Home Features ‘Preventing Diabetes’ – WORLD DIABETES DAY; Theme: ‘Access to Diabetes Care – If...
Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes
World Diabetes Day provides an opportunity to raise awareness of diabetes as a global public health issue, and what needs to be done – collectively and individually – for better prevention, diagnosis and management of the condition.
New figures reveal that over 537 million adults around the world are living with diabetes. The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. This reflects an increase in associated risk factors, such as being overweight or obese.
Guyana’s diabetes prevalence was 11.6% in 2020.
Before diabetes is diagnosed, there is a period where blood sugar levels are high, but not high enough to be diagnosed as diabetes. This is known as prediabetes. It’s estimated that up to 70% of people with prediabetes go on to develop type 2 diabetes.
Fortunately, progressing from prediabetes to diabetes isn’t inevitable. Although there are certain factors which cannot be changed — such as genes, age, or past behaviours — there are many actions that can be taken to reduce the risk of diabetes.
Ways to prevent diabetes
1. Cut sugar and refined carbs from the diet
Eating sugary foods and refined carbs can put at-risk individuals on the fast track to developing diabetes. Our body rapidly breaks these foods down into small sugar molecules, which are absorbed into the bloodstream. The resulting rise in blood sugar stimulates the pancreas to produce insulin, a hormone that helps sugar get out of the bloodstream and into our body’s cells.
In people with prediabetes, the body’s cells are resistant to insulin’s action, so sugar remains high in the blood. To compensate, the pancreas produces more insulin, attempting to bring blood sugar down to a healthy level. Over time, this can lead to progressively higher blood sugar and insulin levels, until the condition eventually turns into type 2 diabetes.
Many studies have shown a link between the frequent consumption of sugar or refined carbs and the risk of diabetes. A detailed analysis of 37 studies found that people with the highest intakes of fast-digesting carbs were 40% more likely to develop diabetes than those with the lowest intakes.
2. Work out regularly
Performing physical activity on a regular basis may help prevent diabetes. Exercise increases the insulin sensitivity of our cells, so, when exercising, less insulin is required to keep the blood sugar levels under control. One study in people with prediabetes found that moderate-intensity exercise increased insulin sensitivity by 51%, and high-intensity exercise increased it by 85%. However, this effect occurred only on workout days. Working out more frequently seems to lead to improvements in insulin response and function.
One study in people at risk of diabetes found that burning more than 2,000 calories weekly via exercise was required to achieve these benefits.
3. Drink water as the
primary beverage
Water is by far the most natural beverage to drink. Using water most of the time also helps us to avoid other beverages that are high in sugar, preservatives, and other questionable ingredients. Sugary beverages like soda and punch have been linked to an increased risk of both type 2 diabetes and latent autoimmune diabetes in adults (LADA).
One large observational study looked at the diabetes risk of 2,800 people. Those who consumed more than two servings of sugar-sweetened beverages per day had a 99% increased risk of developing LADA, and a 20% increased risk of developing type 2 diabetes. Researchers of one study on the effects of sweet drinks on diabetes stated that neither artificially sweetened beverages nor fruit juice were good beverages for diabetes prevention. By contrast, consuming water may provide benefits. Some studies have found that increased water consumption may lead to better blood sugar control and insulin response.
4. Lose weight, especially in overweight or obese persons
Although not everyone who develops type 2 diabetes is overweight or obese, the majority are. Those with prediabetes tend to carry excess weight in their midsection and around abdominal organs like the liver. This is known as visceral fat. Excess visceral fat promotes inflammation and insulin resistance, which significantly increase the risk of diabetes. Although losing even a small amount of weight can help reduce this risk, studies show that the more weight lost, the more benefits are experienced.
5. Quit smoking
Smoking has been shown to cause or contribute to many serious health conditions, including heart disease, emphysema, and cancers of the lung, breast, prostate and digestive tract. There’s also research linking smoking and second-hand smoke exposure to type 2 diabetes. In an analysis of several studies totalling over one million people, smoking was found to increase the risk of diabetes by 44% in average smokers, and by 61% in people who smoked more than 20 cigarettes daily. Researchers stated that even though many of the men gained weight after quitting, after several smoke-free years, their risk of diabetes was lower than if they’d continued smoking.
6. Portion sizes
Whether or not a low-carb diet is done, it’s important to avoid large portions of food, in order to reduce the risk of diabetes, especially if overweight or obese.
Eating too much food at one time has been shown to cause higher blood sugar and insulin levels in people at risk of diabetes. On the other hand, decreasing portion sizes may help prevent this type of response.
7. Avoid sedentary behaviours
It’s important to avoid being sedentary to prevent diabetes. Very little physical activity or no activity, along with sitting all day, would lead to a sedentary lifestyle.
Observational studies have shown a consistent link between sedentary behaviour and the risk of diabetes. A large analysis of 47 studies found that people who spent the highest amount of time per day engaged in sedentary behaviour had a 91% increased risk of developing diabetes. Changing sedentary behaviour can be as simple as standing up from a desk and walking around for a few minutes every hour. Unfortunately, it can be hard to reverse firmly entrenched habits.
8. Eat a high-fibre diet
Getting plenty of fibre is beneficial for gut health and weight management. Studies in obese, elderly and prediabetic individuals have shown that it helps keep blood sugar and insulin levels low. In the digestive tract, soluble fibre and water form a gel that slows down the rate at which food is absorbed. This leads to a more gradual rise in blood sugar levels.
Rather than viewing prediabetes as a stepping stone to diabetes, it may be helpful to see it as a motivator for making changes that can help reduce the risk. Eating the right foods and adopting other lifestyle behaviours that promote healthy blood sugar and insulin levels would give the best chance at avoiding diabetes.
