Diabetes prevention and control is important for good health. If you are South Asian your chances of getting Type 2 diabetes are greater. This contributes to an increased chance for getting cardiovascular disease. In the January/February 2012 issue, I wrote about the unique risks for cardiovascular disease in South Asian people and the recommendations to address those risks. In this article, the focus is on prevention and control of Type 2 diabetes.
The more you know about diabetes, the better off you are on your road to good health.
Insulin and Diabetes
Food is energy and cells in your body need energy, in the form of glucose (a type of sugar). Insulin, a hormone made in the pancreas, helps to balance the amount of glucose in the blood, and therefore the glucose available to body cells. Insulin also helps some body tissues store or release glucose when needed.
There are two Types of diabetes. Type I, which used to be called juvenile-onset diabetes, involves a total loss of the body’s ability to make insulin. Type 2, which used to be called adult-onset diabetes, involves a partial loss of the body’s ability to make insulin. In addition to a decreased ability to make insulin, a person with Type 2 diabetes may have what is called insulin resistance, where certain body tissues do not respond properly to insulin. Type 2 diabetes makes up about 90% of all cases of diabetes. Type 2 diabetes is the focus of this article.
Think of insulin as a key that unlocks body cells so that glucose can be used for energy. Without this key, glucose in the blood builds up, while body cells are starved for energy. When this happens, the body looks for other ways to get energy. High levels of glucose in the blood can be harmful in many ways.
If diabetes develops, and is not well-controlled, long term effects happen. Cardiovascular disease risk increases, as does the risk for kidney disease. Cardiovascular disease includes diseases of the heart and all blood vessels in the body, but most importantly the blood vessels leading to the brain and the heart itself. Kidney disease affects the kidney’s ability to get rid of waste products in the blood. Both cardiovascular disease and kidney disease are serious. For this reason, ways to prevent or control Type 2 diabetes are important for good health.
Bad News and Good News
Risk factors for Type 2 diabetes for all people include having a family history of diabetes, being overweight, storing fat in the abdominal area (belly fat), and being physically inactive.
The bad news is that it has been shown that South Asian people have a greater chance for the development of Type 2 Diabetes even when risk factors are equal or lower.
Dr. Parmit Johal, Surrey BC, wrote an article about prevention and management of diabetes in South Asians. He stated that Canadian South Asians develop Type 2 diabetes three to five times more often than Caucasians. Experts suggest that South Asians develop Type 2 diabetes at a younger age, and have a tendency to store fat in the abdominal area, be insulin resistant, and show metabolic syndrome. Metabolic syndrome includes problems such as increased blood pressure, high blood glucose, and fat in the abdominal area. These problems raise the risk for cardiovascular disease. We know that heredity plays a role in the tendency to develop Type 2 diabetes, BUT …
The good news is that while it is known that the tendency to develop Type 2 diabetes is strongly inherited, there are many steps that you and your family can take on the road to good health.
Because South Asians develop Type 2 diabetes earlier and more often than others, it is important for you to make positive lifestyle changes to prevent development. It is also important to catch Type 2 diabetes early so that you can make changes and get treatment to prevent some of the long term effects of Type 2 diabetes.
If you are in the early stages of Type 2 diabetes you may have no warning signs or you could feel tired, hungry and thirsty, or have to go to the bathroom more often. You might not connect these things with diabetes. At times, diabetes can result in blurred vision. Regular eye exams are important because blurred vision could point to early Type 2 diabetes.
Take Charge of Your Health
Knowledge is important for your health. Think of your doctor as a partner. Many people think that they should not ask their doctor questions. Many people think that their doctor knows everything about their health. It is alright to ask your doctor questions and to make suggestions. Ask your doctor to consider the increased risks for diabetes in South Asians and to consider diabetes screening for you or your family members.
