According to the World Health Organization (WHO), 346 million people in the world are diagnosed with diabetes. In 2004, more than 3.4 million people died from the complications of diabetes, and, this figure is expected to double before 2030. The WHO calls for healthy nutrition, regular exercise, maintaining a healthy body weight, and avoiding smoking to delay or prevent the spread of Type II Diabetes.
The Type 2 Diabetic Epidemic
Historically, this serious chronic illness affected people in low-income groups and the cause of the illness was said to be due to poor environmental conditions related to nutrition. Scientists agree that poor nutrition and a sedentary lifestyle are leading causes of obesity and diabetes. In the United States alone, obesity and diabetic conditions are the main cause of 300,000 premature deaths each year. The rise in statistics is no longer associated with lower income levels and probably represents a cultural shift, in terms of how people psychologically view healthy eating habits.
Unfortunately, 25 percent of Americans do not exercise and the combination of spending time in front of the TV, and eating fast food are two causes for the rise in statistics related to obesity and diabetes. These illnesses are increasing at an exceptionally rapid rate. Although some people are genetically more predisposed to developing diabetes, lifestyle choice is the main cause for the Diabetic type 2 epidemic. There are two ways to maintain a healthy body and two ways to prevent diabetes: Introducing an exercise program into the schedule and following a healthy diet.
The Two Types of Diabetes
Type 1 Diabetes is an autoimmune disease where the body’s immune system destroys the pancreas’s beta cells, which are the cells that produce insulin. Insulin is a hormone which is essential for moving sugar and certain other nutrients from the blood too other body cells. All cells need sugars and other nutrients to allow the body to properly function. Type I Diabetes usually affects young people, but can occur at any time in life. Along with genetic factors, scientists now believe that a virus or toxin may cause the immune system to begin destroying these insulin-making cells. However, I would like to make this clear that the main focus of this article is to discuss Type 2 Diabetes and prevention.
Type 2 Diabetes or Diabetes Mellitus is by far more common than Type 1. Approximately 95 percent of Diabetic sufferers today are of this type. Symptoms occur later in life and the causes are due to the pancreas not producing enough insulin, or the body does not use insulin effectively (insulin resistance). The physiological results are the same as with Type I Diabetes as sugar and other nutrients accumulate in the blood instead of being delivered to the cells. The buildup of glucose (sugar) in blood affects the whole body and can have long-term serious consequences. Increased urination can cause dehydration and pressure on kidneys. Severe dehydration can lead to Diabetic Coma. Long-term high levels of blood sugar can affect the eyes, heart, small blood vessels and kidneys: All of which can lead to infections, strokes and heart attacks.
Diabetic Complications
Detecting the early onset of type II diabetes can be difficult as symptoms are so mild that many people do not notice them: Some may not even aware of the fact that they have diabetes. Mild symptoms, such as increased thirst, hunger, blurred vision, frequent urination, weight gain, tingling in feet, are often overlooked, but prolonged accumulation of sugar in the blood can eventually be life-threatening.
There are several common but serious Complications of Diabetes Type 2
- Eye Damage is often the first problem. Damage to the small blood vessels of the retina can lead to an increased risk of developing cataracts, glaucoma, and blindness.
- Nerve Damage: Accumulation of sugar in the blood can damage the walls of the small blood vessels that feed nerves, particularly in the legs. The first symptoms are tingling, numbness and pain at the tips of the toes or fingers. If untreated, this can cause loss of awareness of feeling in the limbs.
- Foot Infections due to poor blood circulation in the feet increases the risk of various complications. Simple cuts can become seriously infected, and if left untreated, may require amputation.
- Cardiovascular Problems: Diabetes increases the risk of heart attack, coronary artery disease, stroke, atherosclerosis and high blood pressure.
- Kidney Damage: Pressure from frequent urination due to dehydration and damage to the small blood vessels in kidneys can lead to kidney failure or kidney disease, treatable only with dialysis or a kidney transplant.
- Osteoporosis, Alzheimer’s’ disease, skin problems and many other health issues can be affected by diabetes, if left untreated.
Type 2 Diabetes and Obesity
The Cell Metabolism journal published in their July 2009 issue findings of Matthew Watt, Associate Professor from the Monash University. His team discusses a new protein which ultimately explores the relationship between obesity and diabetes. According to this study, fat cells are found to release a protein, which desensitizes muscles and the liver to insulin which causes the pancreas to produce more insulin to counteract this effect. The overworked pancreas eventually slows the production of insulin, causing type II Diabetes.
Almost 90 per cent of people diagnosed with Type II Diabetes are also obese. Excess weight affects the systems ability to maintain blood glucose levels and can cause the body to become resistant to insulin. Obese people who have diabetes need to take even more insulin to introduce sugar into the cells. Because of the complications of this insulin resistance, overweight people who do not have diabetes are at very high risk for Diabetes Type 2.
