Managing Diabetes
Diabetes mellitus comes in a few forms- type 1 or insulin-dependent diabetes mellitus (IDDM), type 2 or non-insulin-dependent diabetes mellitus (NIDDM), and gestational diabetes. There are other clinical variations of the disorder but most importantly, they share a common issue that is the inability to self-regulate cellular fuel or blood glucose levels in the body.
Confusion of old-school classification system: Type 1 diabetes has been associated with juvenile diabetes and Type 2- adult-onset diabetes. Although most cases of type 1 diabetes are diagnosed in childhood and adolescence, adults too can develop the disease. In recent years, type 2 diabetes has been prevalent in children to adolescents and in young adults as obesity rates increase. (Ford-Martin, Blumer, Martin, & Blummer, 2008)
What is diabetes?
Diabetes is a chronic disease that affects one’s body by not having the ability to covert food into energy. After a meal, the body breaks down food into many sources of energy, one of which is glucose (Sugars). During this breakdown, insulin is made up by beta cells produced by the pancreas. Insulin is stored in the pancreas until its needed by the body. During consumption of food, glucose levels in your blood starts to increase, the pancreas releases insulin to help glucose get into cells and make energy. For someone who is diabetic, they either can’t make enough insulin or their bodies are not able to use it effectively.
Without insulin, glucose can’t get into the cell and the cell runs out of energy. Over time cells becomes damaged and glucose builds up in the blood stream. Diabetes is mainly classed into two categories; type 1 – beta cells in the pancreas don’t produce any insulin at all, therefore an individual would need to replace insulin via injections; type 2- beta cells do not make enough insulin or the body is unable to utilize insulin efficiently. The build up of glucose in the blood stream and lack of energy in the cells can cause adverse effects such as impaired vision, fatigue, tingling, pain and numbness to the upper and lower extremities just to name a few. (Association & Staff, 2000), (Ford-Martin et al., 2008)
Who gets diabetes?
One in every twelve adults has diabetes in Australia and statistics show a threefold increase over the last 20 years and numbers are pointing towards going over the 2 million mark by 2020.
+ Individuals with impaired glucose tolerance or pre-diabetes are likely to develop diabetes in the next 5 years.
+ Overweight and obese individuals caused by excess energy intake of food puts the pancreas under stress.
+ Influence by, age genetics, hormones, gender and environmental factors.
+ Sedentary lifestyle
Diabetes is common in certain ethnic groups such as Asians, Aboriginal and Torres Strait Islanders, Afro-Americans, American Indians and Canadians, Hispanics, Polynesians and those in the Middle East.
Other factors that may associate increased risk for type 2 diabetes:
+Gestational diabetes
+ Polycystic ovary syndrome (PCOS)
+ Chronic depression
+ Chronic smoking (>20 cigarettes per day)
+ Heart disease and high blood pressure
+ High birth weight (>5kg)
+ Low birth weight (<2.5kg)
+ Steroids, beta-blockers, diuretics and some antipsychotic medications (CSIRO, Heart, & Institute, 2011)
Here is an assessment tool to see if you are at risk-
Eating well- You are what you eat!
Just like a motor vehicle, you want to have good fuel to run it well without mechanical complications. In this case, eating right will aid in achieving quality of life enabling one to be healthy and lowering the risk of disease. Here are the eight principles you should know:
1. Eat regular meals
This is critical for people who have diabetes. Having regular meals promotes steady blood sugar levels that help avoid unnecessary eating and more energy.
2. Include main food groups The main food groups are fruits and vegetables, carbohydrates, meat and fish and dairy produces. See link for more information.
3. Eat few sugary foodsSugary foods are generally high in calories and lack nutritional value. If you can’t forgo sugar; try artificial sweeteners in coffees and teas.
4. Eat less fried and fatty foodsThe key here is to eat in moderation just like anything else. Having regular fried and fatty foods will only add to additional weight and increase cholesterol levels respectively.
