Diabetes Awareness Week

The 12th-18th June this year is Diabetes Awareness Week. Diabetes Week is an annual UK-wide initiative devoted to raising awareness of diabetes and raising money to help fund research into the condition. Established by British charity Diabetes UK, this week is the annual focal point for the charity’s diabetes awareness, campaigning and fundraising activities (1).

This blog will explain the different types of diabetes, what diabetes is and how to reduce the risk of developing diabetes through diet, lifestyle and nutrients.

Types of Diabetes

The two main types are type 1 and type 2. Those with type 1 diabetes can’t make any insulin so have to take insulin to control their blood sugar. Those with type 2 diabetes do make insulin but either can’t produce enough of it or produce enough but it doesn’t work effectively due to insulin resistance. Gestational diabetes may develop during pregnancy. There are other, rarer types of diabetes.

Prediabetes - some people have a blood sugar level that is higher than usual, but not high enough to be diagnosed as type 2 diabetes. This is called prediabetes, and means you’re at risk of developing type 2 diabetes. Diet, lifestyle and certain nutritional supplements can help to reduce the risk of developing type 2 diabetes.

Symptoms of diabetes

The common symptoms of diabetes include:

• Needing to urinate often
• Excessive thirst
• Feeling more tired than usual
• Losing weight without trying
• Genital itching or thrush
• Cuts and wounds take longer to heal
• Blurred vision

Blood Sugar Control

If you don’t have diabetes, your pancreas senses when glucose has entered your bloodstream and releases the right amount of insulin, so the glucose can get into your cells. But if you have diabetes, this system doesn’t work and glucose can’t get into the cells properly, so it begins to build up in the blood. Too much glucose in the blood can cause serious problems.

Let’s look at how blood sugar control works:

Carbohydrates, Glucose and Insulin

All carbohydrates break down into glucose in the digestive tract. The glucose goes into the bloodstream causing a rise in blood sugar levels. As the body cannot survive if blood sugar levels are too high insulin is released by the pancreas in order to carry the glucose from the blood into the cells. Once in the cells glucose can be stored as energy, or converted to fat. The more insulin you produce the more likely you are to convert glucose to fat.

Diets high in sugar, refined carbohydrates and processed foods mean that insulin is constantly being called upon to carry the glucose into the cells. This can lead to the cells becoming “deaf” to insulin as they get so used to it being present. This can be likened to background noise which you notice when you first hear it but soon forget it is there. More insulin is secreted until the cells let the glucose enter. As, by now, insulin levels are higher than they should be, more glucose is stored as fat and less is available for energy. This often leads to the deposition of fat on the body, especially around the abdomen.

Symptoms such as lack of energy, mood swings, headaches and poor concentration often result from highs and lows of blood sugar.

How to control blood sugar

The key for treatment is to keep insulin levels as low as possible. This entails reducing foods that raise blood glucose rapidly whilst also improving the cell’s response to insulin so less is produced.

Fast releasing carbohydrates break down rapidly into glucose causing a dramatic spike in blood sugar levels and therefore a high need for insulin, which is what we want to avoid. 

Weight Loss and Type 2 Diabetes

Research shows that losing weight can lead to remission of diabetes in those who are overweight. Approaches that have been found to work include following a low calorie weight loss programme of around 850 calories a day. The Mediterranean diet or a low carb diet may also work (1). Remission is not a one-off event, but a process. It needs to be maintained by eating a healthy diet and staying active.

Talk to a healthcare professional about the right approach for you. It may affect your need for medication so you will need to be monitored. 

 Dietary Recommendations for Blood Sugar Control

The main aims are to eliminate foods that raise blood glucose rapidly and include foods that slow the break down of carbohydrates into glucose:

• Avoid sugar and refined carbohydrates.
• Avoid large meals. Large meals provoke a rise in blood glucose and insulin levels so avoid eating large amounts in one sitting.
• Avoid artificial sweeteners – these are implicated in weight gain and have negative effects on appetite and the microbiome. Most diet foods, low sugar or sugar free foods contain them and are best avoided.
• Include protein with your meals. Protein slows down the breakdown of carbohydrates into glucose.
• Eat a diet high in fibre. Fibre helps keep insulin levels low and blood sugar stable. Make sure all your meals contain fibre from whole grains, nuts, seeds, fruit and vegetables.
• Tom Oliver Supplements to Help with Blood Sugar Control
• Folic acid and vitamin B12 - patients using metformin may need to supplement with folic acid and vitamin B12 (1).
• Vitamin D – has been shown to decrease the risk of developing diabetes in those with prediabetes (2) and may be beneficial for those with gestational diabetes (3).
• Chromium picolinate - one of the key nutrients for blood sugar control. Chromium has anti-diabetic properties at a dose of 200-1000 μg/day (4).
• Magnesium – reduces the risk of metabolic syndrome, hyperglycemia, high blood pressure and hypertriglyceridemia (5).
• Zinc – magnesium plus zinc combined have beneficial effects for patients with type 2 diabetes and cardiovascular disease (6).
• Fish oils – long term use of fish oil supplements is associated with a lower risk of T2D (7).
• Multi-vitamin and mineral - problems are associated with inadequate supply of a number of minerals and trace elements including iodine, selenium, zinc, calcium, chromium, cobalt, iron, boron and magnesium potentially leading to imbalances in glucose homeostasis and insulin resistance (8).
• Probiotics – evidence indicates that the gut microbiome is an important regulator of body weight, glucose and lipid metabolism, and inflammatory processes, and may play a key role in the risk of obesity, insulin resistance and type 2 diabetes (9).
• Protein Powders – protein helps to slow the release of glucose from carbohydrates and has a satiating effect. Tom Oliver’s protein powders come in whey or vegan varieties and are a good way of ensuring you get enough protein daily.

Incorporate Physical Activity into your Everyday Life -  exercise improves the cell’s response to insulin meaning less is produced and less glucose is stored as fat. Try to get moving most days of the week. Avoid sitting down for long periods of time.

References

1. https://www.diabetes.org.uk/diabetes-week
2. Ann Intern Med. 2023 Mar;176(3):355-363. Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials. Pittas AG et al.
3. Libyan J Med. 2021 Dec;16(1):1930346. Impact of nutrients and Mediterranean diet on the occurrence of gestational diabetes. Mahjoub F et al.
4. Complement Ther Med. 2021 Aug;60:102755. Effects of chromium supplementation on blood pressure, body mass index, liver function enzymes and malondialdehyde in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials Asbaghi O et al.
5. 2021 Jan 22;13(2):320. Magnesium in Obesity, Metabolic Syndrome, and Type 2 Diabetes. Piuri G et al.
6. Lipids Health Dis. 2020 May 28;19(1):112. The effects of combined magnesium and zinc supplementation on metabolic status in patients with type 2 diabetes mellitus and coronary heart disease. Hamedifard Z et al.
7. Diabetes Care. 2021 Mar;44(3):672-680. Association of Oily and Nonoily Fish Consumption and Fish Oil Supplements With Incident Type 2 Diabetes: A Large Population-Based Prospective Study. Guo=Chong Chen et al.
8. 2020 Jun 23;12(6):1864. Role of Minerals and Trace Elements in Diabetes and Insulin Resistance. Dubey P et al.

Gut. 2022 Jun;71(6):1214-1226. Dietary macronutrients and the gut microbiome: a precision nutrition approach to improve cardiometabolic health. Ja