Type 2 Diabetes… and the risks associated with being overweight.
Firstly, let’s get a good understanding of what diabetes is?
Diabetes (diabetes mellitus) is a condition where there is too much glucose (a type of sugar) in the blood because the body is unable to process it properly and remove it from circulation in the blood.
Diabetes is the fastest growing chronic condition in Australia, with one Australian developing the disease every five minutes. It’s a serious condition that affects the body in many ways. Without correct management, diabetes can lead to serious health complications.
So, what part do glucose and insulin play in diabetes?
Glucose is an important source of energy and is obtained through food. In normal digestion, sugar is converted into energy with the help of a hormone called insulin, which is made by your pancreas (a gland behind our stomach). When you eat, insulin is released by the pancreas to help this conversion process. As insulin circulates, blood sugar levels drop. As blood sugar levels drop, so too does the release of insulin throughout your body.
Someone with diabetes has either too little or no insulin, or the body doesn’t respond properly to the insulin that is produced. Instead of the insulin facilitating the removal of the blood glucose into body cells, the cells become resistant to the actions of the insulin. This leads to high circulating blood sugar levels and for longer. This is called hyperglycaemia.
This can have several serious knock-on effects, such as problems with the heart, kidneys, eyes, feet and nerves.
Types of diabetes
Type 1 diabetes is an auto-immune condition where the immune system destroys the cells in the pancreas that make insulin. About 10% of all diabetes cases are Type 1. It can’t be prevented and there is no cure. Management involves the use of insulin on a daily basis.
Type 2 diabetes is a progressive condition that usually occurs later in life. In some cases, the pancreas still produces insulin, but the body becomes resistant to its normal effects. The pancreas has to produce even more insulin to compensate for this resistance. Eventually the pancreas cannot produce enough of the quantity of the insulin required which causes blood sugar levels to remain high. In other cases, the pancreas just does not produce even the normal amount of insulin due to genetic factors or pancreatic disease. Type 2 diabetes accounts for 85-90% of all cases.
Gestational diabetes is a form of diabetes that can occur during pregnancy as a result of hormonal changes. The condition usually disappears once the baby is born. However, women who develop gestational diabetes are at greater risk of developing Type 2 diabetes later on.
Signs and symptoms of Type 2 diabetes
Diabetes has many symptoms. Some people with diabetes notice several symptoms, while others may notice none.
Typical symptoms include:
Excessive thirst
Passing more urine (usually as a result of drinking more)
Tiredness and lethargy
Unexplained hunger
Cuts or wounds that are slow to heal
Itchy skin or skin infections
Deteriorating vision
Gradual weight gain
Mood swings
Leg cramps
Complications of Type 2 diabetes
Diabetes can lead to long-term complications which can potentially be life-threatening. The longer you’ve had diabetes and the less controlled your blood sugar levels are, the higher the risk of complications.
These complications may include:
Cardiovascular disease, including heart attack and stroke
Kidney damage and kidney failure
Vision problems and blindness
Nerve damage which can lead to digestive problems, erectile dysfunction, poor blood flow and amputation
So, what’s the connection between weight and Type 2 diabetes?
Carrying excess weight, especially when this is stored around the waist, increases a person’s chance of developing Type 2 diabetes.
Excess body fat acts as a barrier to insulin, which is linked to insulin resistance and high blood glucose levels.
Here are 10 things you should know:
1. Am I at risk? How can I tell?
Weight is not the only contributing factor to Type 2 diabetes. Others include your family history, age, ethnicity, activity level, blood pressure and being a smoker. You can estimate your risk of developing Type 2 diabetes in the next five years here, by answering a few questions about your health.
2. Does being overweight mean I will definitely get diabetes?
It's crucial to keep in mind that being overweight or obese is a known risk factor. However, even someone with a healthy weight could get Type 2 diabetes.
Nevertheless, risk management is still very important.
3. How can I decrease my risk of type 2 diabetes?
There are many things you can do to lower your risk. Maintaining a healthy weight is only one (important) factor.
