It’s been called a ticking timebomb. Known for affecting every part of our body, it puts us at risk of heart disease and strokes, as well as blindness and limb amputations – and it’s gaining momentum across the world.
But this health horror story isn’t some new virus sweeping the globe. Type 2 diabetes is an age-old condition that researchers and medics know plenty about. The first symptoms were described in 1552. Yet as a population, we’re just not heeding the preventative advice we’re given, and because of our head-in-the-sand attitude, we’re waddling (or not, as the case may be) straight into the trap.
With Diabetes Week happening now (12-18 June) there’s never been a better time to take stock and stave off type 2 diabetes once and for all. Organised by Diabetes UK, the week features a range of community events, challenges, races and walks, including the one million step challenge – in which we’re urged to do 10,000 steps a day for three months. Other activities will help you understand and manage diabetes if you’ve been diagnosed and encourage you to raise funds in fun, active ways to support the charity.
So just how bad is the global picture? Or is this just hype meant to scare us into shunning the burgers, fries and fizzy drinks and getting up off the sofa?
‘This is a health crisis of enormous impact,’ warns Dr Marilyn Glenville, UK nutritionist and author of Natural Solutions to Diabetes (Lifestyles), ‘not only for you who are suffering, and your nearest and dearest, but also for our healthcare systems. It changes people’s quality and quantity of life.’
And the cause is simple. ‘It’s thought to be due to the dramatic increase in obesity,’ says Dr Marilyn. ‘Carrying excess weight is the greatest single risk factor for developing type 2 diabetes. The risk of type 2 diabetes is seven times higher in obese people than in those of a healthy weight, and three times higher for those who are overweight.’
Data from the International Diabetes Federation has revealed that in 2021, 537 million adults worldwide had diabetes – a 16 per cent increase from two years earlier. More than 90 per cent of those people have type 2 diabetes, the type caused by obesity, a poor diet, a sedentary lifestyle and family history. Pakistan topped the list, with 31 per cent of its population having the condition.
But experts warn other countries aren’t far behind, and the future doesn’t look any rosier – the total number is predicted to rise to 643 million by 2030 and to 783 million by 2045.
Victoria Tipper, a nutritionist at 2b Limitless in Dubai, says the UAE has some of the world’s highest diabetes rates at 18.7 per cent. And she says this is expected to rise to 21.4 per cent by 2030 if our lifestyles don’t change drastically. On top of that, many more people have prediabetes, the condition that precedes full blown type 2 diabetes.
‘The highest prevalence of type 2 diabetes and prediabetes is among UAE nationals above 50 years old, with studies showing that rates were higher in men,’ explains Victoria. ‘It’s been suggested this may be due to lower levels of physical activity and an increased sedentary lifestyle resulting in higher levels of obesity. This, in turn, increases the risk of type 2 diabetes.’
Normally, when we eat, our bodies break food down into glucose, a type of sugar, and release it into our bloodstream. This increases blood sugar, which triggers the pancreas to release insulin. However, in diabetes, the body doesn’t make enough insulin, which causes too much blood sugar to remain in the bloodstream. And the havoc this causes is staggering.
According to the World Health Organisation, diabetes was the largest cause of death in 2019, claiming 1.5 million lives. In the UK, where cases of type 2 diabetes have risen to 5 million, an all-time high, the condition results in 7,000 lower leg amputations per year.
Victoria continues: ‘Having elevated blood sugar levels can be very harmful for nerves, blood vessels and organs and this can lead to many other health issues, such as vision loss and blindness, digestive health issues, limb amputation and kidney failure. Type 2 diabetes increases the risk of heart disease or stroke by five times.’
Worryingly, type 2 diabetes is no longer a later-life condition. Dr Marilyn, who runs The Glenville Nutrition Clinics in London and Kent in the UK and remotely for clients all over the world, says the number of under-40s diagnosed with type 2 diabetes in the UK is rising at a faster rate than among the over-40s.
