Diabetes is a serious chronic medical condition that has a significant impact on the lives of almost half a billion people worldwide (1). This article will attempt to give an outline of diabetes, highlighting the various causes, exploring its diverse types and contemplating the importance of increasing our awareness of this debilitating condition.
Diabetes is more than just a medical ailment, it presents a daily challenge for those affected, influencing every decision, meal, and activity. By addressing the various aspects of diabetes, patients can be empowered to manage their own health, while being offered support to deal with the condition and collaboratively striving for a future where diabetes is better understood, more effectively controlled, and ultimately prevented.
What is Diabetes?
Simply put, diabetes is an issue with the regulation of glucose. So, what is glucose? Glucose is a sugar molecule that functions as our main source of energy. It is also responsible for numerous other functions, including the regulation of blood sugar. When we eat carbohydrates, our digestive systems break down the complex sugars contained in them into simpler molecules, such as glucose. Once absorbed into the body, glucose creates a temporary increase in blood sugar levels. The amount of sugar in the blood is regulated by a hormone called insulin.
Insulin is created in your pancreas and regulates blood sugar by allowing various cells throughout your body to absorb glucose molecules to store as energy, thus lowering the amount of glucose that is circulating in the blood. This process is known as glucose homeostasis. In the case of diabetics, the amount of glucose being absorbed is no longer able to be regulated, leading to an excess amount of glucose in the bloodstream. This can lead to long-term health problems, including heart disease, vision loss, and kidney disease.
Types of Diabetes
While it is true that diabetes is always related to a breakdown in glucose regulation, there are different ways this can happen, leading to multiple types of diabetes, which we will look at in turn:
Type-1 diabetes is an autoimmune condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas, leading to a deficiency. Type-1 diabetes has a strong genetic element and, once activated, can be managed but not cured. The condition is often diagnosed in childhood or adolescence and requires lifelong treatment with insulin therapy.
Type-2 diabetes is often associated with insulin resistance. When cells become insulin resistant, they stop absorbing glucose, which then builds up in the bloodstream, causing the pancreas to produce more insulin. This can result in high levels of insulin (hyperinsulinemia). Over time, the pancreas struggles to keep up with this increased demand and actually begins to produce less insulin, compounding the problem.
Gestational diabetes: Some women develop diabetes during pregnancy, due to the hormonal changes taking place. This usually resolves after childbirth. However, this can indicate a risk of developing Type 2 diabetes later in life.
Preventing Type-2 Diabetes
While the current thinking is that environmental triggers, such as viral infections, play a part in the onset of type-1 diabetes, these triggers are not well understood (2). For this reason, I will focus on type-2 diabetes when discussing prevention. Although Type 2 diabetes is becoming more and more prevalent worldwide, there is a large element of its onset that is related to lifestyle and so there are steps that can be taken to prevent its onset. Below are some lifestyle adjustments you can make now to help prevent the onset of type-2 diabetes, however, if you feel that you may be at risk, it is important to speak to your doctor to obtain a professional assessment.
Maintain a healthy weight: Excess weight has been shown to significantly increase the risk of developing diabetes and even a 5-10% decrease can make a big difference to your health (3). Maintaining a healthy weight has numerous other benefits so taking the time to address this could literally save your life. While there are some factors of weight gain that are out of our control, exercise and a healthy diet are the areas that you can really become proactive in your own healthcare.
Eat a balanced diet: Prioritise whole grains, vegetables, fruits, lean proteins, and healthy fats to control blood sugar levels. Limit or avoid foods high in sugar and refined carbohydrates to prevent rapid spikes in blood sugar. Studies have found that following a Mediterranean diet can lead to a significant reduction in many of the risk factors for developing type-2 diabetes (4). You can learn more about the Mediterranean diet in this article on my website.
Portion control: Be mindful of portion sizes to help prevent over-eating, weight gain and blood sugar spikes. Using small plates and paying attention to hunger and fullness cues can assist in portion control. If you do feel you want a second helping, wait some time before going for more. It takes about 20 minutes for the signal that you have eaten enough to get to the brain. Reflect on whether you are going for more for the delicious taste or for hunger. If you do go for seconds, leave out the carbohydrates and go rather for a little more protein, healthy, fats, and vegetables. The image above gives a rough idea of how you can proportion the food groups on your plate.
Limit sugar and processed foods: Reduce consumption of sugary drinks, high-sugar foods, sweets, refined carbs, and heavily processed foods to mitigate the risk of insulin resistance.
