What is Diabetes?
Diabetes is a chronic health condition in which the human body has excess glucose, or sugar, in the blood. Under normal conditions, when a person eats, the endocrine system releases insulin, a hormone which breaks down food into simpler nutrients like glucose. These then enter the bloodstream to be transported where energy is needed. As a result of this process, blood sugar levels rise. When blood sugar levels are high, the pancreas is signalled to produce more insulin to help bring blood sugar back down to its normal range.
However, when someone with diabetes eats, either not enough insulin is produced or the insulin produced is not processed correctly. This means that blood sugar levels remain high, which can lead to complications all over the body, such as vision loss, stroke, kidney failure, and many more.
According to the WHO, the number of people suffering from diabetes rose from 108 million in 1980 to 422 million in 2014. In the last 2 decades alone, the number of diabetic patients has almost doubled.
Types of Diabetes
Type I diabetes, also called juvenile diabetes, is an autoimmune disease where the person's body attacks its own pancreatic cells (responsible for detecting high blood sugar levels), thereby reducing available insulin levels. Without insulin, the body struggles to use glucose for energy. Type I occurs in children and young adults who require daily insulin injections.
Type II diabetes, or adult onset diabetes, occurs when the body loses its ability to respond to available insulin levels. In other words, the body is desensitised to insulin. This results in high blood glucose (sugar) levels. This is generally considered a lifestyle disease, affecting people aged 45 and over on average. However, genetic factors such as ethnicity should also be taken into consideration when assessing one’s risk of developing diabetes. Specifically, individuals of South Asian, Hispanic, African-American, and Native-American descent are more predisposed to the condition.
Gestational Diabetes occurs when pregnant women develop diabetes before the child is born. If you have prediabetes, the body’s sugar levels are high but not high enough to be classified as diabetic. It is possible to be pre-diabetic and not be diagnosed. However, this is also the stage when it is possible to reverse the effects of the condition back to normal.
Signs and symptoms of diabetes
The signs of diabetes include :
- Increased thirst and frequent urination
- Unexplained weight loss
- Inability to heal wounds, particularly on limbs
- A tingling sensation or numbness in limbs
Many people are asymptomatic and remain undiagnosed until they develop major complications, such as blurring and/or loss of vision, strokes, and kidney problems. According to the Centres for Disease Control and Prevention (CDC), the symptoms of type I diabetes are more severe and typically present during childhood and adolescence. Gestational diabetes shows no symptoms but can be detected if tests are done at weeks 24 and 28. Pre-diabetes can also go undetected for years until it progresses into type II diabetes and a serious complication develops, so it is extremely important to get tested if you believe you are at risk. If you have one or more of the above symptoms, it is crucial you get a blood sugar test with your doctor.
While a cure for diabetes is not yet available, it is possible to reduce blood sugar levels to normal and thus reverse the symptoms of the condition. Likewise, reverting back to a poorer lifestyle can reactivate the condition.
Being overweight or obese is the biggest risk factor in diabetes. This is because the excessive consumption of food can lead to the body becoming resistant to the production of insulin, which helps to control blood sugar levels. Therefore, the most effective way of reversing the condition is by keeping your weight in check. Some may find that bariatric surgery is their best way forward. This involves restricting the size of the stomach, so that the individual becomes fuller more quickly. Studies have found that a third of individuals who undergo this procedure were in diabetes remission 15 years post-surgery.
The following lifestyle factors have the greatest impact on increasing your risk of diabetes. We will also look at what you can do to reduce your risk, starting today.
A healthy, nutritious diet is important not only for preventing diabetes as it assists in managing a healthy weight, but it also boosts energy and mental wellbeing. Moreover, it also plays a crucial role in keeping cholesterol and other risk factors of diabetes in check.
In order to reduce the risk of becoming diabetic, you should avoid consuming excess amounts of fried foods, foods rich in saturated fats and trans-fats, and sugary drinks like juice and soda. Dried fruits, fruit juices, simple carbohydrates, and flavoured coffee can also increase your diabetes risk. On the other hand, whole grains and whole-grain products, water, coffee, tea, poultry, nuts, and beans can lower blood sugar levels.
Keeping weight under check by eating nutritious food, reducing portion sizes, and sticking to a sustainable diet plan can help prevent diabetes. The NHS have also advised that foods with lower glycemic index (GI) and lean protein are good for diabetics.
