Monday 26 September 2016

15 steps to prevent type 2 diabetes

To mark World Health Day's 'Beat Diabetes' theme, Áilín Quinlan gets advice from Professor Seamus Sreenan, consultant endocrinologist at Connolly Hospital and medical advisor for Diabetes Ireland, on how to avoid developing type 2 diabetes

Published 05/04/2016 | 02:30

Avoid refined sugars to prevent diabetes.
Avoid refined sugars to prevent diabetes.

There are two common forms of diabetes: type 1 and type 2. Type 1 is not preventable, while the latter one can often be avoided. This year's World Health Day, taking place April 7, is marked by the theme 'Beat Diabetes'. In type 2 diabetes, your genes influence your chances of developing the condition, which is caused by insulin resistance (the inability of the insulin to work properly).

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However, it's very important to understand that in type 2 diabetes, genetic factors take a back seat to behavioral and lifestyle factors - the Nurses' Health Study, a US study running since 1976, suggests that 90pc of type 2 diabetes in women can be attributed to excess weight, lack of exercise, a less-than-healthy diet, smoking, and too much alcohol.

Research also shows that about two-thirds of all cases of type 2 diabetes can be delayed or prevented by making simple everyday lifestyle changes. With type 1 diabetes, which is not preventable, the body's immune system destroys the insulin-producing cells. To date, no effective treatment has been developed to prevent the damage caused by the immune system which leads to this condition. Here are 15 ways you can reduce your risk of developing type 2 diabetes:

1 Watch your weight

Being overweight increases your risk of developing type 2 diabetes by making the body resistant to insulin. As little as 5-10pc weight loss improves insulin resistance, thereby reducing the risk of diabetes, says Prof Sreenan. Therefore if you're overweight or obese, the advice is simple - lose weight.

2 Watch your waistline

Carrying excess weight around the midriff increases risk. "Weight around the tummy is particularly associated with resistance to insulin," says Prof Sreenan. "The type of fat which collects around the internal organs in the abdomen is very strongly associated with diabetes risk."

This can be limited by sticking to a balanced healthy diet; low-carb diets or other fad diets may help you lose weight at first, but, he says, their effectiveness in preventing diabetes has not been proven. By excluding or strictly limiting a particular food group, you may be giving up essential nutrients.

"I recommend a balanced, healthy diet in which variety and portion control play a major part," says Prof Sreenan.

3 Eat at least three balanced meals a day

A breakfast, a dinner and a tea-like meal is recommended. It's a really good idea to use smaller plates to help you control your portion size, as excessive carbohydrate intake leads to excessive weight gain, which in turn increases your diabetes risk.

4 Eat Breakfast Every Day

According to new research, eating something - anything - within two or three hours after waking up every day, will reduce the risk of getting diabetes.

"Emerging research stresses the importance of eating breakfast daily," says Prof Sreenan.

"Omitting your breakfast is associated with higher blood sugars later in the day and promotes weight gain, thus increasing the risk of developing the condition."

5 Drink coffee

Coffee reduces the absorption of sugar by the intestines. It also reduces insulin resistance which in turn makes you less vulnerable to developing the condition. Some studies have shown that about three cups of coffee a day are associated with a lower risk of developing diabetes, says Prof Sreenan - but, he emphasises, the evidence is stronger for the consumption of unsweetened black coffee!

6 Avoid refined sugars

Eating refined sugars results in extra demand on insulin production so limit or avoid cake, cold drinks, sweets, biscuits, and sugar-sweetened desserts and drinks (including alcohol), which are very high in energy, but low in nutrients.

"There is increasing awareness of the link between the consumption of simple sugars and diabetes and other health conditions, but I still believe the message has not penetrated sufficiently," Prof Sreenan observes.

7 Consume more fibre

Fibre increases satiety and slows the absorption of sugar from foods, thus reducing the post-meal rise in blood glucose levels. Foods high in fibre include fruits, vegetables, beans, whole grains, nuts and seeds. "Most people are not incorporating enough of these foods into their daily diet," says Prof Sreenan.

8 Exercise Regularly

Firstly, exercise contributes to weight loss which reduces the risk of developing diabetes. It also improves the body's ability to use insulin properly, which protects against developing diabetes.

Build in 150 minutes of exercise into your week - or 30 minutes each day most days of the week. This can in turn be broken up into 10-minute sessions if required.

"The exercise necessary to reduce your diabetes risk can include brisk walking, jogging, cycling or swimming," explains Prof Sreenan.

9 Include Resistance Exercises

Remember, your daily exercise doesn't always have to be solely aerobic exercise such as walking or running.

It's also a good idea to work some resistance exercises into your physical fitness regime. Weight-lifting, for example, can use different muscles to those commonly used in popular aerobic exercise, thus providing a different workout which is equally beneficial in terms of reducing diabetes risk.

10 Quit Smoking

Research has shown that smoking will increase your risk of becoming insulin-resistant and thus make you more prone to developing type 2 diabetes.

Giving up smoking will not only help prevent diabetes, says Prof Sreenan, but will also help reduce the risk of associated complications such as heart or kidney disease, nerve damage and foot and leg infections.

11 Cut down your alcohol intake

Alcohol has no nutritional value - but it does have lots and lots of calories, which will promote weight gain. Alcohol also stimulates the appetite, making you want to eat more - and contributing to even more unwanted weight-gain around the midriff.

"Giving up alcohol altogether is the safest option, but if you choose to drink, stick to a maximum of two-to-three alcoholic drinks on two-to-three days a week, and certainly no more than 14 units of alcohol a week," says Prof Sreenan.

12 Get in those Zzzs

Sleeping less than six hours per night will lead to an increased risk of diabetes, according to research. That's because when you're short on sleep, your appetite-regulating hormones can promote increased food intake - and particularly of sweet sugary foods - thus increasing your diabetes risk.

This in part may be caused by a spike in the hormone cortisol which can raise insulin levels and lead to blood sugar imbalances. Get six to eight hours of sleep a night to allow sufficient recovery time for the nerve and other systems.

13 Have Regular Check-ups

High blood pressure and high cholesterol may increase your risk for diabetes as well as other conditions.

"It's important to know your numbers for blood pressure, blood sugar and cholesterol levls, in order to be aware of your diabetes risk," says Prof Sreenan.

Set automatic reminders on your phone or online calendar to ensure you keep your appointments.

"This is particularly important for people who are at particularly high risk of developing diabetes," says Prof Sreenan.

"Such people would include those with a family history of type 2 diabetes, women who had diabetes during pregnancy, people with high blood pressure or high cholesterol, women with polycystic ovaries and people over the age of 45.

"Research has also shown that people of African or Indian origin have higher risk of developing type 2 diabetes."

14 Get A Handle On Stress

Stress can release certain hormones that play a critical role in how the body handles sugar. It also increases your blood pressure, which may in turn increase your risk of developing diabetes. "Our lives are increasingly busy, so it is important to ensure a balanced lifestyle incorporating exercise, which can be a great stress reliever," says Prof Sreenan.

15 Check out the meds

Although a healthy lifestyle incorporating diet and exercise has been shown to be the most effective way of preventing type 2 diabetes, studies have shown that a variety of medications can also prevent diabetes in those at risk, according to Prof Sreenan.

"If you are in an at-risk group and are concerned about your chances of developing type 2 diabetes, seek professional help to determine the optimal diet and exercise regime to help prevent developing the condition - and also to determine whether any of the available medications might be appropriate for you."

■ For more information see diabetes.ie

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