Diabetes Awareness Month
November is Diabetes Awareness Month and the World Diabetes Day is happening on the 14th! We want to take this opportunity to shed light on Type 2 Diabetes Mellitus.
What is Type 2 Diabetes Mellitus (T2DM)?
Diabetes is a general term that classifies a rise in glucose (a form of sugar) levels in our blood. Type 2 Diabetes is when the pancreas does not produce enough insulin or when our body cells do not react to insulin.
Before developing T2DM, you may already have pre-diabetes – where your blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. Your doctor may tell you that you have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT).
What causes T2DM?
The carbohydrate that we ingest from food and drinks gets broken down into glucose and enters our bloodstream. The body produces a hormone called insulin from the pancreas, that helps move the glucose from the bloodstream into our muscles and cells for energy. Effectively, insulin is what helps bring down our blood glucose levels.
In type 2 diabetes, the body’s cells are not able to respond to insulin as well as they should – insulin resistance. In later stages of T2DM, the pancreas may also not produce enough insulin – impaired insulin production. This leads to a higher level of glucose swimming in your bloodstream. When left uncontrolled, complications such as a rise in high blood pressure which can lead to heart-related diseases e.g. stroke and causes damage to our kidneys.
What are the symptoms?
There are several symptoms from T2DM, however some people experience mild symptoms which may be left unnoticed. The symptoms include:
Going to the toilet to urinate very often
Feeling very thirsty
Feeling tired/fatigue
Blurry vision
Cuts/bruises that heal slowly
Tingling, pain, or numbness in the hands or feet
It’s important to see your GP if you’ve experienced any of these symptoms.
Are you at risk of T2DM?
In 2017-2018, 4.9% of the total Australian population had diabetes. People at increased risk of T2DM include those who are:
Pre-diabetes: People of any age with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)
Age: ≥35 years
Ethnicity: Aboriginal, Torres Strait Islander, Pacific Islander, Maori descent, Chinese, Southeast Asian or Middle Eastern.
Family History: type 2 diabetes or gestational diabetes mellitus (GDM)
Weight: Above the healthy weight range - body mass index (BMI) ≥30 kg/m2
Polycystic ovary syndrome (PCOS) (read more about this condition here)
Medications: taking antipsychotic medication
How is T2DM diagnosed?
Before investigating for T2DM, your doctor may screen you for diabetes risk using the AUDRISK tool. If you are at high risk, further blood tests will be conducted at a pathology lab for diagnosis and they involve:
Fasting blood glucose(FBG) or Random blood glucose(RBG) test
HbA1c - Measures the average amount of blood sugar over the past 3 months
Oral glucose tolerance test (OGTT) P.S. Check out our instagram page for more bite-size information!
Fast for 8 hours/overnight
Fasting blood glucose level taken
Given a sugary drink containing 75g of glucose
A blood test will be taken an hour later and repeated at two hours later.
What’s the first thing to do when diagnosed with T2DM?
It is encouraged that you learn as much as possible about the management of T2DM.
Maintaining a healthy weight, including a weight loss of 5-10% body weight if overweight, through healthy eating and regular physical activity as well as regular monitoring of your blood glucose levels will help keep your blood glucose levels within target range and manage your condition. For some people, medication such as tablets or insulin injections may be necessary.
Good communication with your health professionals can help you feel in control and help reach your goals and needs in managing T2DM. Some of the health professionals you may work with include:
GPs
endocrinologists
accredited practising dietitians
accredited exercise physiologist/physiotherapist
credentialled diabetes educators
What should I eat or avoid eating?
Following a healthy balanced diet is important to maintaining your blood glucose level. A dietitian can help provide a healthy meal ideas which involves regular meal pattern and appropriate portion sizes.
To help manage your diabetes:
Learn to identify foods that contain carbohydrate but there is NO need to avoid or exclude carbohydrate altogether.
Choose whole grains and low glycaemic index (GI) carbohydrate containing foods
Include a variety of colourful vegetables (5 serves) and fruits (2 serves) in your daily diet
Always choose lean protein e.g. fish and even substitute this with plant-based protein such as lentils, pulses and tofu
Use low fat or reduced-fat dairy products and limit deep-friend battered or crumbed foods
Limit high sugar-containing foods and drinks e.g. lollies, chocolates, cakes, biscuits, soft drink, cordial and juices
Limit alcohol intake to ≤2 standard drinks (20g alcohol) per day
How much exercise should I do?
For adults, it is recommended to do at least 30 minutes of moderate to vigorous aerobic physical activity on most if not all days of the week (total ≥150 minutes/week). You could spread them out into 3 days a week; no 2 consecutive days without activity. Other physical activities include resistance exercise for a total of 60 minutes/week or yoga and tai chi for 2 – 3 times/week.
For children and adolescents, it is recommended to perform moderate to vigorous intensity activity for 60 minutes/day for at least 3 days/week.
Contact your exercise physiologist or physiotherapist for a personalised exercise plan.
I don’t have T2DM but my doctor says I have pre-diabetes or IGT, should I be worried?
Pre-diabetes or IGT can be reversed!! In up to 58% of cases in the pre-diabetes population, type 2 diabetes CAN BE PREVENTED by making dietary and lifestyle changes to promote healthy weight.
If you have been diagnosed with Type 2 diabetes, it is advisable to see a Credentialled Diabetes Educator and Accredited Practising Dietitian to learn how to manage your weight and your blood glucose levels . Our team at Holistic Dietetics can definitely help you with this!