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Diabetes

The Health Index

In diabetes, blood sugar regulation has gone wrong. There are different types of diabetes:

Type one diabetes

Type two diabetes

Gestational diabetes (during pregnancy)

This is not a complete list, but other types of diabetes are sub-types and much less common.  Diabetes is diagnosed when fasting blood glucose rises above 6mmol/l (108mg/dl), is still above 7.8 (140mg/dl) two hours after eating, and HbA1C (glycated haemoglobin – the ‘long-term’ blood sugar marker) over 7%. 

 

Type 1 diabetes is classed as an autoimmune disease. In this condition, the body’s immune system attacks and destroys those cells of the pancreas that are responsible for the secretion of insulin, a hormone needed to regulate blood glucose. This means that, in people with type 1 diabetes, no or not enough glucose can reach the cells. Until the discovery of insulin and the development of synthetic insulin for injection, a diagnosis of type 1 diabetes meant certain death. 

 

Type 2 diabetes used to be called “adult onset diabetes” as – unlike T1D – it was only observed in older people. It was also fairly rare. Like T1D, glucose from the blood stream cannot enter the body's cells. However, in the case of T2D, the underlying cause is insulin resistance, i.e. the pancreas does produce insulin – at least in the earlier stages – but the cells are unable to recognise and utilise it. The result is, again, an inability of the cells to receive glucose.

What are the causes?

The cause of type 1 diabetes is not known. There appears to be a genetic predisposition, but ultimately the disease seems to be triggered by environmental factors, e.g. a viral infection. Type 2 diabetes, however, is almost entirely diet and lifestyle related. Here, too, a genetic predisposition makes people more susceptible to the disease, but anyone can develop the condition. Common risk factors are:

  • Being overweight and obesity

  • Body composition (abdominal fat)

  • Inactivity

  • Family history

  • History of gestational diabetes

What are the symptoms?

If the blood sugar concentration is too high, the body excretes sugar via urine. The detection of sugar in urine is therefore the leading symptom. Other signs of type 2 diabetes are:

  • Constant thirst

  • Frequent urination

  • Failure to thrive, bed-wetting, weight loss (in children)

  • Fatigue, weakness, dizziness

  • Visual deterioration, changing visual acuity

  • Dry skin

  • Itching

  • Alternating between loss of appetite and attacks of hunger

  • Loss of libido

  • Impaired sexual performance

  • Muscle cramps

  • Numbness in the extremities

  • Pins and needles

  • Poor wound healing, especially on the feet

  • Nausea 

  • Stomach aches

  • Recurring urinary tract infections

  • Menstrual disorders

  • Impaired fertility in women

  • Psychological changes such as aggressive behaviour and irritability

How can a nutrition practitioner help?

In recent years there has been a lot of good news for people affected by type 2 diabetes. We now know that in 50 per cent of cases, it can be successfully reversed through diet and lifestyle changes. That means that all diabetes medication including insulin can be stopped as long as the person affected continues to follow the nutrition advice. And don’t worry, you don’t have to live on lettuce leaves, and calorie-counting does not come into it. Among people falling into the remaining 50 per cent, those who do not succeed in completely reversing their type 2 diabetes, many are able to considerably reduce their medication.

 

So, if you have T2D, it is absolutely worth booking in with a nutrition practitioner.  A nutrition practitioner will ask questions about your overall health and health history, diet, lifestyle and exercise habits. They will look at your food diary to see where there may be room for improvement. Your nutrition practitioner will then develop a customised diet, supplement and lifestyle plan for you.

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