You can get screened for diabetes and prediabetes. If you have risk factors such as having a family history of diabetes, high blood pressure, high cholesterol, inactive and overweight. I recommend that anyone over the age of 40 should be screened.
Left untreated, diabetes can cause complications to the heart, kidneys, nerves, and eyesight can occur. This can lead to heart attacks, strokes, blindness and amputation, and death.
The complications that this disease can cause are devastating.
We have the power to stop it by eating a healthier diet and adopting healthier lifestyle habits.
The WHO (World Health Organization) says “Type 2 diabetes can be prevented". Thirty minutes of moderate-intensity physical activity on most days and a healthy diet can drastically reduce the risk of developing type 2 diabetes”.
Type 2 Diabetes is a chronic disease related to insulin and glucose metabolism. Either your body cannot properly use the insulin it produces (insulin resistance) or your body doesn’t produce enough insulin.
Insulin is a hormone that controls the amount of glucose (a type of sugar) we have in our blood.
Glucose comes from foods and drinks that contain carbohydrates. Some sources of carbohydrates are very high in sugar. Such as table sugar and bread. Others have fewer carbohydrates such as vegetables.
Each time we eat, glucose is released into the blood. It is released in various degrees depending on how much carbohydrate the food contains.
When the amount of glucose in the blood starts rising, insulin is released from our pancreas. Its the pancreas' job to take the glucose out of the blood and bring it to our muscle cells.
Our muscles use glucose as fuel.
If the muscles already have enough glucose and don’t need the more, insulin will bring glucose to our liver and fat cells. It will store the excess glucose for later use, either as glycogen in the liver or as fat on our bodies.
We’ll talk about this later, but insulin is a hormone that can make us gain weight and store fat around the belly.
In the case of diabetes, glucose will stay in the blood and cause our blood sugar to rise.
High blood glucose levels are toxic.
High glucose damages organs, blood vessels, and nerves. If insulin isn’t working, our cells don’t get the fuel they need to function correctly.
These two problems cause the symptoms of type 2 diabetes.
Prediabetes is a medical condition where the blood sugar level is above normal, but still below the threshold of diabetes.
I sometimes explain to my patients that prediabetes is like the very early stages of diabetes. Not fully there yet, but you're on your way.
If you make no changes to improve your health, diabetes will be in your future.
The starting point is our diet. Our Western diet is high in processed carbohydrates. This means our glucose levels are often higher than they should be.
When I say high in carbs, I mean that 60-70% of our calories come from carbs.
Cheerios for breakfast, a cookie as a mid-morning snack, a sandwich for lunch, chocolate bar in the afternoon, pasta for dinner, and maybe sugary popcorn at night.
We talked about how foods containing carbohydrates will trigger the release of insulin.
The more carbs you eat, the more insulin your body has to produce.
In individuals who eat a diet high in carbs over several years, we see their insulin level rising above the normal range.
So, even if these people don’t have a medical condition yet, and are seemingly healthy, they are putting themselves at risk in the long term.
Remember how I said insulin has 2 functions.
Let’s say you eat a piece of cake. A large shot of glucose is sent into your bloodstream. You get a high dose of insulin. The insulin will sweep up the glucose and deliver it to the cells of your working muscles for energy.
The problem is when the muscles aren’t working very hard (i.e., you’re sitting on the couch, at your desk, at the dinner table, etc.)…
When that happens, the muscles say ‘no thanks’ to the offer of more energy. They don’t need it, PLUS their back up stores are already full. Insulin then moves on to store that energy (glucose) as fat.
It tends to store the fat around the abdominal area, causing us to have belly fat.
Glucagon helps us burn fat.
When your blood sugar and insulin levels are constantly high from eating, we prevent a hormone called glucagon from being fully active.
When we're hungry and don’t eat, glucagon breaks down our glycogen and fat stores. It prevents us from getting low blood sugars by increasing them.
Glucagon is our fat-burning hormone.
However, if our blood sugar and insulin level is already higher than normal, glucagon will not get released. We’re then unable to burn those fat stores.
For these 2 reasons, a diet high in carbs causes us to gain weight. That’s why people who are looking to lose weight are often offered a low-carb diet.
After months or years of eating a diet high in carbs and experiencing an increased level of insulin, our body can develop a condition called insulin resistance.
While insulin is a crucial hormone, too much of it can be dangerous for the body. For example, too much insulin would cause your blood sugars to fall too low, which can cause death. Yikes!
Therefore, as a defense mechanism to high levels of insulin, your body starts responding less to insulin as a way to protect itself from low blood sugar.
Our body starts to resist insulin and doesn’t allow it to do its job.
When you think about it, the human body is extremely smart. It has thousands of mechanisms to maintain a certain level of equilibrium.
For example, when you’re too hot, you sweat to bring down your body temperature. When you’re cold, you shiver, your body hair raises up creating goosebumps to help insulate and warm you up. These are examples of the body’s adaptation to short-term changes.
However, when the body is exposed to a “stressor” over a longer period of time, the it will adapt itself to create a new state of balance for this “stressor” to become less of a problem.
In other words, your body created a new “normal”.
Notice how people living near a train track or airport rarely notice the sounds of trains or airplanes anymore? To them, it’s just “white noise”. Their bodies have adapted to this very loud noise and it has become part of their new “normal”.
In the case of insulin resistance, your body and cells simply start responding less well to the effects of insulin.
As a consequence, your cells don’t let in the glucose that the insulin brings to them. If the glucose stays outside of the cells and inside the blood, your blood sugar rises.
To overcome this insulin resistance in your cells, your pancreas pumps out more insulin to push the glucose into the cells, which only provides a temporary solution.
As your insulin levels in your body continue to rise, your body will eventually develop a new state of balance or, a “new normal”. Meaning your cells will develop a new resistance to this higher dose of insulin.
And so the vicious cycle continues. Your pancreas has to work harder and harder.
After working overtime for several years, the pancreas calls it quits and starts producing less insulin.
As you can guess, this is bad news and your blood sugar levels will rise even more than before.
If it hasn’t already, this is when your blood glucose reaches the threshold for prediabetes or diabetes.
Here is a quick explanation of oral and insulin medications. We’ll come back to diet later on.
Prediabetes and diabetes don’t always have very specific or well-defined symptoms.
This is one of the reasons why the condition can go unnoticed for years. It's often found by your doctor “by mistake” on a routine blood test.
When insulin resistance is advanced you're at the prediabetes/diabetics stage. At this point, you can experience symptoms such as having blurred vision, feeling very thirsty and urinating often.
You can prevent diabetes. Imagine being able to turn diabetes symptoms around with some simple diet changes.
Here's how -
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