Diabetes

More than 9 million Canadians live with diabetes or prediabetes. Myths abound about the causes and management of this disease. 

Diabetes has been labelled the global health epidemic of the 21st century. Chances are you or someone you know may be at risk for developing diabetes and not even know it. While type 1 diabetes can’t be prevented, the good news is that there are many ways you can take action and decrease your risks of developing type 2 diabetes.

Additionally, if you or someone you know has been diagnosed with diabetes, there are many ways to effectively manage the disease.

November is Diabetes Awareness Month, and for our diabetes issue alive interviewed Sharon Zeiler, senior manager, Diabetes Education and Nutrition, at the Canadian Diabetes Association in Toronto to dispel some common misconceptions about diabetes. We also talked to Serenity Aberdour, a Vancouver-based naturopathic doctor, for some natural ways to help prevent and manage the disease.

Causes

Myth: Having a sweet tooth and eating sweets or sugary treats can cause diabetes.

Fact: Zeiler explains that eating sugars and sweets does not cause diabetes. However, eating treats often can cause weight gain; being overweight or obese is one of the risk factors for developing type 2 diabetes.

Myth: Regular exercise, eating well, and taking vitamins removes the risk of developing diabetes.

Fact: By following a healthy lifestyle, the risk of developing type 2 diabetes is substantially reduced, but not entirely eliminated. Even people who maintain a healthy diet, exercise, and are at a healthy weight can develop type 2 diabetes. Some risk risk factors out of our control include race (those of Aboriginal, Hispanic, Asian, South Asian, or African descent have a higher than average risk of developing diabetes); family history of diabetes; and being over age 40.

Effects

Myth: Type 2 diabetes isn’t a big deal; it’s type 1 that’s serious.

Fact: Both type 1 and type 2 diabetes are serious. If not well managed, both types can lead to serious complications such as cardiovascular disease, kidney disease, blindness, nerve damage, and amputations.

Myth: A diagnosis of prediabetes means that type 2 diabetes is inevitable.

Fact: There is very good evidence that healthy eating and being physically active can greatly decrease the risk of developing type 2 diabetes—in those individuals at high risk—by about 60 percent. Given the many complications of type 2 diabetes, it is well worth the effort to try to delay or prevent its onset.

Myth: Prediabetes or diabetes does not have many symptoms and only a blood test can confirm it.

Fact: Prediabetes and type 2 diabetes may or may not have symptoms that one can recognize. Anyone 40 years old or over should be tested at least every three years—more often if there are risk factors, including being overweight or having a family member with diabetes.

Management

Myth: Once diagnosed with type 2 diabetes, desserts will have to be eliminated from the diet.

Fact: People with diabetes can have desserts; they just have to fit them into their individual meal plan. Zeiler recommends having fruit, especially fresh fruit, for dessert, as this supplies vitamins and minerals, as well as fibre, at a very modest calorie cost.

Myth: Someone who has been diagnosed with type 1 or type 2 diabetes will find that eating out with friends or family will never be the same.

Fact: People diagnosed with diabetes can still eat out with family and friends, but they should take more care in reading the menu when choosing their meal, Zeiler recommends. Most restaurants, aware that patrons are increasingly health conscious, offer more choices (for example, items that are baked rather than fried, lower fat sauces, substitutions of vegetables or salads for fries) and may also list nutritional information.

Myth: Once someone is diagnosed with diabetes, exercise and nutrition won’t make a big difference in managing the disease.

Fact: According to Zeiler, healthy eating and physical activity are very important in good management of diabetes. When diabetes is well managed, the onset of complications can be prevented or delayed.

Further, Aberdour recommends 30 minutes of moderate to intense exercise five times per week and suggests, based on current research, that a supported exercise program with a coach, instructor, or trainer may have better results in controlling type 2 diabetes than exercising solo.

 Myth: It’s possible to get rid of type 2 diabetes with diet and exercise.

Fact: Once a person develops diabetes, they cannot get rid of it. However, with good diabetes management, such as healthy eating, being physically active, not smoking, and reducing stress, blood glucose levels can be controlled and the complications of diabetes can be prevented or delayed.

By the numbers

• An estimated 350 million people worldwide have diabetes. This number has more than doubled since 1980.
• A 2007 House of Commons Standing Committee on Health report revealed that 26 percent of Canadian children and adolescents, aged two to 17 years, are overweight or obese, putting them at greater risk for developing type 2 diabetes.
• Canadians with diabetes are twice as likely to die prematurely as people without diabetes, and 80 percent of people with diabetes will die from heart disease or stroke.