Nevertheless, the most important takeaway about making nutritional changes to prevent and treat diabetes is that they should be realistic and sustainable. Many believe that a healthy diet means that you can no longer enjoy food, but this doesn’t have to be true. All your favourite foods can still be eaten, as long as it is in moderation.
The more inactive or sedentary an individual’s lifestyle is, the less the body’s endocrine system can function properly. This results in inappropriate insulin production or activity. In other words, the more weight the body gains, the more likely it is for its cells to become insulin resistant, resulting in elevated blood glucose levels and increased risk of diabetes.
It has been shown that just thirty minutes of brisk walking per day, or 5 hours per week, is enough to reduce diabetes risk by 30%. Walking also has additional cardiovascular benefits by reducing cholesterol levels, lowering blood pressure, reducing stress on the heart by eliminating fat deposits, and helping to regulate blood glucose levels. Yoga and High Intensity Interval Training (HIIT) have also been shown by research to benefit diabetes. 12 weeks of HIIT has been shown to reduce diabetes, while Surya Namaskar and Kapal Batti Pranayama have been proven beneficial for reducing the risk of diabetes and high blood sugar levels.
Nicotine in cigarettes hardens and narrows the blood vessels, thereby reducing blood flow in the body. It also causes improper insulin functioning, resulting in smokers needing more insulin shots. It has been found by research that those who smoke have a 30-40% higher risk of contracting diabetes than nonsmokers.
Alcohol results in unnecessary weight gain by adding empty calories, largely in the form of sugar. The presence of alcohol in the blood can also increase diabetes risk by affecting the liver's ability to regulate blood glucose levels, which can result in hypoglycemia.
It is necessary to note that alcohol is harmful for diabetics irrespective of which type. Therefore it is pivotal to be mindful of the amount and frequency that you drink. Six medium glasses of wine spread over at least 3 days is the government guideline for alcohol consumption according to diabetes.org.uk.
Around 1 in 2 individuals with type II diabetes suffer from poor sleep patterns due to unstable blood sugar levels throughout the night, which can lead to insomnia and next-day fatigue. High blood sugar levels can cause your kidneys to be overactive, resulting in the frequent need to urinate during the night, as well as thirst and headaches which can disturb sleep. When blood sugar levels are low, it can result in excessive sweating, nightmares, and confusion.
Not only does diabetes impact sleep, but sleep, or lack thereof, can impact diabetes. Poor sleep can cause high blood sugar levels. The link between them is not completely understood, but it is believed to be the impact of sleep on the production of cortisol (the stress hormone) and insulin. Additionally, sleep deprivation increases the production of Ghrelin (which makes us hungry) and reduces Leptin (which makes us feel full). This means that after a poor night's sleep, you are more susceptible to over-eating or making poor nutrition decisions.
Diabetes can take a toll on your mental health, and result in illnesses such as depression. Diabetes has also been associated with dementia and cognitive decline with age. Relaxing exercises are helpful, as is spending time with friends and family.
Keeping your emotional health balanced is necessary for your physical health. Overall, practising self-care is important for both a healthy mind and body. For you, self-care could involve:
- Spending time with friends and family
- Eating a healthy diet
- Living an active lifestyle
- Allocating time to hobbies
Diabetes is both a genetic and lifestyle disease. While genes cannot be adjusted, one can and must take care to monitor lifestyle risk factors associated with the disease. Diabetes affects not just blood glucose levels but also the heart, kidneys, the nervous system, and the brain. A diabetes patient or anyone at risk must induce life-long changes to manage the severity of the illness.
Managing blood glucose levels is possible if one sticks to a healthy food routine and an active lifestyle.
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- Cunningham FG, et al. Diabetes mellitus. In: Williams Obstetrics. 24th ed. New York, N.Y.: The McGraw-Hill Companies; 2014.
- Francois, ME, Little, JP. Effectiveness and Safety of High Intensity Interval Training in Patients with Type 2 Diabetes. Diabetes Spectrum. 2015. [cited 18 February 2022]; 28(1): 39-44. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334091/
- Malhotra, V, Singh, S, Tandon OP, Sharma SB. The beneficial effect of yoga in diabetes. Nepal Med Coll J. 2005. [cited 18 February 2022]; 7(2): 145-7. Available from: https://pubmed.ncbi.nlm.nih.gov/16519085/