Type 2 diabetes occurs when the body can not produce enough insulin or when it can not respond to insulin. If it is not treated, it could lead to serious complications. Obesity (excess body fat) is one of the main causes of type 2 diabetes.
When fat cells, especially those around the abdominal area become too fatty, they produce chemicals that reduce the body’s sensitivity to insulin. They also prevent insulin’s release from the pancreas. If the fat cells get bigger or multiply, the situation worsens. The fat cells then prevent the release of other proteins that make the body sensitive to insulin. One such protein is adiponectin.
In the early stages of diabetes (pre-diabetes), blood glucose levels may remain normal even when the body’s sensitivity to insulin is reduced. This happens because the pancreas increases the amount of insulin it produces to compensate for the reduced sensitivity. However, if a person remains obese, the body’s sensitivity to insulin further deteriorates, and the pancreases eventually loses its ability to produce extra insulin. Full-blown diabetes is established at that stage.
Obesity places tremendous stress on the body’s ability to control blood glucose. This can result in type 2 diabetes, and if left unchecked it can progress to more serious conditions/complications.
Other risk factors / causes of type 2 diabetes
- Age: individuals over the age of 45 are at a greater risk of developing type 2 diabetes
- Impaired glucose tolerance: higher than normal blood glucose
- History of gestational diabetes
- High blood pressure: blood pressure greater than 140/90 mm Hg
- A history of diabetes in the family (e.g. parent or sibling)
- Ethnicity: People of African and hispanic descent have a higher risk of developing type 2 diabetes
- Women with polycystic ovarian syndrome (PCOS)
- Lifestyle: Poor dietary choices and lack of exercise
The main symptoms of type 2 diabetes include dizziness, frequent need to urinate, hunger, increased thirst, fatigue and blurred vision.
How to manage type 2 diabetes
A patient with diabetes can live a relatively normal life if they manage the condition properly. The most effective way of doing this is to make lifestyle changes and to carefully monitor blood sugar levels.
Diet and lifestyle changes
- Antioxidants: Free radicals are unstable molecules that can cause damage in the body. They are made during normal processes in the body, but they can also come from the environment through pollution and smoke. A build up of these damaging free radicals in the body contributes to the development of type diabetes. Fruits and vegetables, particularly green leafy vegetables are excellent sources of antioxidants, molecules that combat free radicals and protect the body from their damaging effects.
- Carbohydrates: Avoid eating refined carbohydrates like white rice, white flour, biscuits, sweets and chocolate because they cause spikes in blood glucose levels. Instead, eat unrefined carbohydrates like oatmeal, beans and lentils, which provide glucose at a steady rate.
- Fats: A diet that is rich in bad fats, but poor in good fats promotes diabetes. Bad fats include saturated fats (found mainly in animal products) and trans-fatty acids (found mainly in hydrogenated vegetable oils). Healthy fats include monounsaturated fats (found in olive oil and nuts) and omega-3 fats (found in wild-caught fish like mackerel).
- Fibre: Soluble fibre found in foods such as beans, oats, nuts, apples, vegetables and psyllium seed husks play a key role in the control of diabetes. Fibre helps to reduce the rate at which the body absorbs carbohydrates from food, thereby preventing rapid increases in blood glucose. It also encourages the liver and muscles to absorb more glucose from the blood to keep overall blood glucose levels low. Furthermore, fibre can increase the body’s sensitivity to glucose by making other tissues more sensitive to glucose.
- Physical activity: Regular exercise can help prevent or control type 2 diabetes by reducing blood glucose levels, and by promoting and maintaining weight loss. As little as 30 minutes of moderate physical activity daily offers substantial protection from diabetes.
Diabetic patients who do not monitor their blood glucose regularly and who not endeavour to keep it controlled risk health issues like fatigue, impotence and infections. If glucose remains uncontrolled, more serious complications like eye, heart and kidney disease eventually arise.
Every type 2 diabetic patient should own a blood glucose monitor and learn how to use it. This is important whether or not their diabetes is controlled. Glucose monitoring is important for the following reasons: It
- Allows the health practitioner to adjust treatment when necessary to keep the patient’s blood glucose under control;
- Promotes early detection and treatment of hypoglycaemia and/or hyperglycaemia if they arise;
- Improves the chances that the patient adheres to treatment.
