Type II Diabetes and Nutrition
What is Type II Diabetes
Type II diabetes means the body is resistant to insulin, resulting in the body not being able to control blood glucose. The body has elevated blood glucose levels which it is unable to control. Type II diabetes is mostly in obese people, living in developed countries. This is on the rise with low income earners faster than the high income earners. Accordingly to the World Health Organization, 422 million adults are now living with diabetes. This has risen form 4.7% of the world population in 1980 to 8.5% of the world population in 2014. A large proportion of type II diabetes around the world is undiagnosed and continually growing.
If a person is overweight, have high cholesterol, high blood pressure and a family history of diabetes, they could have metabolic syndrome. If you have metabolic syndrome, this means they could be pre-diabetes and developing an insulin resistance.
Type II diabetes causes premature death, cardiovascular disease – heart attack and stroke, blindness, nerve damage, kidney failure and amputation. Increasing social media, advertising and processed foods are a part of our daily lifestyle, resulting in Childhood Obesity and health concerns. This brings on early onset of diabetes in children, which now shows this is no longer just a disease for adults.
(World Health Organisation)
Type II Diabetes and the Anatomy
The pancreas’s cells produce a hormone called insulin, once produced, this travels through the body’s bloodstream to areas of the body where it is needed to transport our glucose to the cells in the body. Without insulin the body’s cells could not process lipids, proteins and carbohydrates, so without insulin the glucose and its energy, the food we eat would not be able to get into our cells and they would not function - we would starve. Our bodies require glucose as a primary source of energy but having high blood glucose results in type II diabetes.
Insulin resistance is when you have glucose in the body waiting for the insulin to distribute to the body but you require more insulin from the pancreas than normal for this to happen. Eventually the body can’t make enough insulin and your blood sugar level rises. This causes damage to your pancreas beta cells.
With pre-diabetes type II your body isn’t making enough insulin but its enough to deal with the problem for now, eventually the body doesn’t produce enough which leads to type II diabetes. The cause of Insulin resistance appears to come from patients who are overweight to obese. Particularly the visceral or intra-abdominal fat that is in and around the liver and other organs, this produces chemicals to stop other cells in the body from dealing with insulin the way it should. Once these chemicals are produced, they can cause inflammation triggering heart disease, inflamed blood vessels and may be reasonable for many other diseases. Consuming too much sugar or unhealthy foods is not what is causing diabetes, it’s what leads to diabetes. Eating these foods can lead to obesity or the body starving but what we do know is that if you eat sugary or unhealthy foods you will have large amounts of glucose into the bloodstream quickly which leads to glucose toxicity and pancreas problems.
(Drugwatch)
If a person changes their lifestyle and have a normal blood sugar level, they may never get type II diabetes. Not everyone with Pre-diabetes will end up with type II diabetes and this is the opportunity to turn their health around. If you have type II diabetes, this can lead to other health problems like heart disease, kidney disease, Retinopathy, Nerve Damage and stroke.
You are five times more likely to develop type II diabetes if you are not active than those who participate in regular exercise. If you have a hormone disorder or take a lot of prescription drugs, this can lead to type II diabetes.
[endif]--![endif]--You may not experience any symptoms at the beginning. You may need to urinate more often, feel tired and most often then not is found in a routine medical practitioner’s examination.[endif]--![endif]--
(World Health Organisation)
Diagnosis & Treatment
To determine if a person has type II diabetes, their medical practitioner will complete either a urine test, fasting blood glucose test or an oral glucose tolerance test. The blood glucose level will be measured and the glycated haemoglobins (HbA1c).
Once diagnosed with type II diabetes, the first treatment is education, diet and exercise. Should this not be helping, the medical practitioner will prescribe pills or insulin replacement therapy.
Once you are aware you have type II diabetes, the patient will need to monitor their blood glucose levels. This happens at least 2 – 4 times a day by a pin prick test in the finger. Then insulin replacement therapy is established by providing the body with a hormone that is needed for blood glucose control. This is injected under the skin from a needle or diabetic syringe. The readings should be between 4-7mmol/l or 72-126mg/dl, if it is above or below the patient will need to consult their medical practitioner to discuss medication and nutritional intake.
