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Diabetes: Slowing the Epidemic

In 1995, 1.5 million Canadians were diagnosed with diabetes. Today, it’s up to 2 million and by 2010 it will rise to an alarming 3 million. While there are two major types of diabetes, 90% of diabetics have Type 2 or Adult Onset Diabetes. Type 2 diabetes is one of the fastest growing yet preventable chronic diseases in Canada today, and the focus of this month’s article.

While Type 2 diabetes usually affects adults over 40, younger adults and children that are obese and inactive are falling victim to it. Because there are often no symptoms, up to 50% of diabetics are unaware they have it and go for long periods of time undiagnosed and untreated. Even of those diagnosed, over 50% do not have their diabetes under control, significantly raising their risk for heart disease and stroke. Diabetes is the 7^th leading cause of death in Canada. The cost of treating diabetes and its complications in Canada is about 9 billion per year.

What is Diabetes?

Type 2 diabetes occurs when the body cannot make enough insulin or properly use insulin for food energy. Insulin is a hormone secreted from the pancreas that allows sugar in the blood to enter cells where it can be used for energy. Without enough working insulin, levels of blood sugar or glucose rise. In time, high blood sugars can result in blindness, kidney damage, nerve damage, amputations, gum disease, heart disease and stroke. Diabetes is a multi-system disease because glucose is everywhere in your body. The higher your blood sugar levels and the longer they are high, the worse the damage to your body.

Who is at Risk?

While Type 2 diabetes is caused mainly by obesity and inactivity, the following risk factors further raise your chance of getting diabetes:

You are over age 45
You have a parent or sibling with diabetes
You don’t exercise regularly
You carry most of your excess weight around your middle
You are Aboriginal, African, Asian, Hispanic or Indo Canadian descent
Your blood pressure is 140 over 90 or higher
Your HDL cholesterol is 0.9 or lower
Your triglycerides are 2.8 or higher
You have been told you have "borderline diabetes" or "pre-diabetes"
You had gestational diabetes when pregnant
You have given birth to a baby weighing over 9 pounds
You are a woman with polycystic ovarian syndrome

While many people with Type 2 diabetes have no symptoms, warning signs include blurred vision, frequent skin, gum or bladder infections, cuts or bruises that are slow to heal, tingling or numbness in the hands or feet, frequent urination, unusual thirst, extreme hunger and extreme fatigue.

Can diabetes be prevented?

Preventing diabetes boils down to lifestyle changes: The vast majority of Canadians could benefit by eating more fruits and vegetables, losing 10-15 pounds and increasing daily physical activity. Modest weight loss has been shown to help keep blood sugars well in control. Exercise does not have to be strenuous, continuous, time-consuming or expensive. In several research studies, any moderate exercise (like 30 minutes of brisk walking a day), lowered risk of diabetes by 30%. Get into the habit of going for a walk, bike ride or rollerblade each day – take your kids, dog and neighbours with you if you need a little motivation. Staying active has huge health benefits over one’s lifetime because along with diabetes, it lowers the risk of so many other diseases.

As for diet, how much you eat is as important as what you eat. Eat smaller meals every 3-4 hours, but stop eating when you are physically full. Get used to eating lower fat, higher fibre meals to manage your blood sugars well. Eat high quality, fibre-rich carbohydrates that slowly raise blood sugar levels, like whole grain breads, cereals, whole-wheat pasta, brown rice, beans and lentils. Eat fewer refined grains like white breads, white cereals, cookies and other sweets as they increase blood sugar quickly. Enjoy plenty of whole vegetables and fruits, and limit juices and sweet drinks. Choose leaner meats, fish and poultry and low-fat milk products. Get your fats from healthy plant sources like vegetable oils, nuts, seeds, avocados and salad dressings, as these are mostly unsaturated fats.

Canadian Diabetes Strategy

The sharp rise in diabetes has caught the attention of our Government. Health Canada is working with provinces to develop a Diabetes Prevention and Control Strategy to help Canadians take greater control over their health. The goals are to educate Canadians about diabetes, prevent diabetes where possible and help people with diabetes better manage the disease and its complications.

While you will hear more on the subject of diabetes as this strategy unfolds, what remains crucial is self-responsibility. Preventing and managing Type 2 diabetes is all about lifestyle changes: maintaining a healthy weight, staying physically active and eating a heart-healthy diet most of the time. And if you are at risk for diabetes, please see your physician for a blood test. Catching it now may make life a lot easier down the road.

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