Diabetes - Causes and Prevention

Diabetes mellitus (sometimes called "sugar diabetes") is a condition that occurs when the body can't use glucose (a type of sugar) normally. Glucose is the main source of energy for the body's cells. The levels of glucose in the blood are controlled by a hormone called insulin, which is made by the pancreas. Insulin helps glucose enter the cells.

In diabetes, the pancreas does not make enough insulin (type 1 diabetes) or the body can't respond normally to the insulin that is made (type 2 diabetes). This causes glucose levels in the blood to rise, leading to symptoms such as increased urination, extreme thirst, and unexplained weight loss.

Types of Diabetes

Type 1 diabetes (previously known as insulin-dependent diabetes)

Type 1 diabetes is an auto-immune disease where the body's immune system destroys the insulin-producing beta cells in the pancreas. This type of diabetes, also known as juvenile-onset diabetes, accounts for 10-15% of all people with the disease. It can appear at any age, although commonly under 40, and is triggered by environmental factors such as viruses, diet or chemicals in people genetically predisposed. People with type 1 diabetes must inject themselves with insulin several times a day and follow a careful diet and exercise plan.

Type 2 diabetes (previously known as non-insulin dependent diabetes)

Type 2 diabetes is the most common form of diabetes, affecting 85-90% of all people with the disease. This type of diabetes, also known as late-onset diabetes, is characterised by insulin resistance and relative insulin deficiency. The disease is strongly genetic in origin but lifestyle factors such as excess weight, inactivity, high blood pressure and poor diet are major risk factors for its development. Symptoms may not show for many years and, by the time they appear, significant problems may have developed. People with type 2 diabetes are twice as likely to suffer cardiovascular disease. Type 2 diabetes may be treated by dietary changes, exercise and/or tablets. Insulin injections may later be required.

Gestational diabetes mellitus (GDM)

GDM, or carbohydrate intolerance, is first diagnosed during pregnancy through an oral glucose tolerance test. Between 5.5 and 8.8% of pregnant women develop GDM in Australia. Risk factors for GDM include a family history of diabetes, increasing maternal age, obesity and being a member of a community or ethnic group with a high risk of developing type 2 diabetes. While the carbohydrate intolerance usually returns to normal after the birth, the mother has a significant risk of developing permanent diabetes while the baby is more likely to develop obesity and impaired glucose tolerance and/or diabetes later in life. Self-care and dietary changes are essential in treatment.

Causes Of Diabetes

Diabetes can be caused by too little insulin (a hormone produced by the pancreas to control blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed to sustain life.

Type 2 diabetes is far more common than type 1 and makes up most of all cases of diabetes. It usually occurs in adulthood. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.

Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes affects more than 20 million Americans. About 54 million Americans have prediabetes. There are many risk factors for diabetes, including:

1. A parent, brother, or sister with diabetes
2. Obesity
3. Age greater than 45 years
3. Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)
4. Gestational diabetes or delivering a baby weighing more than 9 pounds
5. High blood pressure
6. High blood levels of triglycerides (a type of fat molecule)
7. High blood cholesterol level
8. Not getting enough exercise

The American Diabetes Association recommends that all adults over age 45 be screened for diabetes at least every 3 years. A person at high risk should be screened more often.

How To Prevent Or Control Diabetes

Diabetes prevention is proven, possible, and powerful. Studies show that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight. You can do it by eating healthier and getting 30 minutes of physical activity 5 days a week. In other words: you don't have to knock yourself out to prevent diabetes. The key is: small steps that lead to big rewards. Learn more about your risk for developing type 2 diabetes and the small steps you can take to delay or prevent the disease and live a long, healthy life.

Small Steps. Big Rewards. Your GAME PLAN to Prevent

Watch Your Diet

There is no one magic diet that works for everyone. Nor is there a single diet that works best for one individual over a long time. Pay attention to your genetics, and to your ethnic group's traditional foods. If you are African American, that does not mean overcooked vegetables or pork rinds. Such garbage came on the nutritional scene only recently, and is not a true ethnic food. The same is true for Italians who overdose on pepperoni pizza. Being Italian myself as, well as having enjoyed fantastic African cuisine, I can tell you there is a lot more to these diets than the recent introductions often associated with these cultural groups.

Except for Eskimos and a few other highly specialized ethnic groups, all diets must adhere to the same few macronutrient rules. For example:

Eliminate as many processed carbohydrates as possible.
Don't eat carbohydrates 2 hours before bedtime.
Balance your fat/carbos/protein in a roughly 30-40-30 ratio (this is a guideline, not a hard and fast rule--it doesn't work for everyone).
Eat at least 5 or 6 small meals a day.
Always eat a high-protein breakfast.
Did you know that the peanuts offered on airlines are LESS fattening than the fat-free pretzels?
It's true. Stay away from fat-free foods--they make your insulin levels do a yo-yo, and that makes you put on fat. Yuck. Worse, it sets the stage for adult-onset diabetes.

Do NOT eat white flour, bleached flour, enriched flour, or any other kind of wheat flour that is not whole wheat. The glycemic effects of such flours will work against you. Eat whole grain flours, and try to get a variety. Amaranth and soy are two good flours. Eat oat groats instead of oatmeal. In short, get your grains in the least-processed form you can. This holds true for everyone, regardless of genetics (unless you have a malabsorption problem). This one "trick" will help you keep your insulin level on an even keel, and that is paramount to diabetes prevention and management.

What also holds true for everyone is: drink lots of water! Fill a gallon jug twice a day, and make sure you drink all of it. Once you get as lean as you want to be, cut back to a single gallon if you want to. For added fat loss, drink chilled (but not super cold) water. Sodas do not count. Such beverages are extremely unhealthy, for reasons I won't cover here. However, I will say that if you want to get osteoporosis, soft drinks are for you. Soft drinks make for soft bones.

Make sure to eat at least 5 or 6 small meals a day, rather than one big one. Doing so levels out your insulin and your blood sugar. Forget about that full feeling. If you find yourself overeating out of anxiety or boredom, fix the underlying problem -- don't add to it by poor eating!

Stay Healthy.