Emina Jasarevic, ND
Type 2 diabetes has become a global health concern. Our 10 diabetes prevention tips offer simple ways to combat this disease.
For a disease that has become so mainstream that glucose testing kits are now marketed in fashion-friendly carrying cases, there is still so much to learn about diabetes, one of the fastest growing diseases in Canada—and around the world. Diabetes is a chronic condition that results from the body’s inability to sufficiently produce and/or properly use insulin—a hormone produced by the pancreas that enables the body to utilize glucose for energy.
Accounting for 5 to 10 percent of all diabetics, in type 1 diabetes, the pancreas fails to produce enough insulin. For people with this disease, which usually occurs in children and young adults, the cells in the pancreas that produce insulin (called beta cells) have been destroyed by the body’s own immune system.
This type of diabetes accounts for about 90 to 95 percent of all diagnosed cases, with over 60,000 new cases yearly. Type 2 diabetes occurs when the body cannot correctly use the insulin made by the pancreas. At least 92 percent of type 2 diabetes cases can be attributed to lifestyle choices, with 8 percent attributable to genetics.
The fact is, type 2 diabetes is extremely preventable. Here are 10 ways in which you can reduce your risk.
Your health care practitioner can send you for a blood test to screen for diabetes. For type 2 diabetes this is done with a fasting blood glucose test every three years in individuals over 40 years of age. The criteria for a diagnosis of diabetes are two separated fasting blood glucose (FBG) readings of 7.0 mmol/L or greater.
Alternatively, physicians may opt to order an oral glucose tolerance test (OGTT) which involves drinking a 75 g glucose drink (glucola) and having blood sampled two hours later to evaluate blood sugar values. An OGTT greater than 11.1 mmol/L confirms a diagnosis of diabetes.
If your FBG test results are between 5.6 and 6.9 mmol/L or OGTT results are between 7.8 and 11.1 mmol/L, you may be told you have prediabetes or impaired glucose tolerance, a possible precursor to developing type 2 diabetes. (See here for more information about prediabetes.)
The association between central obesity (abdominal fat or the apple-shaped body) and type 2 diabetes is well established. Fat cells, particularly abdominal adipocytes, secrete a number of biological products that blunt the effects of insulin, impair the body’s ability to use sugar, and interfere with insulin production from the pancreas.
A 2005 study assessing twice-weekly progressive resistance training in older men with type 2 diabetes found a significant improvement in insulin sensitivity and fasting glucose as well as decreased abdominal fat. If you can pinch more than an inch off your tummy (try it right now), then it’s time to get moving.
A clinical trial in 2003 assessed Cinnamomun cassia or cassia (what we generally call cinnamon in North America), in 60 diabetic patients who were given 1 g, 3 g, or 6 g of cassia bark powder over 40 days. All groups showed reduced levels of fasting glucose, triglyceride, LDL (bad) cholesterol, and total cholesterol levels.
Cinnamon appears to work due to maximizing insulin receptor function. These herbs do not stimulate pancreatic insulin synthesis (like some hypoglycemic pharmaceuticals such as glyburide) that can potentially worsen insulin resistance.
Recent reviews, however, of this and subsequent studies involving cassia’s effect on blood glucose levels indicate the effects were modest and encouraged the use of additional therapies, including lifestyle modification.
An extract of clove buds (Syzygium aromaticum) has been shown to have insulin-sensitizing effects on adipocytes (fat cells) and hepatocytes (liver cells). Another study conducted on hyperglycemic rats showed significant improvement in diabetic-induced peripheral neuropathy and vascular complications after just two weeks of administering clove oil.
Cloves show promising effects as an antioxidant and anti-inflammatory in the prevention of diabetes—one more reason to enjoy a daily cup of herbal chai.
Berberine is a bitter-tasting yellow plant alkaloid present in the roots and stem bark of various plants, including goldenseal (Hydrastis canadensis). A 2010 randomized blinded trial of 97 subjects investigated the effects of berberine against two conventional hypoglycemic drugs, metformin and rosiglitazone, for two months.