If you know that some of your family members have diabetes or you are concerned that you have increased risk factors for the development of Type 2 diabetes, talk to your doctor about getting tested regularly to catch early Type 2 diabetes. Your doctor may ask you to have a test done to measure your blood glucose after you have not eaten for a number of hours. You might have another test done where you are asked to take a sugary drink and then have your blood glucose tested. These tests will show how well your body is able to regulate the level of glucose in your blood.
If you already have Type 2 diabetes, and have not already done so, visit a diabetic clinic to learn more about diabetes and what you can do to stay healthy. Ask your doctor about a clinic. If you already go to a diabetic clinic, follow the advice you are given regarding diet. If you are on medication, take the medication as instructed. Your pharmacist, doctor, or diabetic clinic nurse can help you with this. Regular exercise can help you stay healthy. Before you start any new exercise, check with your doctor or diabetic clinic nurse. Get regular lab testing done, as ordered, to make sure that your diabetes in under control.
By learning more about your diabetes if you have it, and by following the advice of the experts, you can prevent some of the long term problems that can happen when diabetes is not well controlled.
Think About How You Cook and What You Eat
For prevention of diabetes development, lifestyle changes aimed at lessening the chances for getting diabetes are important. Dr. Johal suggests that diet may have much to do with increased diabetes in South Asians.
South Asians have a rich culture and love to get together with family and friends. Many of these social gatherings revolve around much-loved South Asian cuisine. Cooking methods using a lot of fat, sugar, and deep frying, are risky for the development of Type 2 diabetes or the control of diabetes once it develops. High fat, high sugar foods not only contribute to weight gain, often stored as fat around the middle, these foods also put an added burden on the body’s ability to regulate blood glucose levels. Changing this kind of diet, which is so tied to social activity and culture, is difficult but not impossible.
You can find special recipes created for South Asians that address the need to cut down on the fats and sugars used in cooking. There are many resources available. The Canadian Diabetes Association and the Heart and Stroke Foundation have recipe collections created for South Asian cuisine. At times, South Asian women will get together to cook. What a wonderful opportunity to experiment with new and healthier ways of cooking. As well, South Asian youth can be introduced to healthier cooking methods in the home and school.
Get Moving
Physical activity helps to promote healthy weight and encourages body tissues to respond to insulin better. A health weight may mean less fat stored around the middle, which we now know is one of the risk factors for diabetes development and cardiovascular disease. For the person that already has diabetes, exercise can help to slow some of the long-term effects, such as damage to blood vessels. The right type of exercise can also help the body to make better use of insulin and might mean that less diabetic medication is needed.
Getting more exercise doesn’t have to be complicated, nor do you need expensive equipment. Walking is a great way to increase your activity and, with a friend, walking is a great way to socialize. Consider organizing a walking group in your community. Community centers and other public recreational places offer reasonably-priced and easy to access facilities for exercise.
Steps on the Road to Good Health
There are many resources to help you learn more about diabetes prevention and management. The Canadian Diabetes Association has excellent general information, and also specific information for South Asians. Health Canada is another place to go for information. Talk to your doctor. Talk to your family and friends. You can take positive steps to prevent Type 2 diabetes, or to stay healthy if you have diabetes.
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Tips for Prevention and Control of Type 2 Diabetes
• Learn about Type 2 diabetes, and as a South Asian, know about your increased chances of getting it
• Know that while the tendency to develop Type 2 diabetes is strongly inherited, there are many steps that you and your family can take to prevent development, or control, diabetes
• Know the warning signs for Type 2 diabetes, but also know that sometimes there are no warning signs
• Ask your doctor questions about your chances of getting Type 2 diabetes and make suggestions about finding out if you have early diabetes
• If you already have Type 2 diabetes, take care of yourself by following the advice you are given about diet, medication, and exercise
• Consider lifestyle changes for prevention of diabetes such as healthy diet and cooking methods, and physical activity
• Talk to your doctor, and talk to your family and friends, about how to stay healthy
Catherine Bock, Faculty, BSN Program, Kwantlen Polytechnic University
Catherine.bock@kwantlen.ca
References available on request (contact author)