Stay hydrated: Drinking ample water is crucial for overall health and helps regulate blood sugar levels while controlling appetite.
Manage stress: chronic stress causes cortisol levels to rise, which in turn can increase blood glucose levels (5). Find healthy stress management strategies, such as exercise, meditation, yoga, or engaging in hobbies.
Managing Type 2 Diabetes
While type-1 diabetes can be effectively managed with careful medication from a qualified doctor, type-2 can often be managed and even put into remission with lifestyle adjustments (6). So even if you have already been diagnosed, making some basic changes to your lifestyle can help turn your diabetes around, while also benefiting your health in numerous other ways. Here are some ways that you can begin to manage type-2 diabetes.
Monitor blood sugar: Regularly check blood sugar levels as advised by healthcare providers to understand how food, activities and medications affect your blood sugar levels. Even better, invest in your own blood sugar monitor (such as a Zoe continuous glucose monitor) to help you understand how you are responding to food, exercise, stress, and sleep. This will give unique insights into your glucose levels in real time.
Healthy eating: Focus on a balanced diet and consider collaborating with a nutritional therapist or registered dietitian to develop a tailored meal plan that meets your specific needs and helps stabilise blood sugar levels. Please do get in touch if you would like to discuss this further.
Regular physical activity: Engage in consistent, daily, physical activity, like walking, swimming, cycling, etc., to control blood sugar and enhance overall health.
Nutrients that Help Manage Diabetes and Blood Sugar
While medication and lifestyle changes are fundamental for managing diabetes, certain vitamins and minerals can play a supportive role in helping control blood sugar and reduce the risk of diabetes-related complications. The following are some of the key vitamins and minerals that can assist in the management of diabetes and blood sugar:
Vitamin D: Vitamin D is renowned for its contribution to bone health, and it also plays a pivotal role in regulating blood sugar. Studies indicate that a deficiency in vitamin D is linked to a higher likelihood of developing Type 2 diabetes (7). The prevailing belief is that vitamin D enhances the body’s responsiveness to insulin, thereby aiding in the control of blood sugar levels. To maintain adequate Vitamin D levels, it is advisable to seek daily exposure to sunlight, incorporate fatty fish such as salmon and mackerel into the diet, and consider supplements with the advice of a healthcare professional. You can learn more about the benefits of vitamin D here.
Vitamin B complex: A Vitamin B complex includes other important B vitamins such as B1 (thiamine), B3 (niacin) and B6 (pyridoxine), recognised for their vital role in metabolism and each contributing to stable blood sugar levels. These vitamins can be found in foods, such as whole grains, lean meats, fish, and vegetables. This article lays out the important role that B vitamins play in your health.
Magnesium: Magnesium plays a vital role in various physiological processes, including the metabolism of glucose. It enhances the effectiveness of insulin and potentially improves the body’s insulin response. Given that many individuals with diabetes may have insufficient magnesium levels, it is important to incorporate magnesium-rich foods, such as spinach, nuts, seeds, and whole grains into your diet. I discuss magnesium in more detail here.
Zinc: Zinc is another essential mineral that contributes to insulin production and storage. It plays a crucial role in maintaining the proper function of beta cells in the pancreas, responsible for insulin release. To support blood sugar control, consider including zinc-rich foods, like lean meat, poultry, seafood, and whole grains in your diet.
Cinnamon: Cinnamon, while not classified as a vitamin or mineral, is a spice that has gained attention for its potential in regulating blood sugar. Some studies suggest that cinnamon may enhance insulin sensitivity and lower blood sugar levels (8). Easily integrated into your diet, it can be sprinkled on oatmeal or added to a morning smoothie. However, it is important to consume it in moderation, as individual responses may vary.
In Conclusion
Although vitamins and minerals can play a supportive role in diabetes management, they are not substitutes for medication or lifestyle adjustments. The foundation of diabetes care should still involve a balanced diet, regular physical activity and guidance from healthcare professionals. Before introducing supplements or making significant dietary changes, consult a healthcare provider, as individual needs and responses can differ. Collaborating with healthcare professionals allows individuals with diabetes to effectively leverage, the benefits of nutrients for improved blood, sugar, control, and overall well-being.
Look out for the next article on my website which will explain insulin resistance, discuss some of the causes and suggest several strategies to increase insulin sensitivity.