In the berberine group, fasting blood glucose fell 26 percent, hemoglobin A1c fell 18 percent (both similar to the drugs), and triglyceride levels declined 18 percent (more than either drug).
Berberine also decreased inflammatory liver markers ALT and GGT—a great alternative for patients with concomitant liver disease. This study suggests that 500 mg of berberine twice daily may be as effective as the use of first-line prescription hypoglycemic drugs.
Another herb, Gymnema sylvestre, has been used for more than 2,000 years in India. Preliminary human evidence suggests that gymnema may be efficacious for the management of blood sugar levels in type 1 and type 2 diabetes.
In a 2005 study a water-soluble extract of gymnema caused increases in insulin secretion in mouse and human beta cells suggesting it may be useful for the stimulation of insulin secretion in individuals with type 2 diabetes.
Canadians should be getting at least 21 to 38 grams of fibre per day, yet many of us typically eat only half of that. People with a low fibre intake are at increased risk of developing diabetes, as fibre helps to lower glucose levels, decrease appetite, and increase satiety.
Foods that contain refined white sugar and white flour that has been stripped of its nutritional value have been responsible for a dramatic increase in obesity over the past few decades. The intake of refined sugar has increased to 150 pounds per year in the last century, up from 5 pounds around the 1900s.
Another bad carbohydrate is turning out to be a major culprit in North American obesity rates. High fructose corn syrup (HFCS) can be found in just about everything from baked goods and frozen foods to sugary drinks that are low in nutritive value and high in calories.
A 2004 meta-analysis concluded that HFCS along with declining intake of fibre has been the leading factor in the development of obesity in the United States during the last 30 years.
To avoid HFCS read the labels on everything you buy (even whole grain breads) and purchase those without HFCS; stick with food items that have been sweetened naturally with fruit juices or raw cane sugar.
Recently published studies illustrate that people using “diet” foods (those with artificial sweeteners) actually have a higher risk of developing obesity—thus a higher risk of diabetes.
People consuming diet beverages actually ate more food than those drinking non-diet ones. While the exact physiologic reason has not been wholly elucidated, diet drinkers should take caution and ditch the diet soda.
A variety of nutrients are required for proper glucose regulation, insulin sensitivity, adequate metabolism, and to keep blood pressure and cholesterol levels in check. Two of the most important are magnesium and chromium.
Reported to reduce the risk of developing type 2 diabetes and to improve blood sugar control in type 2 diabetic patients, magnesium-rich foods include whole grains, nuts, and green leafy vegetables.
An important cofactor of the glucose tolerance factor (GTF), chromium is required for the binding of insulin to cell membranes. In 2006 researchers at Yale University studied 43 type 2 diabetics who were on hypoglycemic agents with poorly controlled blood sugar levels and found that chromium (600 mcg/day) combined with the B vitamin, biotin (2 mg/day), enhanced glucose uptake and disposal.
The Mediterranean diet is rich in heart-healthy fibre, fish, fruits, vegetables, and unsaturated (good) fats, particularly olive oil and is low in meats, dairy products, and saturated fats.
A 2009 study included 215 overweight adults with type 2 diabetes who were not receiving medication. The participants were randomly assigned to follow a Mediterranean diet or a low-fat diet for four years. By the end of the study, 44 percent of patients in the Mediterranean diet group required treatment compared to 70 percent in the low-fat group.
Additionally, people who followed the Mediterranean diet lost more weight and experienced greater improvements in heart disease risk factors.
There are numerous studies identifying how low levels of heavy metals such as arsenic, lead, and cadmium increase the occurrence of type 2 diabetes. Heavy metals have been shown to promote oxidation, disturb healthy functioning of the pancreas, and interfere with insulin secretion.
In addition, the pancreas is affected by endocrine-disrupting chemicals, such as bisphenol A and phthalates that leach from plastics and resin-lined cans. It’s advisable to avoid plastic containers, such as food storage containers and water bottles, and use glass or stainless steel containers whenever possible.
Installing a good quality water filter in your home—one that removes heavy metals from your water source—is another good strategy in preventing this sadly ubiquitous disease.