5. Eat low Glycaemic Index (GI) foodsFood that increase blood sugar levels quickly have high GI while foods that increase blood sugar slowly have low GI, this means individuals that have diabetes should stick to low GI foods as they keep blood sugar levels stable and make one feel fuller longer. (http://www.glycemicindex.com)
6. Reduce salt intakeHaving high amounts of salt in your diet increase your chances of having high blood pressure. Having diabetes means you’re twice as likely to develop high blood pressure so reducing salt intake would be wise.
7. Moderate alcohol intakeAlcohol reduces the rate of glucose conversion in the liver, which can result in hypoglycaemia. Drink moderately and try to have only two to three alcohol days a week.
8. Avoid special “diabetic” productsThey cost a lot and they don’t taste as good. They tend to have sweetening agents (sorbitol), which has a laxative effect. Try alternate foods from your local fresh produce. (Claydon, Markham, Toms, & Daykin, 2009)
Lifestyle and Exercise-
One of the simplest ways to bring down blood glucose levels, cut down heart disease and improve overall well-being is to exercise or increase physical activity.
The good news? It’s not too late to start. The first thing to do is to consult with your doctor to get an all clear before you commence. Your doctor might refer you to an accredited exercise physiologist (AEP) to help manage your diabetes with education and exercise plan. Activities and exercise prescribed may vary from person to person as each program is tailored specifically to the needs of an individual based on clinical history presented. This is to ensure that the task required to be performed by the patient does not cause further complications,
ie. For individuals with diabetic retinopathy, activities such as weight lifting, high impact activities and jogging might pose further risks of blood vessel damage and possible retinal detachment. An exercise physiologist may prescribe hydrotherapy or Pilates activities as part of their program. (1)
Based on scientific evidence, it is recommended that individuals living with type 2 diabetes should accumulate a minimum of 210 minutes per week of moderate intensity exercise or 125 minutes per week of vigorous intensity exercise with no more than two consecutive days without training. It is further recommended that two or more sessions (2-4 sets of 8-10 repetitions) of resistance training should be incorporated in the 210 minutes or 125 minutes of total exercise mentioned above. (“Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia,” 2012)
To find the nearest exercise clinic or Accredited exercise physiologist near you clink on this link: https://www.essa.org.au/find-aep/
References:
1. Ford-Martin, P., Blumer, I., Martin, P. F., & Blummer, I. (2008). The everything health guide to diabetes: The latest treatment, medication, and lifestyle options to help you live a happy, healthy, and active life (everything series) (2nd ed.). United States: Adams Media.
2. CSIRO, Heart, B. I., & Institute, D. (2011). The CSIRO and baker IDI diabetes diet and lifestyle plan. Australia: Michael Joseph.
3. Claydon, A., Markham, D., Toms, G., & Daykin, A. (2009). The diabetes guide: Control your diabetes with the complete diet and lifestyle plan. Anne Claydon, Diana Markham, Graham Toms. London: Virgin Books.
4. Association, A. D., & Staff, A. D. A. (2000). Type 2 diabetes: Your healthy living guide: Tips, techniques, and practical advice for living well with diabetes (3rd ed.). Alexandria, VA: American Diabetes Association.
5. The Five Food Groups. (2015, July 27). In this section. Retrieved December 7, 2016, from https://www.eatforhealth.gov.au/food-essentials/five-food-groups
6. Diabetes Australia-Exercise. (2015). Retrieved December 7, 2016, from https://www.diabetesaustralia.com.au/exercise
7. Diabetes Australia- Physical Activity. Retrieved December 7, 2016, from https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/569dbeb5-1afb-42a6-b728-db83990ffdb2.pdf
8. Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia. (2012). Retrieved December 7, 2016, from https://www.essa.org.au/wp-content/uploads/2015/10/ESSA_Diabetes-Position-Statement.pdf
9. FIND AN ACCREDITED EXERCISE PHYSIOLOGIST (AEP), ACCREDITED EXERCISE SCIENTIST (AES) OR ACCREDITED SPORTS SCIENTIST (ASP). Retrieved December 7, 2016, from https://www.essa.org.au/find-aep/