Complete a HbA1c test with your doctor every 6-12 weeks to see how well your body is controlling the blood sugar levels.
Type II diabetes often requires insulin and the majority of deaths in the world are in low income countries.
Exercising and a healthy diet can help with managing weight, energy and fitness levels. Eating the right foods can help get on the right track and reduce blood sugar so that the medication levels may be reduced.
It’s important to take prescribed medication as well as get including fitness and diet modifications. Medication will help correct insulin resistance or help produce the right amount of insulin for the body. So medication will help process the foods you are eating, this will prevent further damage to the body. The medical practitioner will advise if diet and exercise is enough. If not, pills may be required or insulin replacement therapy may be required through the form of an injection under the skin.
The patient can start by slowing increasing their physical levels and small changes to the diet to correct your blood sugar level. Speak to a nutritionist or dietician to get a diet plan set out to help manage blood sugar levels and get support from groups. A food journal will help record the sugar levels each day along side the meals and carbohydrates, medication and diet. Its important emotional eaters get help and focus on eating the right amount of carbohydrates to get on track. Start small with diet and exercise to head in the right direction. Eat three meals but ensure at least two snacks a day are included. Eating 2-3 hours before bedtime and eat a light breakfast is essential. Start by eliminating sweet drinks and alcohol, drink water instead. Introduce some physical activity each day.
Whether you are starting with diet and exercise or medication and diet and exercise, once you start to make a change, a medical practitioner should be able to complete some tests. This will tell if the blood sugar levels have changed and how the body is responding. This is done through a blood sugar monitor test with a prick on the finger with a stick to produce a reading on the day. Or a hemoglobin A1c test which shows the medical practitioner how the blood sugar is for a period of 2-3 months.
Other treatment options
Aromatherapy helps you relax and the oils help with your overall health and wellbeing.
Herbal medicine or remedies are less likely to provide side effects while used for type II diabetes. A consultation with a Herbalist to determine those that are most suitable is required. Herbalist use kinesiology to ascertain which herbs are suitable for each person.
Naturopathic treatments involve clean eating with foods containing certain vitamins and minerals, supplements, herbs and relaxation techniques.
Magnetic therapy is another type of treatment; this is used for promoting health.
Reflexology to assist with organs in the body, reducing stress and improves circulation.
Yoga, qigong and medication can assist with blood glucose control. The breathing, yoga postures and relaxation techniques help with blood glucose levels, blood pressure and blood fat levels.
Acupuncture is a method focusing on life energy (chi) through the body and reducing stress.
Other Tests once diagnosed
Health will be assessed after diagnosis with type II diabetes and a number of tests will be available. There are many possible conditions associated with type II diabetes.
Eye damage – The back of the eye is checked, the blood vessels in the retina may show signs of damage if high blood glucose for many years is present. This may cause the vessels to thicken and leak blood which will impair vision and can lead to blindness. The raised pressure can also cause Glaucoma in the eye. The eye may need surgery or laser treatment where possible.
Nerve Damage – The nerves will not be able to transmit signals from damage caused. The patient may experience muscle weakness or wasting. Blood and nerve supply is checked in the feet to see if they are affected Once a patient has neuropathy, it is reversible but can receive treatment for erection problems if affected.
Kidney Damage – A kidney function test will be completed to ascertain blood fat levels and if they are raised. This could put the patient at risk for cardiovascular problems. A urine test will show if protein is present, which is also a sign that there is inflamed kidney. Kidney damage can develop fairly quickly and after a few years you could have diabetic nephropathy. This this continues, your kidneys could start to fail.
Cardiovascular – Glucose will attack the walls of the blood vessels if your blood glucose is raised for a long period of time. High blood pressure and cholesterol in time this can lead to coronary heart disease. Men with erection problems can also be associated with cardiovascular problems.
Nutritional changes
Eating healthy food can still be pleasurable and meals can be enjoyed. The principles are very similar to following a healthy diet without packaged processed foods.
What food is consumed directly affects the disease progression and the blood glucose levels of a person with type II diabetes. Altering the diet by eliminating the foods below will help with the treatment of the disease, showing a direct link between nutrition and the disease.
