So what is diabetes?

Written by Sarah-Jane Reilly studying  a PLC in nutrition and dietetics

 

Diabetes is an increasingly common metabolic disorder that affects the way our bodies use food for energy and growth. When we eat food, it is digested and converted into glucose (simple sugars). These sugars then enter the bloodstream as a source of fuel for our body cells. The pancreas produces a hormone called insulin which helps to regulate the levels of glucose in the blood by enabling glucose to enter cells in our bodies.
Diabetes is a condition that effects the pancreas’ ability to produce insulin and/or our cells ability to respond properly to insulin. Without insulin, the body’s cells cannot convert glucose into energy. As a result of this, there is a higher than normal level of glucose in the blood (hyperglycaemia) which eventually leads to a person developing diabetes.

There are three main types of diabetes:
• Type one diabetes
• Type two diabetes
• Gestational diabetes

Type one diabetes
Type one diabetes is a chronic condition in which the pancreas produces little or no insulin. It is an autoimmune condition that typically first develops in children or young adults. In autoimmune diseases the immune system produces antibodies against part or parts of our bodies…in this case the body’s immune system destroys the insulin producing (beta cells) of the pancreas.
Type one diabetes may be genetically inherited or triggered by viral infections in those who are genetically susceptible to the condition.
Common symptoms of type one diabetes to be aware of include:
• Frequent urination ( in children, frequent bed wetting even after toilet training)
• Unusual thirst
• Extreme hunger
• Sudden weight loss
• Blurred vision
• Nausea
• Irritability
Type one diabetes is treated with insulin.

Type two diabetes
Type two diabetes is a condition where the pancreas stops producing enough insulin for the levels of glucose (sugar) in the blood or when the body develops a resistance to insulin. Type two diabetes can occur at any age. It is becoming increasingly common for young children to develop this condition as childhood obesity rates soar worldwide.

Risk factors for type two diabetes include:
• Being overweight/obese.
• Having a first degree relative with diabetes (parent, brother, sister, child etc.).
• Having a waist measuring more than 80cm if you are a woman or more than 94 cm if you are a man.
• Having impaired glucose tolerance (higher than normal levels of glucose in your blood).
• Having gestational diabetes during pregnancy.
Type two diabetes can be effectively managed through exercise, a healthy diet and is some cases medication.

Common symptoms of type two diabetes to be aware of include:
• Dry mouth
• Increased thirst
• Being hungry all the time
• Unexplained weight loss
• Passing large amounts of urine
• Numbness, pain or tingling in your hand/feet
• Frequent infections

Top dietary recommendations for preventing/managing type 2 diabetes include:

1. Choose high fibre, slow releasing carbohydrates and avoid highly refined carbs.
Unlike highly refined carbs, complex carbohydrates release their energy at a much slower rate. They prevent a sudden spike in the level of sugar in the blood. They provide us with lasting energy and keep us feeling full for longer. We can introduce complex carbohydrates to our diet by substituting foods like white rice for brown rice, white bread for whole-grain bread and cornflakes for bran flakes.
2. Eat regular small meals at set times of the day.
Our bodies are more capable of regulating the levels of sugar in our blood if we eat small portions of food at set times of the day.
3. Exercise!
We all know that exercise helps us to lose weight. But did you know that it can also lower our blood sugar levels and increase our sensitivity to insulin, the hormone which helps to regulate our blood sugar levels?
4. Prevention is key!
Type two diabetes can be prevented by following a healthy diet. This involves being shop smart and food smart. Read the labels on foods, particularly the RDA of each nutrient. Question general food health claims and limit the amount of sugary refined foods you eat.

Gestational diabetes
Gestational diabetes is a type of diabetes that may develop during pregnancy. It occurs when the mother’s body is unable to produce enough insulin. During pregnancy, the mother’s placenta produces hormones that work against the action of insulin. When this insulin cannot get to into the body’s cells, blood sugar levels rise and the mother may develop gestational diabetes overtime.

But not to fear!
According to the American Diabetes Association, you are at low risk of developing gestational diabetes if you meet all of the following criteria:
• You are younger than 25 years of age.
• Your weight is in a healthy range.
• You’re not a member of any racial or ethnic group with a high prevalence of diabetes.
• None of your close relatives had diabetes.
• You’ve never had a high result on a blood sugar test.
• You’ve never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

According to the HSE, gestational diabetes affects 12% of pregnant women. There is no proven way of preventing gestational diabetes, however, certain steps can be taken to reduce the risks of developing the condition. This steps include:
• Eating a nutritious, well balanced diet, high in fibre and fruit and veg.
• Keeping active and fit during pregnancy.
• Losing excess pounds prior to pregnancy.

Comments from Aveen; If you suspect you have type 2 diabetes you must visit your GP. Diet is imperative in the treatment of type 2 diabetes and you need to include lots of whole foods, fresh vegetables, lean proteins and high fibre foods while limiting sugary foods and saturated fats.Seek help from a dietitian.

Allergies & Intolerances…What’s the difference?

A negative reaction by your body to a particular food or food group is common. This reaction is mostly caused by intolerance to a food or food group rather than an allergy. It’s very common to confuse these two food hypersensitivities as some of the signs and symptoms are the same.

