Rosalee Brown
DIABETES IS one of the leading non-communicable diseases affecting our population.
Type 2 diabetes affects mostly adults and is now even affecting the adolescent population. This disease is increasing at epidemic proportions, especially in developing countries. It is estimated that 333 million people will be affected globally by 2025 if it continues at its current trend, an increase from five to 6.3 per cent of the world's population.
Diabetes is associated with many complications, which include kidney failure, blindness, heart failure, stroke and amputation.
Amputation of the lower limbs is common in Jamaica. This year, World Diabetes Day, celebrated Monday, November 14, has as its theme, 'Put feet first, prevent amputation'. Even with diabetes diagnosis, prevention is still vital, that is, prevention of organ damage with tight daily management of the disease.
DIABETES RISK FACTORS
Obesity
This is a body mass index (BMI) of 30 or more. The risk is increased when the fat is mostly in the upper body and abdomen. This central obesity can also be measured by using waist measurements. A waist that is equal to or greater than 35 and 40 for women and men respectively, is an indication of central obesity. This belly fat is one of the factors which affects the action of insulin - called insulin resistance. This happens when cells in organs (such as the liver) and in muscle and fat, become less sensitive to the action of insulin.
Insulin is important in making the absorption of blood glucose possible. The insulin resistance creates a vicious cycle and more and more insulin is produced to make glucose absorption possible. This leads to excess insulin and the eventual destruction of the insulin producing cells of the pancreas. This further leads to a build-up of blood glucose and eventually a diabetes diagnosis. But even before diagnosis, other damage is ensuing, caused by central obesity.
Inactivity
This can lead to increased fat storage and obesity. Inactivity also reduces the transport of glucose to the cells to be used for fuel by reducing specific transporters which facilitates this passage.
PREVENTION
The diabetes prevention programme (DPP) launched by the National Institute of Diabetes and Digestive and Kidney Diseases in 1996, published results in 2001 which showed that Type 2 diabetes could be prevented in males and females from different ethnic groups, including African Americans, and for persons over 60 years old. These persons had impaired glucose tolerance, which is when results of the oral glucose tolerance test shows glucose higher than normal, but not at the level for diagnosis of diabetes.
The study placed one group of persons on an intensive lifestyle treatment of diet and exercise, another group on medication and another group got a placebo for medication and information on diet and exercise. The group on intensive lifestyle treatment reduced the risk of diabetes by 58 per cent and the group on medication by 31 per cent.
The intensive treatment included a low-fat diet and exercising for 150 minutes per week to lose seven per cent of body weight. The results were so overwhelming that the study was stopped a year early because it proved beyond a shadow of a doubt that lifestyle changes can prevent Type 2 diabetes in males and females of all ages.
TIPS
Eat less to prevent weight increase and to promote weight loss.
Increase vegetables in the diet, they are lower in calories and promote health.
Use less fats and oils.
Use less sugar.
Eat less starchy foods, especially those which are processed.
Get more active, doing ordinary daily activities along with enjoyable high-energy activities such as dance, power walks, a sport, and so on.
You can do it!
Rosalee Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email: yourhealth@gleanerjm.com.