Sweet Treats

While we must always watch our sugar intake, the good news is that some sugars are better than others. Coconut palm sugar, for instance, has a glycemic index of 35 (out of 100) while white sugar has an index of 64. This means that coconut palm sugar will break down more slowly and release glucose more gradually into the body, thus avoiding the same glucose spike seen with white sugar.

Why follow Canada’s Food Guide?

The Diabetes Association’s Zeiler says that Canada’s Food Guide is based on scientific evidence and recommends a pattern of eating that should help Canadians meet their nutritional needs to delay or prevent the onset of illness.

The guide recommends a minimum of seven servings of vegetables and fruit each day to supply the vitamins and minerals we need to stay healthy. Most Canadians do not eat enough vegetables and fruits, thereby missing out on the health-giving properties of these foods.

Manage diabetes naturally

If you have diabetes, there are many natural ways to manage the disease and ease your symptoms. Serenity Aberdour, ND, recommends the following tips.

• Add cinnamon to food and drink to help control blood sugar.
• Eat plenty of leafy greens such as kale and collards, which contain magnesium and B vitamins-—necessary for carbohydrate metabolism.
• Take a contrast shower to help support healthy circulation. Step into a warm shower and alternate between warm—for 2 minutes—and cold—for 30 seconds, repeating twice.
• Try a dry brush exfoliation to improve circulation.
• Have a snack that combines heart-healthy omega-3 fatty acids and protein to keep blood sugar consistent.
• If taking medications to manage type 2 diabetes, speak to the health care practitioner who is monitoring your diabetes about how improvements to your diet and lifestyle may decrease the number or amount of medications you are taking.

Type 1, type 2—what’s the difference?

Type 1
Type 1 diabetes cannot be prevented and usually appears in childhood or adolescence. Having type 1 diabetes means the pancreas is not producing insulin. Those with type 1 diabetes must take insulin and check their blood glucose levels regularly throughout the day to keep them in normal range.

Type 2
Type 2 diabetes can happen at any age and occurs when the pancreas does not produce enough insulin or doesn’t properly use the insulin it makes, causing glucose buildup in the bloodstream. It is a progressive disease, and it may be more difficult to keep blood sugar levels in range over time.

Prediabetes
When blood glucose levels are higher than normal, this is called prediabetes. Many people with prediabetes will eventually develop type 2 diabetes.

Gestational diabetes
This is a temporary condition that may occur during pregnancy. Blood sugar levels return to normal after childbirth; however, women with gestational diabetes are at increased risk of developing type 2 diabetes later in life.

Food for thought

• Strawberries contain fisetin, a naturally occurring flavonoid; a recent study shows that eating fisetin-rich strawberries may lessen complications of diabetes.
• Eating foods rich in chromium such as broccoli and grapefruit helps to regulate blood glucose levels.
• Trans-palmitoleic acid, a fatty acid found in dairy products such as milk, cheese, and yogourt, may slash the risk of type 2 diabetes.
• A study from the University of Toronto found that eating 2 oz (56 g) of nuts daily, instead of a carbohydrate-rich snack, improved both glycemic control and serum lipids in type 2 diabetics.

Did you know?

• A recent study found that women who work rotating night shifts have an increased risk of developing type 2 diabetes.
• Health organizations such as the Canadian Cancer Society and the Heart and Stroke Foundation of Canada are asking provincial governments to tax sugary drinks.
• People who watch two or more hours of TV per day had an increased risk of developing type 2 diabetes, according to a recent study from Denmark.
• Assistance dogs trained to sense episodes of low blood glucose may sense a dangerous drop in blood sugar and therefore help to prevent a hypoglycemic episode from occurring.
  

Are skin tags a sign of diabetes?

Skin tags are protruding growths that often appear on the neck, armpits, and within body folds. They are usually harmless and noncancerous and may occur more commonly in people who are overweight or who have diabetes.

Current research shows there is a potential link between skin tags and diabetes. A 2010 study from Brazil found a strong association between multiple skin tags and patients with insulin resistance—which increases the risk of developing type 2 diabetes. Further, a study from the Netherlands noted that skin tags may also warn of a possible increase in cardiovascular risk.

People with skin tags should discuss the potential for associated health concerns with an appropriate health care practitioner.