What You Need to Know About Diabetes

Sugar? “ooh No, thank you.” I’m diabetic. You will hear this more often than not. Diabetes has become a major medical condition and it’s among the top causes of premature deaths. 

The most contributing factor is a change in our lifestyle and food choices, that often leads to type 2 diabetes.

1. What is Diabetes mellitus?

Diabetes mellitus indeed disrupts this normal process of glucose metabolism. Without sufficient insulin or with cells that are resistant to insulin, glucose cannot enter cells effectively, leading to elevated blood sugar levels. This can cause a variety of symptoms and complications if not managed properly.

Insulin, produced by the pancreas, plays a crucial role in regulating blood sugar levels by facilitating the uptake of glucose into cells for energy or storage as glycogen (in the liver and muscles). When there’s insufficient insulin or the body’s cells don’t respond properly to insulin, glucose remains in the bloodstream, leading to hyperglycemia.

Conversely, when the body needs energy but glucose levels are low (such as during fasting or between meals), the liver releases stored glycogen into the bloodstream as glucose, providing an essential energy source to maintain normal bodily functions. Glucagon is the hormone responsible for stimulating this release of glycogen from the liver.

Understanding these mechanisms of glucose metabolism and hormone regulation is crucial for managing diabetes effectively through medication, diet, and lifestyle modifications.

And sometimes the body is forced into burning fat and proteins for energy.

When there’s insufficient insulin or the body’s cells are resistant to insulin, glucose cannot effectively enter cells to be used for energy. As a result, glucose remains in the bloodstream, causing high blood sugar levels, a condition known as diabetes mellitus. This persistent elevation of blood sugar levels can lead to various complications over time if not properly managed. Managing diabetes typically involves medication, lifestyle changes, and careful monitoring of blood sugar levels to keep them within a healthy range.

When this state of hyperglycemia remains uncontrolled over a long period then we are likely going to introduce diabetes-related complications like stroke, heart attack, impotence, and kidney problems just to mention a few.

2. What’s the difference between type 1 and type 2 diabetes?

Type 1 diabetes 

Is an autoimmune condition where the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. This results in an absolute insulin deficiency, as you mentioned, and typically manifests in childhood, adolescence, or early adulthood.

Because of the destruction of beta cells, individuals with Type 1 diabetes require lifelong insulin therapy to manage their blood sugar levels and prevent complications. It’s quite distinct from Type 2 diabetes, which often develops later in life and is more closely associated with lifestyle factors such as obesity, physical inactivity, and poor diet. While Type 2 diabetes can sometimes be managed with lifestyle changes, medication, and/or insulin therapy, Type 1 diabetes requires insulin therapy from the time of diagnosis.

3. What are the risk factors of diabetes?

• Being overweight or obese: Excess weight, especially around the abdomen, increases the risk of insulin resistance, a precursor to Type 2 diabetes.
• Unhealthy diet: Diets high in refined carbohydrates, sugars, and saturated fats can contribute to weight gain and insulin resistance.
• Family history: Having a first-degree relative with diabetes increases the likelihood of developing the condition, indicating a genetic predisposition.
• Physical inactivity: Lack of regular physical activity can contribute to weight gain and insulin resistance.
• History of gestational diabetes: Women who have had gestational diabetes during pregnancy are at increased risk of developing Type 2 diabetes later in life.
• Diagnosis of pre-diabetes: Pre-diabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as Type 2 diabetes. It’s a warning sign that diabetes may develop if lifestyle changes are not made.
• Age: The risk of Type 2 diabetes increases with age, particularly in individuals aged 40 and above.
• PCOS (Polycystic Ovary Syndrome) or hypertension: These conditions are associated with insulin resistance, which increases the risk of developing Type 2 diabetes. Identifying and managing these risk factors through lifestyle changes, such as adopting a healthy diet, increasing physical activity, and maintaining a healthy weight, can help prevent or delay the onset of Type 2 diabetes. Regular screening and early intervention for those at high risk, especially those with multiple risk factors, are also important for early detection and management.

3. When to see a doctor.

Sometimes you may actually never know you have diabetes, as you may not show any symptoms at all, especially for pre-diabetes. 

But the  3 most common symptoms should send you quickly to the doctor.

• Frequent urination (polyuria): High blood sugar levels lead to increased glucose in the urine, drawing more water from the body, which results in increased urination.
• Frequent hunger (polyphagia): In diabetes, the body’s cells may not receive enough glucose for energy despite high blood sugar levels. This can lead to persistent feelings of hunger as the body tries to compensate for the lack of energy.
• Frequent thirst (polydipsia): Excessive urination caused by high blood sugar levels can lead to dehydration, triggering feelings of thirst as the body tries to replenish lost fluids.