A list of ways a diet can be improved:
Reduce your carbohydrate intake to complex carbohydrates with low glycemic index or low glycemic load.
Reduce salt intake, which leads to the development of high blood pressure. With type II diabetes, your kidneys can’t flush out the salt as easy.
Eat foods with potassium which flushes excess sodium from the kidneys.
Eat Fibre to help absorb and digest food, also helps with cleaning up glucose and fats and with the digestion process.
Eat good fats; monounsaturated to reduce LDL cholesterol and polyunsaturated fats to help protect against heart disease and stroke. And reduce/stop eating trans and saturated foods.
Eat more leafy green vegetables, legumes and fruits with low GI.
Reduce processed packaged food intake
Eliminate packaged or canned drinks, consume water or herbal tea.
Sugars
Simple sugars (monosaccharides) are absorbed directly into your small intestines to the body’s circulation. This causes the body’s blood glucose to rise rapidly. The three simple sugars are fruit sugar – fructose, milk sugar – galactose and glucose – which is also known as dextrose.
Most foods contain glucose; this affects the rise in your blood glucose levels very quickly. Fructose is processed through the liver and then is converted into glucose so is slightly slower at spiking the blood glucose levels.
Disaccharides is sucrose sugar; this can occur naturally in foods but also standard table sugar is sucrose. During digestion, the sucrose is broken down into glucose molecules and then released into the blood. Your blood glucose levels are still affected but it will not spike as quickly as simple sugars.
Polysaccharides/Complex Carbohydrates also during digestion break down into glucose molecules. The Polysaccharides or also known as starches provide a slow constant release and blood glucose levels remain stable. These are the best choices for a type II diabetes patient.
Sweeteners (sugar replacement/sugar free) are designed for people with diabetes provide the same effect as glucose.
Support
Those with Diabetes will require education and support to understand the effects on the body and what is required to maintain a healthy lifestyle.
Australia has many support groups by diabetes educators or people in the community with diabetes. Diabetes WA is an example of a support group run by people in the community with diabetes. This provides people with the opportunity to connect and meet people, solve problems, give advise and socialize with people who have similar concerns.
References
Australian Diabetes Educators Association http://www.adea.com.au/about-us/our-people/branch-executives/wa-branch-executive/
Balch P A, 2010 Prescription for Nutritional Healing (5th Edition) New York, Penguin Group
Brewer S, 2012 Overcoming Diabetes London, Duncan Baird Publishers
Diabetes Australia https://www.diabetesaustralia.com.au/governance
Diabetes WA http://www.diabeteswa.com.au/Living_With_Diabetes/Support_Groups
Doctor Murray http://doctormurray.com/health-conditions/diabetes/ Drug Watch
https://www.drugwatch.com/actos/type-2-diabetes/
Foodzone www.foodzone.com.au
Government of Western Australia – Department of Health http://www.diabetes.health.wa.gov.au/services/metro.cfm
Hilkovitz G, 2008 Preventing Type 2 Diabetes, Beyond Diet and Exercise Scottsdale, Belvista Publishers
Joachim D, Schloss A, Handel A, 2008 The Ultimate Reference on how cooking works, The science of good food Toronto, Canada, Robert Rose Inc
Kenji Lopez- Alt J, 2015 The Food Lab, Better Home Cooking Through Science New York, W.W. Norton & Company Inc
Merendino J, Jibrin J, 2009 The best life guide to managing Diabetes and Pre-diabetes New York Simon & Schuster
Murray M, Pizzorno J, Pizzorno L, 2005 The Encyclopedia of Healing Foods New York, Atria Book
Osiecki H, 2010 The Nutrient Bible, Ninth Edition Eagle Farm QLD, AG Publishing
This H, 2010 Kitchen Mysteries, Revealing the Science of Cooking New York, Columbia University Press
Thompson R, 2012 Glycemic-Load Diabetes Solution USA, McGraw-Hill Companies
Whitney E, Rolfes S R, Crowe T, Cameron-Smith D, Walsh A, 2014 Understanding Nutrition Australia and New Zealand Edition (2nd Edition) South Melbourne, Cengage Learning Australia
