The Diabetes epidemic
Posted on 11th April 2018 at 07:30
Turn the clock back a couple of decades and Diabetes was rarely heard of. And, if it was, only in older people who also tended to be overweight and sedentary. Hence the risk factors being summed up as being “fair, fat and over 40” (!).
Type II Diabetes, also known as “Non Insulin Dependent Diabetes”, was rarely seen in those under the age of 40 and could usually be controlled by diet. Or, occasionally, medication such as Metformin.
Come back to the present day and the picture has changed out of all recognition. Figures released in 2016 estimated that, in the UK alone, 137,000 new cases were reported by Doctors during the previous year in addition to the 1.5 million of the previous decade. Let’s just repeat those figures. 137,000 new cases in a single year. 1.5 million new cases in the previous decade.
A similar picture has emerged in other developed countries including America, Canada and Japan. An analysis of the figures has confirmed that obesity – coupled with a lack of exercise – are major risk factors in the early development of the disease.
More worryingly, Type II Diabetes is increasingly being seen in much younger people – including children – with many not able to control it by diet and going straight on to medication. Since Diabetes is linked to many other degenerative diseases AND has a long list of potentially serious complications, it’s not surprising that these figures have been the cause of great concern.
What is Type II Diabetes?
Before we go any further, we should quickly mention Type I Diabetes, also known as “Insulin Dependent Diabetes.”
Type I Diabetes is an autoimmune condition, where the body’s Immune System mistakenly attacks the Pancreas, preventing it from producing any insulin. As a result, insulin injections are needed for life. It’s much less common and tends to occur in children and young adults. There may be a genetic link, as it’s often found in families, although the exact cause hasn’t been pinpointed.
Type II Diabetes is rather different and caused by a combination of insulin resistance coupled with insufficient insulin being produced for the body’s needs.
What causes it?
Insulin is a hormone produced by the Pancreas, a gland found just below – and behind – the Stomach. It’s released in response to an increase in the amount of glucose circulating in the blood; which comes from the food we eat, particularly carbohydrates and sugars.
Insulin helps the cells absorb glucose, where it’s used as fuel, with any excess being sent to the Liver to be stored as glycogen. As the levels of glucose in the blood start to fall, less insulin is released, in a process known as “negative feedback”.
If you haven’t eaten for a while, blood sugar levels start to fall and the Liver converts the stored glycogen back into glucose. It’s then released back into the blood and taken to the cells for fuel.
As we’ve already mentioned, problems can occur in two different ways. The first is when the cells start to become “insulin resistant”. This means that they aren’t so responsive to insulin and require larger and larger amounts to have the same effect.
The second follows on from this, with the Pancreas becoming exhausted – for want of a better word – so it can’t produce sufficient insulin to meet the demands of the cells. As a result, blood glucose levels start to rise, leading to the classic symptoms of Type II Diabetes.
What are the symptoms?
• Increased thirst and urination, as the body tries to get rid of the excess glucose by excreting it in urine.
• The presence of keytones in the urine. These are a by product of breaking down muscle and fat to provide energy, as there isn’t enough insulin to process the glucose.
• Frequent skin, bladder and vaginal infections. This is due to the body becoming increasingly acidic as glucose levels rise.
• Blurred vision, as the eyes are very sensitive to changes in the composition of blood.
• Extreme hunger, coupled with weight loss, due to the additional demands placed on the body in trying to manage this condition.
• Fatigue and irritability, which really isn’t surprising with everything that’s going on.
What about complications?
• Cardiovascular Disease, with Diabetes being a significant risk factor for Angina, Heart Attacks, Strokes and Atherosclerosis (narrowing of the arteries). This is partly due to the blood becoming more acidic which reduces the amount of oxygen that the red blood cells can carry around the body.
• Nerve damage, with the excess glucose damaging the smallest blood vessels – capillaries – which supply blood to the nerves and muscles. This results in tingling, numbness and burning pains in the extremities, such as the toes and fingers.
• Kidney damage, as the kidneys have to work much harder in filtering the blood. Excess glucose also damages the tiny tubules – glomeruli – where this process occurs with kidney failure being a long term complication requiring dialysis or a transplant.
• Eye damage leading to cataracts, glaucoma and blindness.
• Hearing loss.
• Alzheimer’s Disease. While there seems to be a link between Type II Diabetes and Alzheimer’s Disease, the exact reason for this has yet to be determined.
Why have the number of people diagnosed with Type II Diabetes increased so rapidly and why are so many young people being affected?
Sadly, as already mentioned, this is yet another case of poor lifestyle choices having disastrous – and unforeseen – consequences.
Obesity is now being seen as a major risk factor, for two different reasons. The first is dietary, with the typical western diet being very high in refined carbohydrates and sugars. With them forming the basis of the majority of meals – and snacks (!) – it’s not surprising that the cells start to become insulin resistant and the Pancreas becomes exhausted in the process.
With the benefit of hindsight, the “low fat, high carb” diet, so beloved in recent decades isn’t the healthy option once thought. Added to this these food groups tend to be high in calories, so providing more fuel than the body requires; hence it being stored as fat.
The second then compounds the problem, our increasingly sedentary lifestyles. Just think of the amount of time spent sitting, whether at work, school or in the car AND at home, in front of the TV or computer. And, if you think that this doesn’t apply to you, think again. If you spend a day noticing how much time you spend sitting, you’ll probably be very surprised!
Exercise not only increases the metabolic rate and so the rate at which glucose – and stored fat – is burnt at the time you’re doing it. It also increases it for the rest of the day too, so having a much longer term effect than many people appreciate. In addition, the increased muscle tone from exercise also improves the way in which cells use insulin and, in the process, improves insulin sensitivity.
A study involving people with Type II Diabetes found that increased exercise could have a noticeable effect on insulin sensitivity and blood glucose control after just a fortnight. In this case, the exercise consisted of just three sessions of aerobic exercise each week.
Another study found that those sitting for the longest periods of time were twice as likely to have Diabetes or heart disease. Reducing periods of sitting and getting up to walk around and stretch was found to reduce the risk.
Finally, a three year Diabetes Prevention Program in America found that lifestyle interventions were highly effective at preventing Diabetes in those at a high risk from it AND of reversing the disease in those showing the early signs of it. These consisted of making simple dietary changes – particularly cutting out refined carbohydrates and sugars – and taking 15 minutes of moderate exercise a day. These results were confirmed by a follow up study which monitored the group for 15 years.
Before we finish, just one word of warning
If you’re slim – or only a little overweight – this doesn’t automatically mean that you’re not at risk of Type II Diabetes. This is yet another reason why it’s so important to watch your diet and take regular exercise.
We know that some people get a little fed up – no pun intended (!) – of us talking about the importance of the small lifestyle choices you make each day. However it really is the small things we do, often without ever stopping to think about them, that can have such positive – or, at the other extreme – disastrous effects longer term.
Our bodies are incredibly resilient, not to mention intelligent, and will always do the best they can with what we give them. But there is a limit to what they can do, even if it takes many years – or decades – for this to become apparent. It’s up to us to look after them and give them the resources they need to function efficiently. After all, we only have one body…
As always, the choice is yours.
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