Nutrition, lifestyle and Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus, also known as non – insulin dependent or adult –onset Diabetes (International Diabetes Federation, 2013) is a condition whereby the body becomes resistant to the action of insulin. Insulin is a hormone that is released from the pancreas when the concentration of blood glucose is low. In Type 2 Diabetes, the pancreas is unable to produce enough insulin, or the body is unable to effectively use the insulin that is produced. High levels of blood glucose can cause several health problems, which will be discussed later on. The IDF has reported that 90% of diabetes cases are attributes to Type 2 Diabetes Mellitus. Indeed, Type 2 Diabetes occur later on life, in those aged 40 years and above and is not always easily identified unless through specific tests such ‘blood glucose finger prick tests’ (24hr - Fasting Glucose and 2hr Glucose Intolerance), and urine tests.  However, certain lifestyle factors such as overweight/obesity, physical inactivity, and excessive consumption of foods high in sugar, trans- and saturated fatty acids can contribute to high risks of developing Type 2 diabetes.  Moreover, genetic factors also contribute to the risk of developing Type 2 diabetes; people of Afro-Caribbean and Asian descent are at greater risks of developing diabetes.

Dietary risk factors

Consuming a diet high in sugar is very dangerous to a person with Type 2 Diabetes because you are adding extra sugar to the body, which insulin is unable to reduce and other cells are unable to recycle. In effect, high concentrations of blood glucose remain in the bloodstream. This can cause damage to kidneys, blood vessels within the heart, nerves with eyes (retinopathy) and lower ligaments (peripheral neuropathy). 

Let’s use the kidneys as an example of what goes wrong in Type 2 Diabetes Mellitus. One of the main functions of the kidneys is to filter waste products from the blood and excrete them in the form of urine. In addition, they can reabsorb water and salt from the blood to maintain a good sodium/potassium balance. One of the structures within the kidney, which filter these products, is known as a glomerulus. With respect to a diabetic kidney, ‘raised blood glucose can cause a rise of other chemicals in the kidney.’ These chemicals include proteins and albumin, which can leak from the glomeruli into the urine.  These conditions are known as Microalbuminuria and proteinuria. Microalbuminuria is the first stage of Diabetic Kidney disease and Proteinuria being the irreversible stage.

Lifestyle risk factors

Let’s move on to lifestyle factors. I’d like to begin to discuss how waist –circumference, BMI and other anthropometric (body) measurements play a significant role in the development and risk of Type 2 Diabetes Mellitus. People who consume a diet high in saturated fat and are physical inactive are at risk of gaining weight. If this is not controlled over a period of time people are at risk obesity and more so Type 2 Diabetes Mellitus. A study conducted earlier this year, showed that waist-circumferences greater than 94.65cm show a significant risk and incidence (occurrence of new cases) of Type 2 Diabetes Mellitus.

Recommendations

As previously mentioned before, diet as well as lifestyle factors have a strong influence on the development of Type 2 Diabetes. Therefore, I am going to list a range of dietary and lifestyle factors.

• Consuming a low GI diet will inevitably maintain the concentration of blood glucose in your bloodstream and reduce the activity of insulin. These include food rich in rye, barley, basmati rice, apples, bananas, oats, lentils and nuts.
• Consuming a diet rich in Monounsaturated – and polyunsaturated fatty acids (MUFAs and PUFAs) can prevent one of the secondary risk factors of Type 2 Diabetes, such as cardiovascular disease. MUFAs and PUFAs can be found in oily fish such as salmon, sardines and tuna, and nuts such as Brazil, almonds, hazelnuts, pine and peanuts. Also plant oils such as sunflower, sesame and olive oil are rich in mono-unsaturated fatty acids.
• If you fall into the ‘overweight category’ of the BMI chart (25 -29.9 kg/m², it would be important to consider taking   aerobic exercises such as rowing, swimming, running and jogging for at least 30 – 45 minutes a day.     
• Maintain a waist – circumference of 80cm for females and 94cm for males.
• In Summary, maintaining a healthy diet and taking part in physical activity will help you to achieve an equal height – weight ratio (Body Mass Index) and reduce the risk of obesity and Type 2 Diabetes, essentially.