar is filtered through the kidneys and spills into the urine.

We are able to use lifestyle factors to control Type 2 diabetes better than Type 1. Fortunately Type 2 is the commonest type of Diabetes. Therefore prevention in this type is a big deal. We shall deal with this Type 2 now only.

HOW TO PREVENT AND CONTROL TYPE 2 DIABETES

It is especially important to make Diabetes prevention a priority. There are several lifestyle factors to watch for those at high risk. For example, if you are overweight or have a family history of the disease, lifestyle modifications are very critical. With time poorly managed diabetes will damage the eyes, blood vessels, nerves, heart and the kidneys. Damaged kidneys can no longer filter blood well to remove the poisonous waste chemicals. When this happens, one requires dialysis. This is a procedure to assist the kidneys excrete the poisonous wastes that they are unable to do on their own.

We now know that one’s lifestyle will make or break the process of getting diabetes or progressing to kidney damage. A good preventative diabetic prevention program will increase the pancreas’s ability to handle the sugar adequately (what we call increased sensitivity) and reduce the rates of complications (such as damage to eyes, nerves, kidneys and heart) resulting from high blood sugar levels.

There are 6 basic diabetes risk factors which when on the flip side of the coin are key for prevention and diabetes control. These risk factors are part and parcel of our modernity and what the changing times have brought:-

  1. Lack of exercise,
  2. Increased weight,
  3. High fat diets,
  4. More stress
  5. Increased use of tobacco and
  6. Increased use of alcohol.

In short, Diabetes prevention is as basic as eating more healthfully, becoming more physically active and losing a few extra kilograms (which incidentally is done by both exercise and diet); and it’s never too late to start. Making simple changes in your lifestyle now will help you avoid getting diabetes, and if you already have it, it will help you avoid the serious health complications of diabetes down the road.

SO WHAT IS THE BOTTOM LINE IN THE DIABETES STORY?

Genes loads the gun….

Lifestyle pulls the trigger!

TIME TO CHANGE THE NARRATIVE: STOP DIABETES!

WHAT ARE KEY DIABETES PREVENTION TIPS?

The latest diabetes prevention tips from the world famous trend setting American Diabetes Association, summarizes their findings:-

Tip 1: Get more physical activity.

Greatest benefit comes from a regular fitness program, and not an erratic occasional exercise regimen. A minimum of 4 times a week exercise program is advised. This will also help you lose weight, lower your blood sugar; and more importantly boosts your body’s sensitivity to Insulin (i.e. makes your pancreas handle insulin better), thus helping keep your blood sugar within a normal range.

Tip 2: Get plenty of fibre on your diet.

Fibre is called roughage. It’s rough, it’s tough, and it will help you. Foods high fibre includes vegetables, legumes (beans, peas, lentils, dhal etc), whole grains, nuts, seeds and fruits. Fibre in diet improves your blood sugar control, lowers your risk for heart disease and helps promote weight loss. Go for whole grains as these are the ones that help blood sugar control. Consequently brown and whole grain bread is better than white flour bread. This includes various breads, chapattis, pasta products and many cereals.

Tip 3: Loose extra weight.

If you have diabetes and are overweight, your diabetes prevention may just hinge on weight loss. Every kilogram of weight you shed improves your blood sugar control and overall health. In one study, overweight adults reduced their diabetes risk by 16% for every kilogram of weight loss. Also those who lost weight and also simultaneously exercised regularly, reduced their risk of developing diabetes by almost 60% over 3 years. Losing weight is not easy. But you can seek professional help to lose weight via a good program of diet and exercise. May I caution that you avoid the many fad diets in the market. Low carbohydrate and high protein diets may help you lose weight at first (sometime you only loose fluid), but their effectiveness at preventing diabetes is either unknown or absent. Besides you may end up with essential nutrient deficiencies.

Tip 4: Keep off tobacco products and alcoholic beverages.

These promote diabetes, its complications and also other health problems such as heart disease, high blood pressure and cancers. The use of tobacco and alcohol is no longer considered a social amenity, but a serious health hazard to those with Diabetes. To manage and keep away from diabetes, avoid these two habits.

Tip 5: See your doctor for diabetes screening, especially if you are overweight, you don’t exercise or have a family history of diabetes i.e. one of your family members have diabetes. When you next see your doctor, share your concerns about diabetes and this nugget. They will check your blood sugar and possibly urine, and offer additional suggestions based on your medical history.

Now that you have the tips, what counts is taking steps to make them a habit. May I suggest you start by choosing an exercise regime that is comfortable and enjoyable. It really doesn’t matter which one so long as its exercise. Then choose a convenient time for you. Some walk over lunch time and skip lunch altogether. Another rope skips every evening when they get home. I met another bicycling every weekend. Another has an exercise cycle/treadmill al home to use every evening. Others go swimming in the evenings after work. A colleague of mine swims at the club every morning at 5 am. Now that’s determination. But it’s not for everyone to swim at that hour. Choose what works best for you. Then work on your diet to have more plant and less animal origin products. These are small choices which will prevent you getting (or controlling) diabetes or not.

Now that is something to think about……..and include in your new year’s resolution!

HAPPY AND HEALTHY NEW YEAR- 2019