4. Why is the insulin hormone important?

Insulin is a hormone produced by the pancreas that plays a crucial role in regulating blood sugar levels. Its primary function is to facilitate the uptake of glucose into cells throughout the body, where it can be used for energy production or stored for future use.

When insulin is insufficient or ineffective (as in Type 1 or Type 2 diabetes, respectively), glucose cannot enter cells effectively. As a result, blood sugar levels remain elevated because the glucose remains in the bloodstream rather than being utilized by cells for energy. This elevation of blood sugar levels can lead to various complications if not properly managed.

5. Why is nutrition important?

Food plays a central role in managing diabetes effectively. The choices we make about what and how much we eat directly impact blood sugar levels. A balanced diet consisting of complex carbohydrates, lean proteins, healthy fats, and plenty of fruits and vegetables is crucial for managing blood sugar levels and overall health in individuals with diabetes.

Here are some key dietary principles for managing diabetes:

1. Carbohydrate management: Monitoring carbohydrate intake and choosing complex carbohydrates (such as whole grains, fruits, vegetables, and legumes) over simple sugars can help regulate blood sugar levels more effectively.
2. Portion control: Controlling portion sizes helps manage calorie intake and prevent blood sugar spikes.
3. Balanced meals: Meals that contain a balance of carbohydrates, proteins, and fats can help stabilize blood sugar levels and provide sustained energy throughout the day.
4. Fiber-rich foods: Fiber slows down the absorption of glucose and helps regulate blood sugar levels. Including plenty of fiber-rich foods like fruits, vegetables, whole grains, and legumes in the diet is beneficial.
5. Healthy fats: Choosing sources of healthy fats, such as avocados, nuts, seeds, and olive oil, can help improve insulin sensitivity and manage blood sugar levels.
6. Regular meal timing: Eating meals and snacks at consistent times throughout the day can help regulate blood sugar levels and prevent overeating.
7. Hydration: Drinking plenty of water and avoiding sugary beverages can help prevent dehydration and support overall health.

6. Why is Medical Nutrition Therapy important?

• Very important to help you prevent the onset of diabetes.
• Helps you to manage your blood sugar levels and maintain them at a normal range.
• Helps delay and prevent the occurrence of diabetic complications which can be life-threatening and very expensive to treat.

7. What Foods does a Nutritionist recommend?

• Fruits and vegetables; are low in calories, and full of vitamins, minerals, and fibre. Slice your fruits into smaller portions, and eat 5 portions every day. Include a variety of these fruits and vegetables to get the most out of them.
• Carbohydrates (Like bread, pasta, potatoes, and rice) are the first culprits, they raise blood glucose levels quite fast. Prefer foods with a low GI-glycemic index mostly whole grains, whole wheat, pasta, and brown rice. Which will enter your blood system more slowly than the foods with a high glycemic index like processed foods like cakes, sweets, soda, and energy drinks. Learn ways for portion control.
• Healthy proteins (less red meat/processed foods) More plant-based proteins. Proteins may not raise your blood glucose levels fast, but animal proteins are to be moderated to also reduce the consumption of saturated fats.
• Dairy foods( More proteins and calcium) Check for added sugars, good for bones/teeth, good for muscles. (eat every day.)
• Oils /fats (Less saturated fat more unsaturated fat from nuts and seeds).
• Say NO to the high fat, high salt, and added sugars.

8. What are the most common complications?

• Cardiovascular diseases: Diabetes increases the risk of heart disease, including heart attacks and strokes, due to factors such as high blood pressure, high cholesterol levels, and damage to blood vessels.
• Neuropathy: Nerve damage caused by diabetes can lead to various complications, including erectile dysfunction, as well as numbness, tingling, or pain in the extremities.
• Nephropathy: Diabetes can damage the kidneys over time, leading to kidney failure and the need for dialysis or kidney transplant.
• Retinopathy: Diabetes can cause damage to the blood vessels in the retina, leading to diabetic retinopathy, which can result in vision loss and blindness if left untreated.
• Skin conditions: Diabetes increases the risk of various skin conditions, including bacterial and fungal infections, as well as slow wound healing.
• Hearing impairment: Diabetes has been linked to an increased risk of hearing loss, although the exact mechanisms are not fully understood.
• Foot damage: Nerve damage and poor circulation associated with diabetes increase the risk of foot problems, including ulcers, infections, and, in severe cases, amputation.
• Depression: Living with diabetes can be challenging, and the stress of managing the condition, as well as the impact of complications, can contribute to depression and anxiety.