Diabetes: Nutrition & Lifestyle Considerations

World Diabetes Day is marked every year on 14 November. This date marks the birthday of Sir Frederick Banting – one of the founding fathers of insulin.

OVERVIEW

Diabetes (sometimes referred to by the scientific name diabetes mellitus), is a series condition where your blood sugar levels, or blood glucose is too high. This can happen when your body can’t produce any insulin. It can also happen when your body doesn’t produce enough insulin or the insulin that is does produce isn’t effective.

 

WHY IS INSULIN SO IMPORTANT?

Why is insulin so important? Insulin does an essential job in allowing the glucose (sugar) in our blood to enter our cells and give our body energy. When your body digests and breaks down the food and drink that you consume into glucose, this glucose then enters your bloodstream. However, without any or sufficient insulin, the glucose can’t enter into your body’s cells. This causes a build up of glucose (sugar) in the bloodstream and which causes high blood sugar levels. If left untreated, the high sugar levels can make you very unwell and damage parts of the body, including your eyes, heart and feet.

TYPES OF DIABETES

There are 2 main types of diabetes; type 1 and type 2 diabetes.

Type 1: causes blood sugar levels to be too high, as your body can’t make insulin. This is because the body attacks the cells in the pancreas where insulin is made.

Type 2: causes blood sugar levels to be too high as the insulin your pancreas produces either does not work properly, or your pancreas produces too little insulin for your body’s needs. Around 90% of people with diabetes in the UK have type 2 diabetes.

Whilst type 1 and type 2 diabetes are the most common types of diabetes, there are also lots of other diabetes. Around 2% of the UK population have these other types of diabetes which can develop as a result of taking certain medications, as well as surgery or hormonal imbalances. These include but are not limited to, gestational diabetes (which some women develop during pregnancy), neonatal diabetes, maturity onset diabetes and type 3c diabetes (which develops when another disease causes damage to the pancreas, which affects its ability to produce insulin).

WHAT CAUSES DIABETES?

The cause of diabetes very much depends on the type that you have.

Type 1 diabetes – the exact causes are unknown however, family history can slightly increase your risk, as there are several genes linked to type 1 diabetes

Type 2 diabetes - age, family history, ethnicity, living with obesity or overweight are all risk factors

However, what all types of diabetes have in common is that they cause people to have too much glucose (sugar) in their blood.

WHAT ARE THE SIGNS AND SYMPTOMS TO LOOK OUT FOR?

 

Having diabetes symptoms doesn’t mean that you definitely have the condition, so always contact you GP to discuss any symptoms you may be experiencing:

Common symptoms of diabetes include:

  • Needing to pass urine a lot, especially at night
  • Constantly thirsty
  • More tired than usual
  • Losing weight without trying to
  • Wounds taking longer to heal
  • Blurred vision
  • Increased hunger

 

Sometimes for those with Type1 diabetes, these symptoms can come on really quickly. Diabetes UK describe these as the 4 Ts:

  • Thirsty - being constantly thirsty and not being able to quench your thirst
  • Tired – being incredibly tired and feeling like you constantly have no energy
  • Toilet – needing to pass urine very frequently
  • Thin – looking thinner than usual and losing weight, without changes your diet and lifestyle

In this instance it is important to make an urgent appointment with your GP or call 111 for further advice and support. A blood test is used to diagnose diabetes. Getting a diabetes diagnosis as early as possible ensures that you receive the right support and treatment.

 

TREATMENT

The treatment and management of diabetes depends on the type you have.

Type 1: type 1 diabetes is treated by taking insulin. You count the carbohydrates you eat and drink and try to balance this with doses of insulin, or continuous doses of insulin (insulin pump).

Type 2 diabetes: In some cases, type 2 can be treated without taking insulin or other medications to help lower your blood sugar levels. Getting support in being as active as possible, eating healthily and going for regular health checks to manage blood sugar levels, can help manage it.

COMPLICATIONS

All types of diabetes need to be managed and treated otherwise this can lead to a number of acute (short term) and chronic (long term) health complications. Acute complications include; hypos (where blood sugar levels are too low), hypers (where blood sugar levels are too high. On the other hand, poor management of the condition can lead to eye problems (retinopathy), foot problems, high blood pressure, nerve damage (neuropathy), gum disease and sexual problems in both men and women.

 

NUTRITION RECOMMENDATIONS

Contrary to popular belief, there is no such thing as a diabetes diet and there is no way of eating that will work for everyone, as no two people are the same and there are different types of diabetes. However making healthier food choices is important, to help manage diabetes. Eating healthier can help to better manage blood sugar level, reduce the risks of diabetes complications and reduce the risk of developing heart problems and high blood pressure.

-Carbohydrates – opt for high-fibre wholegrain varieties; this will help to release sugar more slowly into your blood stream, and reduce the risk of dev. sudden ‘hypers’

-Eat more fruit and veg - different fruits and vegetables contain different vitamins and minerals so try eating a wide variety and colour

-Choose healthier fats - opt for nuts, seeds, oily fish, plant oils and avocados over fatty and processed meats, butter, ghee, pastries and lard

-Choose lean proteins – lean meat and fish, eggs, pulses and low-fat dairy. Try to cut down on fatty cuts and red & processed meats

-Eat less salt and sugar - cutting down on ‘free’ or added sugar can help to better manage blood sugar levels, whilst reducing salt intake will help to reduce the risk of developing high blood pressure; which you are already at a greater risk of developing when you have diabetes

-Avoid foods labelled as “diabetic foods” - there is no evidence that these kinds of foods have any benefit over eating a healthy, balanced diet

Always try and aim for a food-first approach and get your nutrients from foods you consume, rather than taking supplements.

SPECIAL CONSIDERATIONS - There are many factors that can impact blood glucose (sugar) levels and that those with the condition need to be mindful of, so that they can manage their diabetes accordingly. Alcohol and physical activity for example, naturally lower your blood sugar levels, so it is important to bear this in mind to adjust your insulin

LIFESTYLE RECOMMENDATIONS

Lifestyle factors will need to be tailored and unique sot each induvial, however trying to ensure that blood sugar levels are within the target range set by you medical/ healthcare team are really important for managing your long-term symptoms and reduce the risk of complications.

A few lifestyle factors are especially important to consider for those with diabetes are as follows:

  • Stopping smoking – diabetes can affect circulation. Stopping smoking is therefore important to help to reduce the risk of developing long-term health complications.
  • Going to all your medical appointments – having regular check-ins with your medical team can ensure that symptoms can be monitored and any problems with blood sugar levels can be caught early and further support made available.

Keeping active – exercise and moving more is important for diabetes, regardless of which type you may have:

- If you take insulin, regular activity can help your body to use insulin better and may reduce how much you need to take by reducing insulin resistance.

- Help you keep your blood sugar levels within target range

- Can help some people with type 2 diabetes put it into remission

- Cardiovascular exercise can help reduce blood pressure and improve cholesterol which helps protect against other health problems caused by diabetes like heart disease.

- Help with healthy weight maintenance

- Help your strengthen muscles, joints and improve flexibility

- Can help to improve mental wellbeing - exercise releases endorphins, which you could think of as happy hormones. Doing a form of movement you enjoy is shown to reduce stress levels and improve low mood.

References:

What is diabetes? | Getting to know the basics | Diabetes UK

Living with diabetes | How to manage diabetes | Diabetes UK

10 tips for healthy eating with diabetes | Diabetes UK

World Diabetes Day