Put diabetes on hold

We know it’s common, and we know it’s only going to get worse — unless we do something about it. Currently, over 9 million Canadians live with diabetes or pre-diabetes, according to the Canadian Diabetes Association. By 2020, it is predicted to cost our struggling health care system $19.2 billion a year, and people with diabetes will pay between $1000 to $15,000 a year out of their own pockets for medications and medical supplies.

However, the human costs are much higher: Diabetes can steal up to 10 – 15 years from your life expectancy, not to mention the complications it can cause like kidney disease, blindness and nerve damage. Diabetes remains the sixth leading cause of death in our country and each year, plus it’s a contributing factor in 41,500 deaths in Canada. Eighty per cent of people with diabetes will die of a stroke or heart disease.

But let’s forget the scary numbers for a moment: there is something we can do about the statistics. Ninety per cent of all cases are type-2 diabetes — where your body doesn’t produce enough insulin to process glucose (our body’s “fuel”) or it can’t properly use the insulin it does make. This condition usually develops in adulthood — though in recent years it has been showing up younger and younger people. Our chances of developing it are heavily influenced by our everyday lifestyle choices.

Still need proof? A 2009 study from the US-based Diabetes Prevention Program Research Group shows that diet and exercise can ward of diabetes for as much as a decade. During the Diabetes Prevention Program (DPP) involving 3000 participants who were at high risk, researchers discovered that participants who followed a healthy diet (aimed at weight loss) and exercised regularly reduced their risk of diabetes by 58 per cent. The effects were also long-lasting — in the years following the study, participants in the diet and exercise group had a lower risk even if they didn’t maintain those healthy lifestyle choices.(Read the abstract here.)

Once you have type-2 diabetes, there’s no going back. The condition can’t be cured or reversed, and can get worse over time as it becomes more difficult to manage blood glucose levels (or blood sugar levels).

However, if you can identify the first signs of trouble, you can help stop type-2 diabetes before it starts.

Catching pre-diabetes

That’s where pre-diabetes (also known as “impaired glucose tolerance” or “impaired fasting glucose”) fits in. It’s when your blood glucose levels are higher than they should be, but not quite high enough to warrant a diagnosis of type-2 diabetes. Catching the condition early is important because doctors warn that the damage and complications associated with diabetes can actually start during the pre-diabetes stage.

The good news is a diagnosis of pre-diabetes doesn’t mean you’ll develop diabetes. In fact, knowing about the condition can actually help you delay the onset or prevent it altogether. Taking steps to treat the condition — usually through diet and exercise — means glucose won’t build up in the blood and cause further damage. It’s possible to get your blood glucose levels back down to normal if you take the right steps.

The bad news: pre-diabetes usually doesn’t have any symptoms, and experts note that people often have the condition for several years without realizing it. (Many people with type-2 diabetes don’t experience any symptoms either.) Without intervention, pre-diabetes can develop into type-2 diabetes within 10 years.

So how can you tell if you’re affected? Pre-diabetes is picked up through regular screening tests like the fasting glucose test and glucose tolerance test. Typically, doctors will start administering these routine tests every three years after you reach the age of 40. However, if you have other risk factors you might need screening sooner and more often.

Reducing the risks

The risk factors for pre-diabetes are the same as for diabetes, and include things you can’t change as well as ones you should be doing something about.

Factors you can’t control include:

– Age: People over the age of 40 are at higher risk.

– Family history: If a parent or sibling has type-2 diabetes, you’re more likely to develop pre-diabetes and type-2 diabetes as well.

– Ethnicity: People of Aboriginal descent are three to five times more likely to develop the disease. People of Hispanic, South Asian or African descent also have a higher risk.

– Medical history: people who have been diagnosed with heart disease, high blood pressure, high cholesterol, polycystic ovary syndrome, insulin resistance or schizophrenia are at higher risk. Women who had gestational diabetes should also be aware that it could contribute to their chances of developing type-2 diabetes.

Factors you can control include:

– Weight: Being overweight or obese is the most important risk factor, especially if you carry this extra weight around your middle.

– Fitness (or lack thereof): Regular exercise uses up glucose so it won’t build up in the bloodstream. Studies have shown that losing 5 – 7 per cent of your body weight and exercising 30 minutes most days of the week can reduce the risk of type-2 diabetes by nearly 60 per cent. If you’re over 60, those same measures translate to a 71 per cent reduction.

– Diet: In addition to causing weight gain and chronic inflammation, a high-fat, high-sugar diet can cause blood sugar levels to spike. Healthy choices — like whole grains and plenty of vegetables — help maintain consistent blood sugar levels.

– Smoking: This habit increases the risk of a multitude of diseases, many of which go hand-in-hand with diabetes.

– If you have a cluster of health conditions — which can include high fasting glucose levels, high blood pressure, abdominal obesity, high levels of triglycerides and low levels of HDL (“good cholesterol”) — you may have what is known as “metabolic syndrome”. Metabolic syndrome puts you at higher risk for diabetes and heart problems.

In other words, people who are overweight, have a poor diet or don’t exercise regularly can do something to correct these issues — and it’s important to realize they’re risk factors. The aging of the population, increasingly sedentary lifestyles and poor diet are behind the rise in diabetes incidence in Canada.

Just press “pause”

So what’s the bottom line? If you want to prevent type-2 diabetes (and the potential complications), your best defense is to live well and identify problems early on. Simply put:

– Eat a healthy diet. You know the drill — plenty of fruits and vegetables, lots of fibre, low-fat foods and fewer salty, sugary and refined foods.

– Exercise. At the very least, get your 30-60 minutes of exercise most days of the week.

– Maintain a healthy weight, especially if you’re prone to gaining weight around your mid-section.

– Get regular screenings — including blood glucose, blood pressure and cholesterol levels every three years after age 40, or as often as your and your doctor feel is necessary.

In some cases, a medication called metformin may be prescribed, but lifestyle choices are the usually the first plan of attack.

Right now, the future looks somewhat bleak with a projected forecast of 380 million people worldwide having diabetes by 2025. Current estimates predict that a child born after the year 2000 has a one in three risk of developing the disease during his or her lifetime. The numbers don’t have to look like this — when there’s so much we can do to prevent the disease.

Education is half the battle. If you’re looking for more information, check out some of the sources we used for this article:
Canadian Diabetes Association
National Diabetes Information Clearinghouse (NDIC)

If you have any questions or suspect you might be at risk, pay a visit to your doctor.

Updated November 2012.

Photo ©iStockphoto.com/ Nikolay Mamluke

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