Advice that has worked in the past is still valid:
Consuming a diet high in fibre, fresh fruit and vegetables, and lean protein from either plants or animals
Reducing your inactive hours
A mix of cardio activity (gym classes, swimming, walking etc.) with strength and flexibility exercise (weights, yoga, Pilates) and incidental exercise (doing housework, taking the stairs, walking around the shopping centre)
Keeping alcohol intake to a minimum
Quitting smoking
4. Is my current weight healthy?
You can get an idea of if your current weight is healthy by using the methods below:
BMI – this is a scale from 18.5 (underweight) to 30+ (obese)
Waist measurement – a measurement of 94cm+ for men or 80cm+ for women may indicate increased risk of diabetes
Ethnicity, pregnancy, medical complications, age and other contributing factors can also affect the results of both methods. For more personalised advice, next time you visit the chemist, talk to your pharmacist about ways to attain or maintain a healthy weight.
5. If I’m overweight, will I have to lose a lot of weight to be healthy again?
Good news! Losing weight doesn't have to be drastic. In fact, for over 60% of people, Type 2 diabetes can be avoided with a weight decrease of just 5–10% of total body weight. Aim to lose around 1 kg every 4 weeks by adopting good dietary and lifestyle modifications.
6. Is a high protein diet essential for weight management?
While eating protein on its own won't help you gain muscles, combining it with strength training will help build muscle. Proteins are a crucial ingredient that aid in building lean muscle, satisfying appetite for extended periods of time, and may boost metabolism. Eating small amounts of protein throughout the day (rather than a large amount at one time) with each meal increases your body’s ability to utilise it to build muscle.
7. Are high protein diets a better way to lose weight?
Actually, no. Very high protein diets can have negative effects on the kidneys and liver, alter bowel movements unfavourably, and leave people deficient in nutrients found in fresh produce and healthy fats. Our protein requirements do change during adolescence, pregnancy and other life stages. The Australian Dietary Guidelines is a great source of information to find out the correct protein requirements for our various stages of life.
8. Is it true that carbs are bad?
The Glycemic Index (GI) indicates how carbohydrates are broken down in the body and converted into energy.
Not all carbs are bad. Carbs are not “bad”. In fact, since they are the primary fuel supply for our body, it needs them to function properly.
Wholegrain breads, sweet potatoes, soy, beans, lentils, the majority of fresh fruit, milk, pasta, and rolled oats are examples of low GI carbohydrates that enter the system more gradually.
White bread, potatoes, and short-grain rice are examples of high GI carbohydrates that digest fast into sugars and quickly reach the bloodstream.
A diet consisting in low GI, high fibre carbs is beneficial for those with Type 2 diabetes.
9. How much should I exercise if I have Type 2 diabetes?
Being active makes the insulin your body work better and encourages the usage of more blood glucose, which lowers our total blood sugar levels. Because we exercise, the muscles are more sensitive to the insulin that is already present in our bodies - interestingly, this effect may persist for up to 24 hours.
Remember that regular exercise strengthens our muscles and bones, lowers cholesterol levels, improves cardiac health, and improves mental health even if there is no weight reduction.
10. What about medication to help with weight loss?
There are also medications available that can assist in achieving your weight loss goals. However, as with all medications, you need to be assessed for their suitability in your health regime and be assessed for any risks or side effects that may be accentuated due to your medical conditions or other medication you might take.
The pharmacists at Thomsons Lake Pharmacy can advise you on options that are available over-the-counter or if it might be best for you to discuss with your doctor the possibility of using prescribed medications such as Semaglutide (Ozempic) or Liraglutide (Saxenda) to help with the management of diabetes or weight loss respectively. The use of the prescribed medications would need to be carefully considered by your doctor and its suitability in your personal situation.
Would you like to learn more about Type 2 diabetes?
The Pharmacists at Thomsons Lake Pharmacy can help you manage your diabetes to reduce the risk of getting diabetes and complications developing in the future with a Diabetes Medication Review where one of our pharmacists will review your medication and general health and discuss the best ways to manage your condition. Please inquire about this service next time you visit the chemist.