When Diabetes comes knocking...
With November being diabetes awareness month and 14 November being World Diabetes Day, we have to stop and reassess what we are doing in the awareness of this growing disease.
According to the International Diabetes Federation (IDF) there were 1,826,100 people living with diabetes in South Africa in 2017. In the past two years this number has surely increased.
Diabetes Mellitus type 2 is strongly linked to unhealthy lifestyle and dietary habits and can - in many cases - be prevented.
What are the risk factors?
- Family history
- Overweight/ obesity
- Physical inactivity
- High intake of processed foods, refined starches, and sugary foods and drinks
- Low intake of fresh fruit and vegetables and high fiber foods
- Gestational diabetes (diabetes during pregnancy)
What are the symptoms of diabetes?
Fasting (before consuming food or drinks) blood sugar levels should ideally be below 6mmol/L and 2 hours after food or drinks below 8mmol/L. These levels should be checked regularly to ensure early detection of higher than normal levels.
Other tests that your doctor will often perform include an OGTT (Oral Glucose Tolerance Test) and HbA1c. An OGTT is performed to test how long it takes for blood sugar levels to return to normal after a sugar containing drink was consumed. This test is often performed to see if a person is pre-diabetic/ insulin resistant. The HbA1c test is performed to see if the blood sugar levels have been normal or increased over the past 3 months.
What complications can I experience if I am diabetic?
Complications can arise during the early or later stages after diabetes was diagnosed. They can either be microvascular (small blood vessels) or macrovascular (big blood vessels).
Microvascular:
- Eye damage (retinopathy) increasing your risk for glaucoma, cataracts and blindness
- Kidney damage (nephropathy) increasing your risk for kidney failure and consequently dialysis and a need for a kidney transplant.
- Nerve damage (neuropathy) causing numbness, tingling feeling and nerve pain in especially feet and hands (can occur anywhere in the body).
Macrovascular:
- Increased blood pressure (with a risk of chronic hypertension and consequent risk for a heart attack or stroke)
- Increased blood lipids i.e. cholesterol levels (also a risk for chronic cardiovascular diseases).
- Decreased blood circulation (affecting wound healing and blood and oxygen delivery to all the limbs and organs).
If you are diabetic, it is important to have a yearly (or 6 monthly) eye test and ideally also a podiatrist assessment to ensure that your eye health and foot health is taken care of. Your doctor will generally do a yearly or 6 monthly set of blood tests and check ups (depending on your risk) to ensure that your kidneys are healthy and that you haven't developed increased cholesterol levels or high blood pressure.
How do I manage diabetes and can I prevent it?
Diabetes can be managed very well, especially when diagnosed early.
Medically, your doctor may prescribe medication to improve insulin sensitivity and the functioning of the pancreas. Some diabetics may need to inject insulin soon after diagnosis or after being diabetic for a longer period.
It is important to understand that the medical treatment of diabetes is essential and you should discuss any changes you want to make with you doctor, before you change anything yourself.
Be mindful of areas in your body already experiencing symptoms or complications:
- If you have glasses or contact lenses for poor vision, ensure that you use these. Also don't postpone or cancel your eye test.
- Make sure to check your foot health often and take extra good care of wounds, cuts or blisters to avoid infections.
- Follow dietary guidelines/ restrictions if you have seen a dietitian and have been instructed to follow these by your doctor.
- Use your glucose monitor often and ensure that you understand how to react if your readings are higher or lower than normal. (Consult your doctor, pharmacy, dietitian, nurse or diabetic educator about this.)
Lifestyle and dietary adaptions can significantly improve the management of your disease. These can also be implemented to prevent the disease.
Lifestyle and dietary habits to follow:
* Have small, regular meals throughout the day
* Keep to smaller portions and avoid overeating
* Fruit and vegetables should be used regularly
- ensure that this makes up half the volume of your food intake
* Use legumes (beans, peas, chickpeas, lentils) regularly to increase your dietary fiber and lean protein intake.
* Focus on low glycaemic index foods (follow the link below) - slow digesting carbohydrates.
* Include lean, unprocessed protein foods preferably to processed, high fat alternatives.
* Give preference to unsaturated, plant fats and foods rich in omega-3 fatty acids (e.g. fatty fish) - fats that contribute to your health.
* Include lower fat dairy food and drinks daily.
* Avoid sugary foods and drinks and use water and lower kilojoule drinks as your drink of preference.
* Limit alcohol use to 1 drink per day (or less)
* Use salt sparingly and be aware of the contents of salt in food products.
* Aim to be as physically active as possible and encourage physical activity in children.
Reading and understanding food labels and endorsements can assist you in buying healthier, sustainable energy foods.
Follow a healthy diet and improve your lifestyle to keep your risk low and have a regular check up with your doctor to ensure that your health is well looked after.
For more on the low GI concepts, food lists and more, follow this link www.gifoundation.com.