A true food allergy causes your immune system to react to a protein found in particular foods. When your immune system reacts quickly to the protein, it creates cells that can be detected by a blood test. Once these cells are created, they encourage the release of substances that cause your body to physically react. This process usually takes less than 2 hours and the physical reactions to these substances can range from mild symptoms e.g. skin reaction to reactions that can be life-threatening. The sooner these reactions occur, generally the more severe. This is to do with the type of cells and substances that are created. For instance a life-threatening allergic reaction known as anaphylaxis can cause breathing trouble and dangerously low blood pressure instantly.

On the other hand food intolerances are generally less serious. It is thought that they do not involve the immune system and are therefore not fatal. The physical reactions associated by these intolerances usually involve the gut.

Allergies involve an immune reaction, can be life-threatening are actually quite rare (1-10% of the population).
Signs and symptoms may include nausea, vomiting, a tingling mouth, hives, and swelling of the lips, face, tongue and throat. The
reaction is fairly instant (usually within 1 hour). Common allergens include cow’s milk protein, chicken eggs, peanuts, tree nuts and seeds, fish, shellfish, soya & wheat.

Whereas food Intolerancesare not life threatening and are relatively common (>20% population). Signs and symptoms may include nausea, vomiting, cramping and diarrheoa, sinusitis, indigestion, irritable bowel and migraines. The reaction is also a gradual process (few hours to days) which can make them difficult to identify. The most common food intolerances are FODMAPs like lactose as well as MSG (monosodium glutamate) & gluten.

Both allergies and intolerances need to be diagnosed and the food or group of foods avoided. Diet is obviously central. When you have an allergy, you will have to avoid the offending foods completely. If you have an intolerance, you must discover your tolerance level or threshold to the offending food. However, keeping your diet balanced, healthy and full of all necessary nutrients while remaining completely symptom free is no easy task and therefore a qualified dietitian or clinical nutritionist is crucial.

Polycystic Ovarian Syndrome (PCOS)- Diet

If you have PCOS, you are certainly not alone… In fact, it affects 5-10% of women of child-bearing age! It’s the most common hormonal issue in women and is one of the main causes of infertility. The exact cause of PCOS appears to be unclear however diet has been shown to be central in both development and treatment.

So what is PCOS?
Both males and females have ‘male’ and female’ hormones. However, males have more ‘male’ hormones than women and via versa. Women with PCOS have slightly higher than normal levels of the male hormones circulating in their blood. This affects the balance of female-to-male hormones, often resulting in the formation of small cysts-like sacs on the ovaries… hence the name poly (meaning many) cystic ovarian syndrome. The symptoms associated with PCOS are a result of this imbalance and therefore vary greatly from woman to woman.

Why is it associated with being overweight?

PCOS is more often found in women who are overweight as insulin may play a central role in development. Insulin is a hormone found in the body that helps bring glucose, formed from the digestion of sugars and starches, into our body’s cells to be used as energy or else stored. Many women with PCOS have too much insulin circulating in their blood due to ‘insulin resistance’. Insulin resistance is where insulin is less effective at lowering blood glucose levels therefore more insulin is secreted to accommodate this. This excess insulin has been shown to increase the production of male hormones. The main cause of insulin resistance is excess weight around your middle.

Why treat PCOS?

As PCOS effects the menstrual cycle in women, it can play a role in infertility. Additionally and importantly, the other symptoms of PCOS may also be upsetting for women. However, in the long term, PCOS has been linked to the development of chronic conditions and diseases like the metabolic syndrome, type 2 diabetes, heart disease, high blood pressure and cancer of the womb…. Therefore it must be treated.

Diet….

The first step should always be looking at diet and exercise. Eating a balanced diet and exercising regularly can help obtain a healthy weight and manage some of the common symptoms in PCOS like insulin resistance. Insulin resistance can increase weight gain but can also be caused by weight gained…. It’s a bit of a chicken and egg situation…. Regardless of which came first or if they resulted at the same time, excess body fat can make insulin resistance worse thereby increasing insulin levels and aggravating symptoms.
In fact studies have shown that even moderate weight loss (5-7% of total body weight lost) may significantly improve symptoms and regulate the menstrual cycle. However a healthy diet is beneficial to all women with PCOS, even if not overweight.

So what diet changes can help?

A healthy diet for women with PCOS is slightly different to a healthy diet for the general public. Although ensuring a healthy balance of carbohydrates, proteins and fats is crucial… too much or too little of any vitamin and mineral can be detrimental. For example, adequate levels of some of the essential trace minerals like chromium are needed for insulin activity. While zinc, often considered just the immune-boosting mineral, plays a role in proper hormone function and B vitamins are important in ensuring the metabolism of protein and carbohydrate-rich foods.

Do you think you have PCOS?