‘Eating a healthy diet, eliminating refined carbohydrates including sugar, and taking nutrients to help the body stay insulin sensitive are all recommended,’ she says. ‘The most commonly prescribed medication for type 2 diabetes is metformin and this will often be the first medication suggested. It’s an insulin-sensitising drug which works by re-sensitising the body to insulin, reducing the absorption of glucose in the digestive system and lowering the liver’s production of glucose.
‘But the USA’s Diabetes Prevention Programme found that lifestyle interventions (diet and exercise) were actually more effective than metformin in preventing or delaying diabetes.
‘And the researchers pointed out that, as well as preventing diabetes, they had a beneficial effect on weight, blood pressure and lipid levels (increasing our HDL ‘good’ cholesterol and lowering triglycerides). Metformin can have a beneficial effect on weight, but it doesn’t seem to have any effect on blood pressure or lipid levels.’
So what lifestyle changes can we all make, whatever our age, to reduce our risk of diabetes? And if we’ve been diagnosed, what can we do to at least manage the condition, if not reverse it? Dr Marilyn and Victoria share their tips.
Miss the first meal of the day at your peril, says Dr Marilyn. ‘Skipping breakfast just one day a week increases your risk of developing type 2 diabetes by six per cent. Missing it five or six days a week increases it to 55 per cent.’
Don’t just shovel delicious-tasting food and drinks into your mouth without thinking – be aware of what you’re eating, suggests Victoria. ‘Cut the refined carbohydrates, sugar and processed foods as they drive up inflammation and blood sugar levels,’ she says.
Catch It Early
Check your skin for darkened areas, advises Dr Marilyn. ‘Prediabetes is diagnosed via a blood test when the HbA1c level is 42-47 mmol/mol (6-6.4 per cent),’ she says. ‘There aren’t many clear-cut symptoms of prediabetes, but you may see darkened skin on your body, often between your elbow and shoulder. You may also develop skin tags on your neck, underarms and eyelids, showing your blood sugar isn’t as balanced as it could be.’
Eat In The Right Order
The order of your food intake during a meal matters, reveals Victoria. ‘Eat your carbs last after proteins and fats and make sure they’re from wholegrains or starchy vegetables like sweet potatoes,’ she says. ‘Avoid processed, refined carbs like white bread, white rice and white pasta.’
Make Your Minerals Work
Choose minerals that work to keep you healthy, advises Marilyn. ‘The most important nutrients to reduce your risk of type 2 diabetes are chromium and magnesium,’ she says. ‘Chromium aids with balancing blood sugar, improves insulin resistance and helps with losing fat around the middle, and magnesium helps to balance blood sugar and keeps you insulin sensitive.’
Enjoy mussels, broccoli, grape juice and Brazil nuts for chromium, and pumpkin and chia seeds, almonds, spinach and cashews for magnesium.
Eat, Then Walk
Keeping moving after you’ve eaten is vital, stresses Dr Marilyn. ‘Research has shown that people who ate two slices of white bread and then went for a walk lowered their blood sugar levels more than those who walked before eating the bread,’ she reveals. ‘Walking for ten minutes after each meal lowers blood sugar levels more effectively than walking for 30 minutes at any other time of the day.’
Mix And Match
Keep your blood sugar levels stable by adding a fat or a protein to a carbohydrate, advises Victoria. ‘If you have a piece of fruit, which is a carbohydrate, add some protein in the form of nuts – this will lower blood sugar levels,’ she says.
Be Vitamin Savvy
Foods rich in B vitamins, such as broccoli, Brussels sprouts, leafy green vegetables, chickpeas, and kidney beans, are your ally, says Dr Marilyn. ‘They help turn your food into energy rather than storing it,’ she explains. ‘Add some cinnamon too, as it’s a natural insulin sensitiser.’
Have An Aperitif
Use apple cider vinegar, suggests Victoria. ‘One tablespoon of apple cider vinegar in water 30 minutes before each meal will lower your blood sugar levels,’ she says.
Be Sugar Aware
Look out for hidden sugars, says Marilyn. ‘Sugar is often ‘hidden’ in foods like tomato sauces and salad dressings, as well as in processed and fast food, so check the labels,’ she says. ‘Ironically you need to eliminate artificial sweeteners – research has shown they increase your risk of being overweight and developing type 2 diabetes.’