Understanding a chronic condition
Diabetes mellitus is one of the most common chronic conditions in the world and occurs when the body fails to process glucose correctly. Many South Africans have diabetes, but a large number remain undiagnosed. Type 1 diabetes is a progressive autoimmune disease that is usually diagnosed in children and young adults, whereas type 2 diabetes is mostly caused by unhealthy lifestyle and usually starts in adulthood.It is however entirely possible to live a healthy life with diabetes. If you learn to recognise the symptoms of diabetes early, receive proper medical care and make healthy lifestyle changes, diabetes does not have to be a debilitating condition. We hope you find the information useful and informative, and that it does much in the way of increasing your understanding of what’s becoming a growing global lifestyle disease.
The 3 Main Types Of DiabetesType 1 diabetes – occurs when the pancreas stops producing insulin. It usually starts in young people under the age of 30, including very young children and infants, and the onset is sudden and dramatic. People who have type 1 diabetes must inject insulin to survive. Insulin dosages are carefully balanced with food intake and exercise programmes.
Type 2 diabetes – is caused when the insulin, which the pancreas produces, is either not enough or does not work properly. Approximately 85 – 90% of all people with diabetes are type 2, and many people who have this condition are undiagnosed. Most type 2’s are over 40. They are usually overweight and do not exercise. Type 2 diabetes may be treated successfully without medication. Often loss of weight alone will reduce glucose levels. Eating patterns and exercise play important roles in management. Tablets may be prescribed to help improve control, however, many type 2’s will eventually use insulin.Although type 2 is, in itself, not life threatening, in many ways it is more dangerous than type 1, as its onset is gradual and hard to detect. High blood glucose levels over a long period of time can cause serious damage to the delicate parts of the body and lead to blindness, heart attack\stroke, kidney failure, impotence and amputation.
Gestational diabetes – is a temporary condition that occurs during pregnancy. Both mother and child have an increased risk of developing diabetes in the future.
Is diabetes serious? There is no such thing as ‘mild’ diabetes. Diabetes is always serious. If it is left untreated or is not well managed, the high levels of blood glucose associated with diabetes can slowly damage both the fine nerves and the small and large blood vessels in the body, resulting in a variety of complications. These include heart disease, blindness, amputation, kidney disease and erectile dysfunction or impotence. The good news is that with careful management, these complications can be delayed and even prevented, but early diagnosis is very important.
You need to know what the symptoms of diabetes are and whether you are at risk.
What are the symptoms?
Signs and symptoms of diabetes include the following:
- Unusual thirst
- Frequent urination
- Unusual weight loss
- Extreme fatigue or lack of energy
- Blurred vision
- Frequent or recurring infections
- Cuts and bruises that are slow to heal, boils and itching skin
- Tingling and numbness in the hands or feet.
However, many people who have type 2 diabetes may show no symptoms.
Who is at risk?
Risk factors for developing diabetes include the following:
- Being aged 35 or over
- Being overweight (especially if you carry most of your weight around your middle)
- Being a member of a high-risk group (in South Africa if you are of Indian descent you are at particular risk)
- Having a family history of diabetes
- Having given birth to a baby that weighed over 4kg at birth, or have had gestational diabetes during pregnancy
- Having high cholesterol or other fats in the blood
- Having high blood pressure or heart disease
Managing Diabetes
What should I eat?
Food is important in keeping your body healthy, whether you have diabetes or not.
However, most people don’t pay much attention to their basic nutritional needs. Diabetes highlights the importance of a well-balanced eating pattern.
If you have diabetes, there are three important benefits from a nutritionally sound diet –
- Helps you achieve and maintain good control of your blood glucose levels.
- Helps regulate body weight.
- Prevents or delays onset of long term complications of diabetes.
Diet Planning
Eat plenty of breads and cereals (preferably wholegrain), pulses, vegetables and fruit. These foods offer a number of benefits and should make up the bulk of your diet.They contain plenty of carbohydrate, fibre, vitamins, minerals and phytochemicals and, if you eat them regularly, will help control your diabetes.
Bread and cereal – Include heavy seed-bread, low GI breakfast cereals, brown rice, wheat, barley, oats, maize, rye, and pasta. With breads, think wholewheat and wholegrain.
Pulses (legumes) – Include dried beans, peas and lentils.
Vegetables – Include plenty of non-starchy vegetables in your daily diet together with starchy ones. Vegetables, other than starchy ones, are low in carbohydrate, but high in fibre and are a particularly rich source of minerals and vitamins. Starchy vegetables include potatoes, sweet potatoes, sweetcorn and parsnips.
Fruit – Include all varieties. Some fruits are lower in carbohydrate than others.
Limit your sugar intake
Sugar (cane sugar) has a medium GI rating and so having diabetes does not mean a total ban on sugars. It means you can eat small amounts without making your blood glucose levels rise excessively. However, eating too much sugar is not a good idea as it adds to your total carbohydrate and kilojoule intake and will replace the nutritionally better and more filling carbohydrate foods.
General guidelines for choosing food
- Limit your fat intake
- Include a food from each of the food groups at each meal
- If you are overweight, eat smaller portions and reduce your intake of fat.
- Limit the amount of alcohol you drink
- Control your weight
- Choose a nutritious diet from a variety of foods
- Cut back on salt
- Drink plenty of water
- Visit a dietician to work out a diet plan suitable to your own particular lifestyle.
Can you prevent diabetes?
There is unfortunately no known prevention for type 1 diabetes yet, but vaccine studies are proceeding, even in South Africa. However, Scientists believe that lifestyle and type 2 diabetes are closely linked. This means that lifestyle is one area which individuals can focus on to help prevent or delay the onset of the disease. A healthy diet, weight control, exercise, reduction in stress and no smoking are important preventative steps.
There is good evidence to show that controlling weight, getting plenty of exercise and eating a diet low in fats and high in complex carbohydrates – fruit and vegetables – lowers the risk of Type 2 diabetes in most people. Many medical authorities also recommend that anyone who has a family history of Type 2 diabetes should have their blood glucose checked regularly, particularly once they are older than 40. Some doctors recommend that anyone over the age of 40, regardless of family history, should have regular blood glucose checks.
If impaired glucose tolerance is detected, then early preventative measures such as weight loss, exercise and a change of diet may well prevent or at least delay the onset of Type 2 diabetes.