12 questions to ask yourself….
1. Does it run in your family?
2. Are you overweight?
3. Did you grow pubic hair at a very young age?
4. Do you have trouble conceiving?
Do you…
5. Store excess weight around you middle?
6. Struggle to maintain your weight?
7. Have irregular periods?
8. Crave carbohydrate?
9. Have excessive hair growth on face, chest, stomach, back, toes and thumbs?
10. Have male-pattern baldness (alopecia)?
11. Have acne?
12. Have patches on your skin (neck/arms/breasts/thighs) that are thick and dark brown?
If in doubt, seek advice….

Try to stop type II diabetes in its tracks…

With up to 30,000 people with undetected type 2 diabetes in Ireland, diabetes has become very topical amongst Irish health professionals. Early detection is key as there are many effective treatments out there to help you obtain good control of this condition which will help prevent further serious health problems.

Type 2 diabetes is diagnosed by abnormal blood glucose levels which often result in symptoms. The symptoms include extreme thirst, fatigue, blurred vision, increased need to urinate, numbness pain or tingling in your hands or feet, frequent infections and rapid and/or unexplained changes in your weight. It’s not just the symptoms of high blood glucose levels that need to be of concern to people but the fact that these high levels cause serious health conditions like blindness, kidney failure, cardiovascular disease and nerve damage.

The good news is that type 2 diabetes is something that we can prevent. However, for those Irish people with pre-diabetes and the approximate 146,000 people with undetected pre-diabetes, the battle to stop the progression to diabetes must start now. People with pre-diabetes have a 5-15 fold higher risk of developing type 2 diabetes within a 3-5 year period. Also the higher than normal blood glucose levels that diagnose pre-diabetes can result in the same health risks.

One of the greatest risk factors for developing diabetes is being overweight. Unfortunately, as you may know losing weight can be challenging. It involves not only changes to you diet but also to your lifestyle. Successful lifestyle change hinges on healthcare professionals recognizing that each patient needs his or her own personalized plan. This plan should incorporate risk reduction and other prevention-related elements like healthful eating, physical activity, monitoring of health issues, taking their medication appropriately and behaviour change.

Also worth noting is that you may avoid having to take any medications by taking control of your diet upon diagnosis.
If you don’t do what’s best for your body, it is you that comes up short in the end. If you are having trouble losing weight, ask for help. As Benjamin Franklin said ‘you may delay, but time will not’.

So old school, it’s new school…

We can learn a lot from our elders and their past nutritional habits… while our current diets are increasingly full of convenient foods that tend to be processed…. Years ago people relied on natural basic unprocessed foods… So here are my top 6 health foods that fall into the ‘old school’ category!

1. Prunes
The humble dried plum seems to get a lot of abuse… However I have been noticing it is making its way back into the limelight. Its nutrient rich (phytochemicals, potassium and copper), keeps you ‘regular’ (soluble and insoluble fibre coupled with sorbitol and phenolic compounds) and is extremely versatile. My advice is to not only use it as a snack but to try it in both sweet and savoury dishes like porridge, scones, stews and casseroles…

2. The spud
The poor potato has received so much bad press over the years… Why? Maybe because if you make it into french fries, crisps or waffles, it may not be the healthiest food… However potatoes are jam packed with nutrients including protein, fibre (as much as 6 prunes!), folic acid, iron, vitamin C (equivalent to 2 apples!), magnesium, phosphorus, potassium (twice as much as a banana) and some B vitamins. The boiled potato is also one of those low GI, slow releasing energy foods. So bring back the meat and two veg dinner that we once enjoyed so much!

3. Barley
Barley is not just used for soups (or beer), but was used as a staple carbohydrate source in savoury dishes. It’s tasty, high in soluble fibre (gel like fibre that’s great for your digestive health and can even lower cholesterol!), low GI (slow releasing energy) and has a nutty texture… ideal for salads! Plus, like these other wonder foods, it contains lots of nutrients like B vitamins, minerals like selenium, iron, magnesium, zinc, phosphorus, copper as well as antioxidants and phytochemicals!

4. Tinned salmon
Tinned salmon is not only affordable, handy to have in your cupboards and doesn’t involve preparation… but it also provides you with omega 3 fatty acids that are great for you heart, brain and joint health! The quality of salmon from a tin has greatly improved in recent years. So perhaps try having this ‘superfood’ in a sandwich, with wholewheat pasta or even try your hand at making fish cakes!

5. Porridge
Oats are back in vogue due to their numerous health benefits…. They are low GI, high in soluble fibre, very affordable and contain health boosting phytochemicals. You don’t have to make your porridge with water… Make your porridge creamy by making it with low fat milk! Milk will provide extra nutrition like protein and calcium which will feed your active tissues. So start the day a sensible way!

6. Brussels sprout.
The once shunned boring veggie is now back! It’s been around since the 13th century as a result of cabbages mating… but recently people are talking about how they used to despise them…. Perhaps cooking method is to blame? When boiled they leave the house with a smell so potent and distinguishable… And they have a strong bitter taste….
So its not surprising that the new in vogue cooking method, roasting them, is being considered the reason for their return. The intense heat when roasting caramelises the sprouts making them sweater which surprises our taste buds… The outer leaves are crispy but the inner sprout becomes soft. Just lay your sprouts out of a baking tray to roast dry. And like lots of veg, the smaller ones are sweeter!