Diabetes represents a major health concern to the people of Australia. The latest stats from the Australian Bureau of Statistics 2011-13 Australian Health Survey showed that one in every twenty Aussie adults has diabetes, with Australians aged 65-74years having the highest rate (almost one in every seven). In addition to this, a further three percent of Aussies are at high risk of diabetes, with their fasting blood glucose levels being elevated to between 6.1-7.0mmol/L. People who are obese have a much higher rate of developing diabetes, with obese Aussies being seven times more likely to develop diabetes than those who are of normal weight or underweight. Further to this, having a family history of diabetes is another big risk factor, with over half of all Australians with diabetes also having a parent of sibling with the disease.
On a more positive note, over half of all Australians with diagnosed diabetes are effectively managing their condition.
Diabetes is a disorder of metabolism – how we process our foods (carbohydrates, fats and proteins) is intimately linked it our blood glucose control, manufacture and energy production. After consumption, glucose passes into the blood stream where it is used for growth and energy. From here, glucose enters the cells and can be utilised in a number of ways. In order for glucose to gain entry, insulin must be present. Diabetes can occur when the pancreas does not secrete enough insulin or if the cells of the body become resistant to insulin, leaving the glucose unable to enter the cells. This can lead to a series of symptoms and if left untreated, serious complications.
Diabetes is characterised by poor glucose control, seen through elevated blood glucose levels, elevated blood insulin levels, or significantly reduced blood insulin levels.
During diabetes type 2, insulin levels are typically elevated indicating a loss of sensitivity to insulin by the cells of the body. Later, as type 2 diabetes progresses, insulin levels can drop and insulin deficiency can magnify further the effects of insulin resistance.
Type 2 diabetes has loosely been termed ‘adult onset diabetes’. Unfortunately, as diabetes becomes more common throughout the world, cases of type 2 diabetes are becoming surprisingly common in younger people and children. Early identification of diabetes is imperative to managing the illness and reducing symptoms. In determining the risk of developing type 2 diabetes environmental factors such as food and exercise play an important role in the disease progress.
Factors that increase your risk of developing diabetes type 2 include:
- Age, your risk increases if you are above 45 years of age
- Cardiovascular disease (or family history of cardiovascular disease)
- Elevated triglycerides, low HDL, or both
- Family history of diabetes (parent or sibling)
- History of gestational diabetes
- Hypertension (high blood pressure)
- Increased hip-to-waist ratio
- Obesity or overweight
- Sedentary lifestyle
The diagnosis of type 2 diabetes is typically (but not always) made after the age of 50 years in Caucasians. To a significant effect, diet, lifestyle and exercise play large roles in the development, or avoidance of type 2 diabetes mellitus.
Regular exercise can result in an increase in the sensitivity of insulin, resulting in a decrease in the insulin resistance that is the key player in type 2 diabetes(1, 2). Whilst most people think of exercise as a way to reduce weight, it has multiple additional benefits including increasing metabolism, increasing insulin sensitivity, improved mood and increased mental performance. Fortunately, for insulin sensitivity benefits, you do not need to spend every spare minute at the gym, sweating up a storm. Regular moderate-to-vigorous physical activity has been found to have a strong and statistically beneficial relationship to insulin response in those with normal or resistant insulin (1). In fact, this benefit can be noted as early as after your first exercise session, with the benefit being strong after a moderate-to-vigorous session, and present, but not statistically beneficial, in low intensity exercise sessions. Unfortunately, the benefits start to reverse after 5-10 days of no exercise.
Carrying around extra weight can interfere with your insulin response and thus create a large risk factor for diabetes development. In particular, it is your body fat percentage that is the key player for the ‘overweight’ or ‘obese’ individual. Reducing your body weight and thus reducing your body fat percentage by as little as 5kg can have a significant impact on your insulin response and your diabetes risk. Maintaining this weight loss is imperative for the insulin sensitivity benefits.
Finally, your food choices play a significant role in your risk of developing type 2 diabetes mellitus. Diets high in saturated fats and processed, refined carbohydrates, and low in fibre and lean protein plays a major role in the development of insulin resistance. Glucose requires insulin for their utilisation in cells, and an over consumption of this, via carbohydrates or sugars, will require an excessive amount of insulin to enter the blood stream in order to ‘action’ the glucose from that meal. The excessive requirement of insulin can result in a dampened response and eventually an insulin resistance.
Several well-designed large trials have shown that lifestyle and dietary modifications can be used to effectively prevent and control type 2 diabetes (3-5). If you feel you are at risk, or you would like some support, please fill in the contact form to the right.
- Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. International journal of sports medicine. 2000;21(1):1-12.
- Nelson RK, Horowitz JF, Holleman RG, Swartz AM, Strath SJ, Kriska AM, et al. Daily physical activity predicts degree of insulin resistance: a cross-sectional observational study using the 2003-2004 National Health and Nutrition Examination Survey. The international journal of behavioral nutrition and physical activity. 2013;10:10.
- Asaad G, Soria-Contreras DC, Bell RC, Chan CB. Effectiveness of a Lifestyle Intervention in Patients with Type 2 Diabetes: The Physical Activity and Nutrition for Diabetes in Alberta (PANDA) Trial. Healthcare (Basel, Switzerland). 2016;4(4).
- Arambepola C, Ricci-Cabello I, Manikavasagam P, Roberts N, French DP, Farmer A. The Impact of Automated Brief Messages Promoting Lifestyle Changes Delivered Via Mobile Devices to People with Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Controlled Trials. Journal of medical Internet research. 2016;18(4):e86.
- Franz MJ. Diabetes Nutrition Therapy: Effectiveness, Macronutrients, Eating Patterns and Weight Management. The American journal of the medical sciences. 2016;351(4):374-9.