There are two types of diabetes: Type 1 and Type 2.
In this article I will focus on type 2 diabetes, which is more common.
In the past, type 2 diabetes was something that affected mainly older people, however, it is becoming more and more prevalent among younger people as obesity prevalence increases and it is now not unusual to diagnose type 2 diabetes in people in their early twenties and even in their teens. Diabetes is currently so prevalent that it kills more people worldwide annually than cancer does. That’s scary for a disease that is often brushed off as ‘nothing to really worry about’. Another worrying fact about diabetes is that for all the people diagnosed with diabetes, there are probably three times as many people with undiagnosed diabetes or Pre-diabetes.
So, why is diabetes becoming so prevalent and why is it so often diagnosed late?
The incidence of type 2 diabetes is rising as a result of changes in our diet and lifestyle. To understand this, we need to have a very basic knowledge of what diabetes actually is.
Type 2 diabetes is a disorder of insulin production.
Insulin is secreted from the pancreas in response to rising blood sugar levels after eating. The function of insulin is to move the glucose or sugar from the blood stream, where it has detrimental effects, into the cells that need it for energy (such as brain cells). In a well-balanced diet of whole foods, low levels of insulin are required to shunt glucose from the bloodstream. When a diet becomes loaded with sugar and highly processed foods, more insulin is required to move glucose. Higher insulin levels cause weight gain and increased fat cells in turn cause insulin resistance, which means that even more insulin is needed to serve its function. High insulin levels thus precede the high blood glucose levels that are traditionally required to make a diagnosis of diabetes. We call this state prediabetes or insulin resistance. The good news is that this state is largely reversible with very strict lifestyle changes.
Diabetes is often diagnosed late because the symptoms of diabetes only manifest once the disease has been present for a while. This is a problem because the later the diagnosis is made, the more irreversible damage has been done to organs such as the heart, kidneys and eyes. It’s almost a case of once you have symptoms of diabetes, it’s too late. Ideally, you want to catch diabetes in the prediabetes phase. This should make obvious the importance of regular screening for diabetes and prediabetes. Most pharmacies will do a fingerprick gluose test which will diagnose overt diabetes, but you may need to see your doctor for formal blood tests if you want to exclude prediabetes or quantify how bad your diabetes is.
Management of diabetes includes lifestyle changes, oral medication and injectable insulin. Once the diagnosis of diabetes has been made, it will require life-long treatment. Lifestyle changes are relevant to the management of diabetes at any stage, but during the prediabetes phase, they can actually reverse changes.
Exercise increases cellular sensitivity to insulin, thus decreasing insulin requirements, which makes it a cornerstone to the management of diabetes and prediabetes. This effect is independent of the weight loss effect so even if you can’t lose weight, simply exercising alone will have some benefit. Obesity is linked to diabetes and losing weight by following a diet low in refined carbohydrates, sugar and processed foods will help manage and prevent diabetes.
In summary, type 2 diabetes is a serious and horrible illness, but it is important to remember that it can be prevented, and if not prevented, then at least optimally managed.
The cornerstones of management are:
Healthy lifestyle choices including exercise and following a diet low in sugars and refined carbohydrates
Regular and early screening for diabetes and prediabetes
Compliance with treatment once it has been initiated
Regular and early screening for diabetic complications once the diagnosis of diabetes has been made.
You will notice that the common theme throughout the above list is that the cornerstones of management and prevention are all within your control.
To a large degree, you get to decide whether you get type 2 diabetes and how bad it will be.
Isn’t that a wonderfully freeing thought to end with?