Patients with diabetes should check their blood glucose levels once they wake up in the morning, two hours after each meal and at bedtime. Ideally, blood glucose levels should be in the following ranges:
Morning: <120 mg/dl (6.7 mmol/l); Two hours after meals and at bedtime: <140 mg/dl (7.7mmol/l)
If you are unable to get a blood glucose monitor, your doctor will do this for you by measuring your HbA1C levels. HbA1C is a measurement of the average level of blood glucose over the past three months. HbA1c is beneficial because it helps to determine the risk of a patient developing serious diabetic complications. Patients with type 2 diabetes should get their HbA1c levels monitored every three to four months, depending on how stable their condition is.
Complications of type 2 diabetes
Severe complications can arise when blood glucose levels are not controlled.
Short-term (acute) complications
- Hypoglycaemia: This happens when a patient leaves a long gap between meals, or injects too much insulin, drinks alcohol excessively or exercise too much, too quickly. Symptoms including sweating, tremor, hunger, dizziness and nervousness indicate hypoglycaemia. Night-time hypoglycaemia manifests itself as night sweats, bad dreams or early-morning headache.
- Ketoacidosis: This can affect people who do not know they have diabetes or people who should use insulin, but avoid using it for long periods. In such cases, the lack of insulin results in extremely high blood glucose and a buildup of acidic molecules. These acidic molecules (ketones) are formed when fat is broken down. If ketones continue to accumulate in the blood, it leads to ketoacidosis. This condition is a medical emergency because without immediate intervention it is fatal. Symptoms of diabetic keotoacidosis include fruity breath, pain in the abdomen, hyperventilation, dehydration, excessive urination and disorientation.
Long-term (chronic) complications are much more common than short-term complications among patient with diabetes. The eyes, kidneys, nerves and the lining of the blood vessels are the most commonly affected areas. This is because these organs cannot control how much sugar they receive from the blood (insulin does not function in these areas). So, when sugar levels remain high for very long periods, they saturate them and cause severe damage. Hypertension, nutrient deficiencies and damage to blood vessels are other factors that can increase the risk of chronic complications in diabetes.
- Cardiovascular disease: Atheroscelorosis, whis leads to the narrowing of artery blood vessels throughout the body is one of the complications that can occur. Diabetes also increases the risk of stroke, coronary artery disease and cerebrovascular disease.
- Retinopathy:Diabetes can cause haemorrhages and scarring in the retina that ultimately lead to blindness. Diabetes also increases the risk of cataracts.
- Neuropathy: This is the loss of nerve function. Symptoms of this include tingling sensations, numbness, and pain with a feeling of burning. It happens most commonly in the feet but it can spread to other nerves in the body and cause diarrhoea and constipation. In cases where people lose feeling in their legs and do nothing about it, sores and lesions may develop. This can develop into gangrene and in severe cases amputation.
- Nephropathy: This is also known as kidney disease, and it is a leading cause of end-stage kidney disease in diabetes. It increases the risk of death, mainly from cardiovascular cases.
- Depression and dementia: Up to 20% of people with diabetes develop depression. Patients with depression have a poor chance of following dietary recommendations, exercising and monitoring their glucose levels. Diabetic patients with depression also have a high risk of developing dementia.
Botanicals that may help control diabetes
- Aloe (Aloe barbadensis): Aloe vera contains many active compounds including vitamins, minerals, enzymes, and saponins. Its gel is useful in reducing blood glucose and increasing insulin sensitivity in patients with diabetes. *You can by this from any Forever Living distributor*
- Bitter melon (M. charantia): This plant is also known as bitter gourd. It that produces elongated fruits that have a distinct bitter taste. Fresh juice from the fruit reduces fasting glucose and improves sensitivity to insulin. *You can buy this from Spar*
- Cinnamon: Of the ∼250 varieties of cinnamon that exist, only 4 are used to make cinnamon spice used in cooking. Cinnamon is prepared by stripping the outer bark of the tree and allowing the inner bark to dry and curl into its usual quills. It is available in either its whole quill form (cinnamon sticks) or as a ground powder. Cinnamon has the ability to reduce fasting glucose and HbA1c levels. *You can buy this from A New Earth Lagos, 14B Akin Adesola Street, Victoria Island Lagos*
- Fenugreek (T. frenum-graecum): Fenugreek seed is often used to enhance the flavour, colour and texture of food. Its seeds can stimulate the pancreas to produce more insulin, and improve fasting glucose levels. They also have positive effects on HbA1c levels.
If you suspect you have diabetes, please contact Professor Fasanmade at Lagos University Teaching Hospital (LUTH). He is a renowned Diabetes specialist.
If you would like to learn how to keep your diabetes well controlled through diet, I would suggest buying this book.
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