Associate Professor Watt is excited about the potentials for counteracting this effect with new drugs, but the writers for the medical journal Lancet believe that treating diabetes with drugs is the wrong approach. In their June 2010 issue, Lancet writers call the epidemics of obesity and type II diabetes “a public health humiliation.” They call diabetes a ‘mostly preventable disease’, which requires changes in lifestyle and nutrition, and claim that, by treating diabetes with medications, “the medicine might be winning the battle of glucose control, but it is losing the war against diabetes.”
The New England Journal of Medicine, Diabetes Prevention Program Research Group found that as little as a 7% weight loss can cause a 58% decrease in the risk of developing diabetes from pre-diabetic stage. They are stating that lowering weight in the pre-diabetic stage, by only 7% can lessen the chances of getting Type II Diabetes by almost half! For example, a 200 lb. overweight person will decrease their chances of contracting diabetes type 2 if they loose 14 lbs. Changing ways people cope and manage an illness is the health psychology relationship.
Coping with Diabetes and Treatment
The treatment for diabetes means controlling blood glucose levels and minimizing the risk of complications. This process begins with people implementing a few key radical lifestyle changes, such as introducing regular exercise and maintaining a healthy weight through proper nutrition. For obese people, losing weight can be the main challenge, but it can deliver the most impact. Unfortunately, Type 2 Diabetes in time usually worsens. While lifestyle modification can slow down the progression of the disease, it might be necessary to add medication to keep the glucose at a healthy level.
Diabetic drugs control sugar in blood, some by stimulating the pancreas to produce and deliver more insulin, some by preventing the production of glucose from the liver, and others by blocking the actions of stomach enzymes. These stomach enzymes break down carbohydrates or cause cells to be more sensitive to insulin. At some point, the diabetic patient may need to use injectable insulin to control the sugar level. It is extremely beneficial for the diabetic patient to keep a close watch on cholesterol levels and blood pressure, as most diabetes patients die from heart attacks.
Psychology and fighting Type 2 Diabetes with Diet
Changing cultural beliefs and implementing a lifestyle change is difficult for many in our society to achieve. A serious worldwide campaign promoting the importance of maintaining a healthy lifestyle should be implemented, and obesity should be treated as a problem not just related to one’s physical appearance. Type II Diabetes is one illness that can be prevented with paying attention to living a healthy lifestyle and changing cultural beliefs in terms of applying healthy food practices.
Although there are many diets available online that are advertised as “diabetes-fighting” diets, to prevent the onset of type II diabetes scientists suggest following a healthy food program. A diet rich in fruits, vegetables and fiber, combined with regular exercise. However, people who already have type II diabetes might need a more personal diet plan, depending on other problems they have as a consequence of the illness. As a general guideline, nutritionists recommend a diet that is low in calories, high in different complex carbohydrates (fruits, beans, vegetables and whole grains), low in saturated fats (stay away from cheese, butter and fatty meat) and high in monounsaturated and polyunsaturated fat (use olive oil.) This is no surprise as this is the same diet recommended for maintaining a healthy weight.
In conclusion, thousands of people from all over the world are struggling to control, and manage their blood sugar to keep the diabetes from creating serious damage to their bodies. In the meantime, extremely little is being done to change the main culprit causing the disease: An unhealthy lifestyle with little or no exercise and poor nutrition. Children are growing up following their parents’ lifestyle, growing obese and increasingly showing onset of type II diabetes in early childhood. The basic premise that I would like people to understand is that you have a choice, and a lot of our physical health is in our hands.
References
Crowe, Seamus, Wu, Lindsay, Economou, Catherine, Turpin Sara M., Matzaris, Maria, HoehnKyle L., HeveneAndrea L., JamesDavid E., DuhElia J. , Watt, Matthew J. (2009). Pigment Epithelium-Derived Factor Contributes to Insulin Resistance in Obesity. Cell Metabolism. Volume 10, Issue 1, 40-47. Retrieved 22 August 2011 from http://www.cell.com/cell-metabolism/abstract/S1550-4131%2809%2900159-4
Diabetes Prevention Program Research Group. (2002). Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. New England Journal of Medicine. 346:393-403. Retrieved 22 August 2011 from http://www.nejm.org/doi/full/10.1056/NEJMoa012512 .
Hu, Frank. (2003). Sedentary lifestyle and risk of obesity and type 2 diabetes. PubMed, US National Library of Medicine National Institutes of Health. 38(2):103-8. Retrieved 22 August 2011 from http://www.ncbi.nlm.nih.gov/pubmed/12733740
The Lancet, Volume 375, Issue 9733, Page 2193. (2010). Type 2 diabetes—time to change our approach.Retrieved 22 August 2011 from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961011-2/fulltext
World Health Organization. Diabetes Fact sheet N°312 (2011). Retrieved 22 August 2011 from http://www.who.int/mediacentre/factsheets/fs312/en/
Dr. Cheryl MacDonald, RN., Psy’D.
Health Psychology of San Diego
760 439-9331
