Type 2 diabetes is the most common form of diabetes. It was once called, “Mature onset diabetes” but in line with increasing obesity trends and the lowering of the age when sufferers become afflicted with this illness this name has been dropped. In fact, so close is the relationship between obesity and Type 2 diabetes that the term “diabesity” has been coined. Diabetes is a chronic disease characterized by an elevated blood glucose levels resulting from the body not producing enough insulin or the effectiveness of the insulin being lowered. A combination of genetic predisposition and poor lifestyle choices (e.g. diet and exercise habits) contribute to the evolution of this illness.
Currently approximately 6% of the Australian population suffers from this ailment. 280 Australians develop diabetes every day and it’s the fastest growing chronic disease in this country. A further 2 million Australians have pre-diabetes and are at high risk for developing type 2 diabetes.
Predictions suggest that by 2020, should the current obesity epidemic not be curtailed, Type 2 diabetes may afflict up to 18-20% of the population. In years gone by the expected age of onset was 40, currently the expected age of disease onset is 25.
Complications associated with diabetes include blindness, nerve damage, kidney disease, lower limb circulating problems (sometimes resulting in amputations) and cardiovascular disease.
The good news is up to 58% of cases of pre-diabetes can be prevented from developing into of type 2 diabetes simply through diet and lifestyle changes. You can make a real difference to your own health.
CARBOHYDRATES – THE KEY
Carbohydrates are starches and sugars which are broken down to glucose in the body. The glucose then enters the bloodstream with the “blood sugar” level gradually rising. Insulin is then secreted by the pancreas into the bloodstream to aid with the transportation of glucose into muscle cells and the brain where it is used as an energy source. For diabetes suffers the body is either not producing insulin (or in enough quantity) or the cell receptors are not working and can not take in the available glucose. Either way the diabetic must constantly monitor blood glucose levels to ensure they don’t have too much or too little glucose circulating. Small regular meals containing carbohydrate can help facilitate this by helping to keep the blood glucose levels relatively stable. This is why diabetics regularly test their blood glucose levels manipulating their blood glucose levels by ingesting some carbohydrate or injecting some insulin.
WHERE ARE CARBOHYDRATES FOUND?
Breads, cereals and grains.
Fruit and starchy vegetables such as potatoes.
Milk and yoghurt.
Confectionary and soft-drinks.
Carbohydrates are NOT found in meat and fats.
LIFESTYLE HAS AN IMPACT
By modifying ones’ lifestyle Type 2 diabetes can be prevented, delayed and even reversed/treated. The keys to this are regular physical exercise which has an “insulin type effect” on muscle tissue making it more sensitive to the uptake of circulating blood glucose. Those suffering from Type 2 diabetes should eat in a similar manner to what is recommended to the general population:
Smaller more regular meals spread over the day are much better than one big meal. For most people three meals and one or two snacks at the longest stretches between meals works.
Put your focus on eating healthy fats rather than low fat. Your body needs good fats to function at its best, and good fats will also have a beneficial effect on your heart health. Choose avocado, extra virgin olive oil, nuts and seeds over processed foods high in fat. Limit fatty meats, especially processed meats, choosing grass-fed, game meats, poultry, fish and seafood instead.
Choose carbs with a low Glycaemic Index (G.I.) such as wholegrains (e.g. oats, barley, wholegrain bread, wholegrain pasta), legumes (e.g. lentils, beans, chickpeas), most fruit, milk, yoghurt and pseudograins such as quinoa and amaranth.
If you are overweight one of the best things you can do is lose a few kilos. Research shows that losing even 5% of your body weight significantly lowers your risk of heart disease and helps you to control your diabetes, lowering the risk of complications.
WHAT IS THE G.I.?
Dietitians used to label carbohydrates as either “simple” or complex”. It was believed that simple sugars raised blood glucose levels faster than complex starches. More recent research has found that all carbohydrates enter the bloodstream at different rates. The GI is affected by factors such as cooking, processing, ripeness as well as the fat and fibre content of a meal. The rate at which a carbohydrate is broken down to glucose affects the blood glucose levels. Those carbohydrates that are broken down quickly are labelled “high” GI foods producing a rapid spike in blood glucose levels. Those carbohydrate foods that break down more slowly are termed “low” GI foods and give a longer, more sustained release of glucose into the bloodstream.
The absolute amount of carbohydrate in the meal is also important and it is the combination of the GI and the amount of carbohydrate that ultimately predicts the blood glucose response. This is called the ‘glycaemic load’ of the meal. For best blood glucose control you are best to limit high GI foods, or when you do have them choose only a small portion and as part of a mixed meal. Instead choose mainly low GI foods in moderate portions.
LOW GI FOODS
Aim at consuming at least one of the following type of carbohydrate foods at each meal:
Breads that are made from wholegrains (not the same as wholemeal or multigrain). Look for words such as stoneground or sourdough. Good options include Burgen Breads, Performax, Ploughman’s Wholegrain, heavy fruit loafs, pumpernickel.
Crisp breads such as Ryvita, Pumpkin Seeds & Oats, Ryvita Sunflower Seeds & Oats.
Breakfast cereals such as rolled oats, raw untoasted muesli or the Goodness Superfoods range.
Choose small salad potatoes for a lower GI. Big baking potatoes and mashed potatoes have very high GI values.
Fruits such as apples, oranges, peaches, plums, pears.
Pasta, wholegrains such as Freekeh, barley or corn, pseudograins such as quinoa or amaranth.
Legumes, including lentils, chickpeas and beans.
Non-starchy vegetables such as salad vegetables which have low carbohydrate contents and therefore little affect on blood glucose levels.
HOW MUCH CARBOHYDRATE IS ENOUGH?
How much carbohydrate you need depends on how active you are, how big you are, your gender and whether you follow any special diet. For example vegetarians usually have a higher carbohydrate diet than meat eaters, simply because they consume more plant food. The Australian Dietary Guidelines recommend 6 serves a day of wholegrains and 2 1/2 serves of dairy for the average adult19-50 years. Ladies over 50 it’s recommended you up your serves of dairy to 4 and reduce your grain serves to 4. One serve equals: a slice of bread, 1/2 cup cooked grains, 2/3 cup wholegrain breakfast cereal, 3 wholegrain crisp breads, 1 cup milk, 2 slices of cheese or 3/4 cup (200g) yoghurt.
Diabetes Australia: www.diabetesaustralia.com.au