November 14 is World Diabetes Day.

Type-2 diabetes has become a global health concern with an estimated 425 million people affected by diabetes. Among worldwide adults over-18, the prevalence of diabetes has risen to over 8.5%, up from 4.7% since 1980. By 2030 the World Health Organization predicts diabetes will be the 7th leading cause of death. Sadly, most of this can be prevented by better diet and more exercise.

What is Type-2 Diabetes

To work properly our bodies need to maintain healthy level of glucose (sugar) in the blood. As the main source of energy, glucose is delivered throughout the body via the bloodstream. The hormone insulin, which is produced in the pancreas, helps convert glucose into energy and power the body’s cells. If there is an excess sugar (carbohydrate) intake over a long period of time (years) the cells of the body become less responsive to the insulin. This results in the need to produce more insulin to reach the same effect. This is called insulin resistance, which is the first step in the chain of carbohydrate metabolism disorders that eventually result in pre-diabetes and diabetes.

This means that since the body cannot break down the glucose it remains in the blood stream. When you hear that someone has ‘high blood sugar’ this is the result of insufficient insulin production. High blood sugar can cause short- and long-term damage to the body, impacting many areas of the body including heart, brain, kidneys, eyes, and feet.

At least 92 percent of type-2 diabetes cases can be attributed to lifestyle choices. Only 8% is the result of genetics.

Where does glucose / blood sugar come from?

If you are someone who almost never drinks sugary sodas or munches on candy bars, you might think that you won’t be at risk for diabetes; think again. Glucose gets into the body via the carbohydrates in the food we consume. High carbohydrate foods include bread, pasta, rice, cereals, fruits, starchy vegetables, milk and yoghurt. The body breaks carbohydrates down into glucose which then enters the bloodstream. To enter all the cells of the body insulin is needed to turn the glucose into energy.

What happens when there is a lack of insulin?

Instead of being turned into energy, glucose from carbohydrates stays in the blood resulting in high blood glucose (sugar) levels and can make a major change in metabolism. The measure of glucose in the blood is called glycemia, and too much blood sugar is hyperglycemia. Hyperglycemia can lead to long- and short-term health complications, including diabetic ketoacidosis which is a life-threatening condition needing immediate hospital treatment. The formation of fatty deposits on blood vessel walls (atherosclerosis) damage the vessels supplying blood to vital organs, increasing risk of heart disease and stroke, kidney disease, problems with vision, and damage to nerves.

What are the signs of type-2 diabetes?

The Mayo Clinic, widely renowned as one of the world’s best hospitals, identifies these as the main symptoms of type-2 diabetes:

• Increased thirst and urination – Excess sugar in the blood draws fluid from the cells leading to increased thirst. The kidneys are unable to perform the normal reabsorption of water leading to increased trips to the bathroom.
• Unintended weight loss and fatigue – To function, many cells, e.g. brain, muscle, red blood cells, use glucose as a form of energy. Without proper levels of insulin these cells are unable to work optimally.
• Blurred vision – Glucose is present in the fluid inside the lens portion on the eye, needed to maintain proper focus of vision. Elevated blood glucose causes the fluid surrounding the lens, resulting in difficulties focusing and changing the way light breaks in the fluid. The inability to focus clearly will be a noticeable sign.
• Healing slowly – When blood sugar levels are high the repair function in connective tissue change. Healing will happen much more slowly as well as an increased risk of bacterial infections. Small cuts or wounds on the feet can lead to serious infections, even jeopardizing the entire leg!

If you have experienced any of the symptoms above, you should have your blood sugar checked by a doctor.

How to decrease your risk of type-2 diabetes

First, be aware of your risk factors and family history. Discuss them with your doctor.
Making a few lifestyle changes reduce the chances of developing type 2 diabetes. Additionally, these same lifestyle changes will also lower the chances of developing heart disease and some cancers.

• Weight – Excess weight is the single greatest cause of type 2 diabetes. By losing about 10% of your weight, if above the healthy range, you lower your chances of developing type 2 diabetes by half.
• Diet –  Choose more fresh fruit and non-starchy veggies, whole grains, lean meats, and fish. Limit consuming alcohol and foods high in saturated and trans fats, added sugars, and carbohydrates. These foods will raise your blood sugar levels.

• Exercise – You already know exercise is good for you, especially if you are sitting at desk all day. If you have, or are at risk of diabetes, reducing glucose in the blood is very important. Since muscles can use glucose without insulin when you’re exercising it doesn’t matter if you are producing less insulin. Muscles get the glucose they need, decreasing the level of glucose in the blood.

Before you begin exercising, set realistic goals. If you have unrealistic goals it is easy to become discouraged when they are not realized. If you haven’t exercised much recently, you will want to start speak with a doctor first to make sure you do not over exert yourself. Start slowly and gradually increase the amount and intensity of your exercise plan.

While not all forms of diabetes are controllable but by watching what you eat and exercising regularly you can reduce the risk of type-2 diabetes. The long-term impact of these lifestyle changes will go far beyond diabetes as risk from heart disease and cancers will also be reduced.

November 14 is World Diabetes Day. For more information about Type 2 Diabetes or to see if you are at risk of having or developing the condition, please schedule your next consultation or annual health maintenance exam with Dr. Ágnes Hegedűs, an Internist who specializes in diabetology.