Type 2 diabetes, where to from here…

Diabetes Australia (2015) states type 2 diabetes is a progressive condition in which the body becomes more resistant to the normal effects of insulin (insulin resistance) and or gradually loses the ability to produce enough insulin in the pancreas (reduced insulin production). In addition, type 2 diabetes can be strongly connected to genetics of ethnic backgrounds.

Usually the disease develops in individuals over the age of 45 years but in this present day it is reported that type 2 diabetes is occurring more frequently in younger age groups including children, adolescents and young adults.

Type 2 Diabetes Confusion

Type 2 diabetes is a confusing disease and many people don’t really understand what is going on in their body. So, to break it down simply, below is a recap of what type 2 diabetes is.

The pancreas, an organ in the body, produces the hormone insulin. Insulin stops the blood sugar levels getting too high by unlocking cells in muscle, fat and liver and allowing sugar in. In addition, the liver, fat and muscle cells store this sugar as glycogen (a storage form of sugar) for reserved energy. We use this stored energy when we have not eaten in a while, for example when you are asleep or when you exercise.

Insulin resistance, also known as, reduced insulin sensitivity is when the liver, muscles and fat cells do not respond to the effects of insulin and remain closed. So, the pancreas works harder to send out more insulin so that the cells open. However, like a piece of machinery that has been overused the pancreas eventually wears out and stops producing insulin or does not produce enough and this is when the blood sugars remain high. This results in damage to the surrounding body tissues and on other organs. The development then leads to a diagnosis of type 2 diabetes which may see you be put on medication.

However, type 2 diabetes or insulin resistance is not the end of the road and you can turn this diagnosis around.

Pausing type 2 Diabetes

With a healthy diet and regular physical activity, you can send type 2 diabetes into a paused state and or into remission. For example, insulin sensitivity is like a dimmer switch, it can be strong or weak. To make insulin sensitivity strong, a moderate amount of weight loss with a good diet and regular physical activity is the key to achieving this result.

Weight loss:

People with insulin resistance are encouraged to lose a moderate amount of weight, at least 5 to 10%, which improves insulin sensitivity and fasting blood sugar levels. However, how you lose the weight is important. Following a fad diet or restricting food is not only dangerous but could reduce insulin sensitivity and worsen the condition. What you are aiming for is reducing your calories/ kilojoules by a certain amount, that is tailored just for you and takes your height, weight, gender and energy levels into consideration. In addition, you will still consume a balance of all the food groups in moderate amounts.

On this note it is good to mention here the importance of not following a very low carbohydrate diet, such as The Atkins diet or Ketogenic diet. It is of the opinion of many people, that has also been made popular with celebrities and in general population, that there is promise of a low-carbohydrate diet to control blood glucose or facilitate weight management. However, these diet trends forget the importance of evidence-based practice.

For example, the evidence that does exist surrounding this topic, such as that a very low carbohydrate diet (being less than 50 g per day) is the presumption that if people reduce their carbohydrate intake that they will burn body fat resulting in weight loss, are inconclusive. This is because these studies often lack many participants, they are short in duration, they have varying follow ups and they may lack a control group. In addition, there is no definition or guideline as to what a low carbohydrate diet is. Furthermore, recent research highlights that following a high protein diet, being mainly animal based, can worsen insulin sensitivity and increase your risk for obesity, heart disease and high cholesterol. Nonetheless, Diabetes Australia (2018) has put out a Position Statement to all with any type of diabetes who are wanting to follow a low carbohydrate diet which you can find here.

If this approach is something you are in the middle of trying or are wanting to try for rapid weight loss, it is only appropriate for a short duration, so no more than 6 months (Warshaw & Smithson, 2018). And it is strongly advised that you speak with an Advanced Practicing Dietitian (APD) and or your Diabetes Health team as one diet does not fit all.  

Good nutrition:

Good nutrition is comprised of many combinations, however diet tends to emphasize nutritious wholefoods, such as fruits, vegetables, wholegrains, nuts, dairy and fish. This provides enough calories and leaves you feeling satisfied.

So, a healthy diet that includes all the food groups is key to improving insulin sensitivity. Consuming nutrient rich foods that are also high in fibre, such as fruits and vegetables that helps you feeling fuller for longer and which naturally stops the need for extra snacking, as well as improve the Glycaemic Index (GI) of all meals. In addition, a higher consumption of vegetables in the diet also leads to lowering the risk of other diseases such as heart disease, cancers and stroke.

Exercise:

Exercise, especially resistance training (weight training) stimulates our muscles. When muscles are stimulated this increases our insulin sensitivity as the cells in muscles are more inclined to be responsive to insulin. In addition, the muscle’s insulin sensitivity can last hours and even days after exercise. This you tube video may help explain a little further. https://www.youtube.com/watch?v=qPZF1CaL3bc

Therefore, by aiming to achieve 30 to 60 minutes of physical activity 5 to 6 days a week can help improve insulin sensitivity and assist with weight loss.

To conclude: Type 2 diabetes is a complicated disease with a strong genetic component to its development, thus keeping in mind everyone is genetically different. Furthermore, there is no cure for Type 2 diabetes however, by following the above strategies can make a big difference. Keeping in mind, these changes are not a temporary fix where you can stop practices once you start seeing results. Hence, implementing lifestyle changes that incorporate exercise and diet into your daily life practice is essential.

If you are looking at reducing your weight or needing help balancing out your foodgroups you may contact me for a FREE 15 minute consult on my webpage. Alternatively you may also like to check out my workshops, intital consults with follow ups and cooking classes I have to offer on my home page.

References:

Asaad, G., Soria-Contreas, D.C., Bell, R. C., & Chan, C. B. (2016). Effectiveness of a lifestyle intervention in patients with type 2 diabetes: The physical activity and nutrition for diabetes in Alberta (PANDA) trial. Healthcare, 4,73 doi:10.3390/healthcare 4040073

Diabetes Australia. (2015). What should I eat? Retrieved from https://www.diabetesaustralia.com.au/what-should-i-eat

Diabetes Australia. (2015). Type 2 diabetes. Retrieved from https://www.diabetesaustralia.com.au/type-2-diabetes

Diabetes Australia. (2018). Low carbohydrate eating for people with diabetes. Retrieved from https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/8b4a8a54-f6b0-4ce6-bfc2-159686db7983.pdf

Gregg, E. W., Chen, H., Wagenknecht, L. E., Clark, J. M., Johnson, K. C., Safford, M. M., Kitabchi, A. G, Pisunyer, F, X., Wing, R, R., & Bertoni, A. G. (2012). Association of an intensive lifestyle intervention with remission of type 2 diabetes. Journal of American Medical Association. 308, 23: 2489-2496

Ndwigga, D. W., MacMillian, F., McBride, K. A., & Simmons, D. (2018). Lifestyle interventions for people with and at risk of type 2 diabetes in Polynesian communities. A systematic review and meta-analysis. International Journal of Environmental Research & Public Health, 15, 882, doi: 10/3390/ijerph. 15050882

Tian, S., Xu, Q., Jiang, R., Han, T., Sun, C. & Na, L. 2017, Dietary protein consumption and the risk of type 2 diabetes: A systematic review and meta-analysis of cohort studies. Nutrients, vol. 9, no. 9.

Warshaw, H. & Smithson, T. (2018). Very low carbohydrate diets. Retrieved from https://www.todaysdietitian.com/newarchives/1118p28.shtml