Type 2 Diabetes - what you need to know
It can be a scary time being diagnosed with Type 2 Diabetes, however it is important that you don’t blame yourself. Type 2 diabetes can be caused by a number of factors and can be well-managed to help reduce the risk of any health implications.
What is type 2 diabetes and pre-diabetes?
Diabetes a chronic disease where sugar (glucose - a simple sugar which comes from the carbohydrate foods that we eat) builds up in the blood stream and your blood sugar levels get too high. Insulin, a hormone made by the pancreas, allows your body to use glucose for energy or to store it for future use. Type 2 (T2) diabetes is caused when the pancreas either doesn’t make enough insulin or the body’s cells become resistant to insulin. This results in the body not responding as effectively to insulin, which then increases the amount of excess glucose in the blood stream. Excess blood glucose can damage the body’s cells and lead to additional health complications, if it is not controlled over time.
Type 2 diabetes is the most common form of diabetes. There are over 250,000 people in New Zealand who have been diagnosed with diabetes (of which around 90% have type 2). Type 2 diabetes is more common in those with a family history of diabetes and among Māori, Pacific and South Asian people. It usually develops in adults but it is becoming more common in children.
Pre-diabetes is where a person’s blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. People with pre-diabetes are at increased risk of developing both diabetes and cardiovascular disease . It is estimated that 1 in 4 New Zealander's are living with pre-diabetes symptoms and are as yet undiagnosed.
Symptoms of type 2 diabetes
Some people may have no symptoms at all or they may have had symptoms for a few years and not realised. Symptoms of diabetes may include:
Going to the toilet frequently
Tiredness
Feeling thirsty
Getting infections frequently
Getting infections which are hard to heal
Poor eyesight or blurred vision
Often feeling hungry
If you have any of the symptoms outlined above, it is important to discuss them with your GP. Diabetes will be diagnosed by blood glucose tests which can be ordered by your doctor.
Complications of Type 2 Diabetes
Photo by Christopher Sardegna on Unsplash
Having high blood sugar levels and blood pressure over time, can result in some health complications. When glucose (sugar) builds up in the body it can damage the small blood vessels and nerves in the body. This can lead to the following issues, especially if the blood glucose levels continue to go unmanaged:
Eye problems such as retinopathy or blindness
Kidney disease and/or failure
Poor circulation or nerve damage, especially to the extremities such as feet
Thyroid issues such as hypothyroidism
An increased risk of infection
Can type 2 diabetes be prevented or delayed?
If you know you’re at high risk of diabetes or if you have pre-diabetes, you can take action that may help to ensure that you don’t get type 2 diabetes. While we cant change some risk factors, like our genes or age, T2 diabetes can be prevented or delayed by modifying our diet and lifestyle. Focusing on the quality of the diet, such as increasing the amount of fruit and vegetables we eat, as well as undertaking regular physical activity (at least 30 minutes most days), can all help to postpone and even halt the development of T2 diabetes.
How can T2 diabetes be managed?
While Type 2 diabetes can’t be cured, it can be managed so that those with Type 2 diabetes can continue to live healthy and active lives. T2 diabetes can be well-controlled by focusing on making healthy eating choices and undertaking regular physical activity. It can also be controlled by medication. Suitable treatment options will be best discussed with your GP.
When it comes to what to eat, it is recommended that those with type 2 diabetes follow the same eating pattern that is recommended for everyone. That is, eating mostly whole and less-processed foods, with plenty of non-starchy vegetables & fruit and some gain foods & starchy vegetables, protein foods (legumes, fish, seafood, eggs, poultry, or lean meat, if you wish), low fat milk & milk products, and healthy oils nuts, and seeds.
People with diabetes do not need to buy special ‘diabetic’ food or cook separate meals. The whole family can eat and enjoy the same healthy food.
Diabetes New Zealand recommends the following healthy eating habits for those with with type 2 diabetes:
Drink plenty of water. Avoid drinking fruit juice and other sweet drinks.
Eat breakfast, lunch and dinner every day.
Base your meals around the Diabetes New Zealand Healthy Plate model.
Eat some carbohydrate food at each meal, but not too much.
Choose low sugar, low saturated fat, low salt, and high fibre food.
Carbohydrates and diabetes
Blood glucose levels are affected by the amount and type of starchy and sweet food we eat or drink. While those with diabetes don’t need to avoid carbohydrates, it is important to focus on the quality and quantity of carbohydrate foods in the diet, as well as the timing. Because carbohydrate foods (e.g grain foods, starchy vegetables, legumes, fruit, cereals, dairy, juices and bakery items) contain sugars, they need to be spread out evenly throughout the day, rather than eating or drinking a large amount in a single sitting. Eating a similar amount of carbohydrate at each meal, each day helps to keep the blood sugars more stable and even, rather than having spikes.
Choosing whole grains and other low Glycaemic Index (GI) carbohydrate foods, which provide a slow release of glucose into the blood stream, rather than a quick burst, is also recommended. Highly refined and processed carbohydrate foods (e.g bakery items, white rice, white bread, lollies, soda and juices) all provide the body with a quick release of glucose to the bloodstream, which can result in blood sugar levels increasing above the recommended levels. However, while the carbohydrate quality is important it is the total quantity of carbohydrates that reigns supreme.
Eat more non-starchy vegetables and fruit
It’s not often you get told to eat more of something but when it comes to fruit and non-starchy vegetables, eat up! Even though fruit and vegetables contain carbohydrates, it is still important that those with diabetes continue to include these nutritious foods in their diet for their many health benefits. In fact, Diabetes New Zealand recommends that those with diabetes, eat more serves of fruit and vegetables than what is recommended for the general public. Those with type 2 diabetes should aim to have at least 3 - 4 serves of non-starchy vegetables. Non-starchy vegetables include vegetables such as asparagus, green leafy vegetables (spinach, silver beet, lettuce, bok choy etc), broccoli, cabbage, celery, peas, pumpkin, courgette, eggplant, capsicum and cucumber. It is also recommended to eat at least 3-4 servings of fruit, spread throughout the day. Where possible, try to ‘eat a rainbow’ and eat fruit and non-starchy vegetables from as many different colours as possible. Each different colour provides a different array of nutrients.
Get moving!
Being physically active is crucial in helping to manage your diabetes. It can help to manage your blood sugar levels and blood pressure, as well as lift your mood, reduce stress and support good sleep habits. It is recommended, to do at least 30 minutes of moderate exercise most days of the week. Activity can be broken up into intervals (e.g. 3 x 10 minutes) and includes the likes of brisk walking, swimming, cycling, gardening, cleaning or dancing. All activity counts, no matter how big or small, so try to get your body moving as much as possible, by doing something you enjoy.
The key is to start off slowly and set yourself small achievable goals. This might be starting off with a walk to the letter box each day and then building up to a walk to the end of your road, and then eventually around the block.
Some tips to get more activity into your day:
Park your car a little further away
Take the stars rather than the lift or get off a couple of floors earlier than needed
Walk to the local shops or walk the kids to school
Move more around the office e.g. walk and chat to a colleague about a task, rather than sending an email
If you are not yet physically active, it’s crucial to start slowly and to discuss your activity options with your doctor first.