Diabetes is a common health condition that has become more prevalent in our community, but can be well managed with the correct dietary approach. Diabetes occurs when the body is unable to produce a hormone called insulin, which helps move glucose out of the bloodstream and into the cells.
When there is an increased buildup of glucose in the bloodstream, this process leads to blood vessel damage. In type 1 diabetes, there is no insulin production, and these patients are required to be on lifelong insulin management.
In type 2 diabetes, the body does not make enough insulin, but these patients can focus on diet and exercise to help improve their sugar control. Although type 2 diabetes was previously thought to affect mostly adults, today we are finding that many children also develop type 2 diabetes due to sedentary lifestyle, lack of exercise, and poor diet. In the clinic, I manage or diagnose type 2 diabetes very frequently, and I rarely meet patients with type 1 diabetes.
Type 2 diabetes accounts for nearly 90% of all diabetic cases. Both men and women have a 40% risk of developing diabetes in their lifetime. In type 1 diabetes, these patients are working with an endocrinologist, whereas primary care practitioners generally manage type 2 diabetes.
There is a simple blood test called Hemoglobin A1c, which is the way we assess for diabetes. When the A1c levels range from 5.7 to 6.4, this is called prediabetes. In prediabetes, we focus on working with a nutritionist, regular exercise, and rigorous lifestyle changes to prevent developing diabetes. When the A1c levels are 6.5 or more, that is considered diabetes, and we focus on dietary and medication management. Unfortunately, if the lifestyle behaviors are significantly poor, then the A1c levels can rise over 10 and would require insulin to help decrease the sugar levels. There are specific risk factors that are recommended to get the A1c levels checked, including overweight, family history of diabetes or gestational diabetes, sedentary lifestyle, hypertension, elevated cholesterol, and age over 45 years.
Some of the common symptoms that are present in diabetes are extreme thirst, frequent urination, increased hunger, fatigue, blurred vision, and unexplained weight loss. There are many long-term complications that can occur from the elevated sugar levels in the blood vessels. The conditions that affect large blood vessels result from an increase in fat or plaque formation, leading to heart disease, peripheral vascular disease, and strokes. At the same time, diabetes can damage the small blood vessels leading to kidney disease, vision problems (diabetic retinopathy), and nerve pain (diabetic neuropathy).
For diabetic patients, it is recommended to get a diabetic foot and eye exam once a year, as well as purchase a glucose monitor. A healthy lifestyle approach with exercise and a well-balanced diet is critical to prevent diabetes. The main benefit of exercising helps the body utilize insulin more efficiently, which allows the cells to get adequate glucose.
The following foods to avoid include sugary beverages, white bread, pastries, fried and baked goods, high sugar snacks, and red or processed meats. However, a diet that incorporates healthy carbohydrates, fiber-rich foods, and healthy fats can help prevent diabetes. These healthy food choices include fruits, vegetables, whole grains, nuts, beans, peas, avocado, canola oil, and fish.
If medication options are recommended, then a decision should be made based on the patient's history, as there are many types of medications. There are helpful diabetic resources to read about, including the American Diabetes Association, TCOYD (Take Control of Your Diabetes), and Breakthrough Diabetes (formerly JDRF).
