What is Type-2 diabetes?
Type-2 diabetes is a chronic (long-term) disease marked by high levels of sugar in the blood. It is sometimes called a lifestyle disease, because it is more common in people who don’t do enough physical activity, and who are overweight or obese.
Type-2 diabetes is diagnosed when the pancreas does not produce enough insulin (reduced insulin production) and/or the insulin does not work effectively, and/or the cells of the body do not respond to insulin effectively (insulin resistance).
Type-2 diabetes is the most common form of diabetes, contributing to approximately 85% of all cases.
There are currently over 1.2 million people in Australia with diabetes. This figure is expected to increase significantly in the coming years, with over 2 million people at high risk of developing diabetes.
People with diabetes have a higher risk of developing heart disease, stroke, high blood pressure, circulation problems, lower limb amputations, nerve damage and damage to the kidneys and eyes.
In 2004-2005, 60% of all people reporting diabetes also reported having cardiovascular disease
– Australian Bureau of Statistics
Risk Factors
Many Australians, particularly those over the age of 40, are at risk of developing Type-2 diabetes through poor lifestyle choices such as inadequate physical activity and poor nutrition.
Some genetic factors may also increase your risk of developing type-2 diabetes.
Symptoms
Common symptoms include:
- Increased thirst;
- Frequent urination;
- Unexplained weight loss;
- Increased hunger;
- Reduced energy;
- Reduced healing capacity;
- Itching and skin infections;
- Blurred vision;
- Increased weight;
- Mood swings;
- Leg cramps.
Insulin
Insulin is a hormone produced by the pancreas that allows the body to use glucose from carbohydrates in the food for energy, or to store glucose for future use. Insulin helps keep your blood glucose level from getting too high (hyperglycemia), or too low (hypoglycemia).
Many of the cells in your body use glucose for energy. However, glucose cannot go into most of your cells directly. After you eat food and your blood glucose level rises, the beta cells in your pancreas are signalled to release insulin into your bloodstream.
Insulin is often described as the key that unlocks the cell to allow sugar to enter the cell and be used for energy.
If you have more glucose in your body than it needs, insulin helps store the glucose in your liver and will release it when your blood glucose level is low or during times of physical activity. Therefore, insulin helps balance out blood glucose levels and keeps them in a normal range. As blood glucose levels rise, the pancreas secretes more insulin.
If your body does not produce enough insulin or your cells are resistant to the effects of insulin, you may develop hyperglycemia, which can cause long-term complications if the blood sugar levels stay elevated for long periods of time.
Below is a table explaining risk levels based on your blood glucose levels, in both fasted and non-fasted (2-hours post-meal) states.
What can you do about lowering your risk?
For a start, your lifestyle choices can definitely lower your chances, or, at least delay the onset of type-2 diabetes.
There are some factors that you can not change, such as your genetic makeup and predisposition to developing type-2 diabetes. You can, however, do something about being overweight, waist measurement, how active you are, eating habits, and how much or often you smoke.
Even if you haven’t won the gene pool lottery, you can still reduce your risk with positive lifestyle choices. This is called gene expression. Simply put, you genes load the gun, but it’s your environment that pulls the trigger.
What does this mean? Well, by increasing your physical activity, improving your eating habits and getting some quality sleep you will be well on the way to lowering your overall risk.
Sleep quality
Poor sleep can affect diabetes both directly and indirectly, by changing normal patterns of hormones, contributing to greater weight gain and obesity, and causing changes to lifestyle.
Sleep deprivation or poor sleep quality, especially as we reach middle age and older, can almost double your risk of developing type-2 diabetes, according to several large studies.
Sleep deprivation also increases the stress hormone cortisol, which can make cells even more insulin resistant.
By improving your sleep patterns you will be setting yourself up for success. Sleep has a strong influence over eating patterns, exercise habits, and the hormones that regulate hunger and satiety.
Physical activity
The Australian Government Department of Health guidelines for physical activity suggest that adults should be aiming for somewhere between 2.5 and 5 hours of moderate level physical activity per week, or alternatively, 1 to 2.5 hours of high intensity physical training.
Most people understand the benefits of pushing some weight around in the gym, but this doesn’t mean that everybody needs to live there. A casual jog or run around the river, swimming some laps in the pool, a game squash or even a short hike will all work well. The variations are endless.
Even something as little as adding a 30 minute walk after meals you can greatly reduce the amount of insulin required to transport glucose around the body.
The take away here is that some physical activities better than zero physical activity.
Nutrition
Making the shift to more of a whole food based diet and lowering your overall carbohydrate intake will great reduce the body’s requirement to control insulin. A paleo type diet is a good place to start as it eliminates most of the troublesome foods like refined sugars, cereals and grain based products, and emphasises on eating lean meats and fish, along with plenty of vegetables and some healthy fats and oils.
The aim here is to reduce the amount of insulin required to transport glucose around the body. Lowering your dietary carbohydrate intake will most definitely reduce the need for your body to produce insulin.
How low-carb do you have to go? Well… The issue here is that what works for one person may not work as well for the next. This is where personalised nutrition can play a part in your success. All this means is that different foods react differently with different people.
Modern era diets can be upwards of 55% carbohydrate for total caloric intake. This can be about 300-350 grams per day. That is quite high considering how sedentary the modern lifestyle has become.
Lets say you half that number. 100-150 grams per day. Pretty easy to do if you ditch cereal and grain based products. It takes a lot of broccoli and spinach to total 100 grams of carbohydrate.
Now combine that with quality sleep and some physical training, and you will be reducing your body’s requirement to produce insulin whilst activating optimal fat burning processes.
Another bonus is that you will be lowering your total caloric intake without a real loss of nutrient density, so you’ll probably find that you’ll also lose a few unwanted kilograms at the same time, which will likely improve several other health biomarkers, leading to an improved quality of life.
To me, that looks like a net win.
If you are struggling with controlling your insulin levels, it is always best to consult with your health professional.
David Marcato 