Understanding diabetes

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World Diabetes Day is commemorated annually on 14 November. The Heart and Stroke Foundation, South Africa (HSFSA) shines a light on this condition because of its link to cardiovascular disease (CVD).

What is diabetes?

Before the link between Diabetes CVD can be discussed, it is important to have an understanding of diabetes itself.

Diabetes occurs when the levels of glucose (sugar) in the body are too high.

This happens either because the body doesn’t produce enough insulin or the body doesn’t use the insulin it produces effectively. Insulin is a hormone (i.e., a single) necessary to carry glucose from the bloodstream into the cells where it is used for energy.

If there is too little insulin or resistance to insulin, blood glucose levels continue to rise, because glucose is not removed from the bloodstream. One in ten South Africans has diabetes, but roughly one in two of these individuals don’t know it because it has not been diagnosed.

There are three types of diabetes: type 1 (insulin-dependent), which usually affects younger people; type 2 (non-insulin-dependent diabetes), which tends to develop gradually in adults and is much more common; gestational diabetes, which is high glucose levels only during pregnancy.

This type of diabetes can be resolved after giving birth, but can also increase the risks of type 2 diabetes developing later in life.

Symptoms and risks of diabetes

It is important to understand the risk factors associated with diabetes and these include: being overweight or obese, physical inactivity, unhealthy diet, family history of diabetes and previous diabetes in pregnancy (gestational diabetes).

If we look at the symptoms of diabetes, they vary from constant thirst to passing more urine than normal, tiredness and blurred vision.

Diabetes has a close link to CVD. It causes damage and narrowing of the blood vessels. Further to this, diabetes is known to increase blood triglycerides (a type of fat) and decrease levels of “good” HDL cholesterol.

Diabetes also increases the risk of a heart attack or stroke and makes one more prone to the development of atherosclerosis and blood clots.

As diabetes can affect the nerves of the heart, symptoms of angina may not be felt in the usual way and may be passed off as indigestion or an upset stomach. This leads to delays and difficulties in diagnosing angina and heart attacks.

Managing diabetes

There are many dietary tips to bear in mind (in addition to adhering to medications if prescribed by a doctor) which have a role to play in the management of diabetes. These include the following:

Eat a healthy, balanced diet with small, regular meals, which will help to regulate your blood sugar levels. Eat high-fibre foods. High-fibre starches will help to control blood sugar levels. Eat at least 5 fruit and vegetables daily and include a wide variety of legumes such as beans, peas, lentils and soya.

Limit added sugars such as sweets, chocolates, sweetened soft drinks, fruit juices, flavoured water and milky drinks. Cut down on sodium and salt. A high salt intake is linked to high blood pressure. Reduce your salt intake to no more than 5g (one level teaspoon) of salt, from all sources, a day.

Reduce the salt added to your food during cooking and at the table. Make use of fresh and dried herbs, spices, garlic or lemon juice to add flavour to your food, without adding extra salt or salty seasonings like chicken or BBQ spice.

Foods like packet soups, stock cubes, gravies, cheese, many breakfast kinds of cereal, bread, salty snacks, processed meats and fast foods are very high in salt, so should be used sparingly.

Choose healthier fats: cut down on unhealthy fats like saturated and trans fats which can raise blood cholesterol levels. These can be found in foods such as fatty and processed meats, chicken skin, butter, ghee, cream and hard cheeses, pies, pastries, biscuits, crackers, fast foods and deep-fried potato or slap chips.

Replace these with healthier fats such as mono- and polyunsaturated fats found in sunflower, canola or olive oil, soft tub margarine, peanut butter, nuts and seeds, avocado and fish.

Choose foods high in omega-3 fats which are good for your heart and can help to reduce triglyceride levels (a type of fat in the blood) and lower blood pressure. These include fish, especially naturally oily fish such as sardines, pilchards, mackerel and salmon, which according to the Heart and Stroke Foundation, South Africa should be eaten at least twice a week.

Drink alcohol carefully. Alcohol can affect blood sugar levels, so it is recommended that it is consumed with food to prevent hypoglycaemia. Those who choose to drink alcohol should do so in moderation.

Moderation equates to no more than one drink a day for women and two for men. Portion with caution. Try to portion your plate according to the ‘Plate Model’ where:

Half of your plate consists of non-starchy vegetables such as broccoli, cabbage, tomatoes, cucumber, carrots etc. A quarter of your plate consists of high-fibre starches such as brown rice, whole-wheat pasta, sweet potato, and butternut.

Another quarter of your plate consists of lean protein such as grilled skinless chicken, fish, lean mince, ostrich meat, and soya.

Remember that a person living with diabetes doesn’t need special products and that choosing available healthy foods is the best approach.

George Herald