Diabetes – Different Types and Prevention

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by Amandeep Sandhu, RD
Nutrition to You Dietitian

 

Introduction:

Often people that are seen in Diabetes clinics are unsure of what type of Diabetes they have.  Many make the assumption that if they are prescribed insulin that that automatically means they have Type 1 Diabetes. In this blog, we will look at the difference between Type 1 and Type 2 Diabetes as well as preventing and certainly delaying Diabetes.

Diabetes Prevalence and Cost

Diabetes Mellitus is the medical term for Diabetes.  Diabetes is a serious condition with potentially devastating complications that affects all age groups worldwide. As of 2009, 2.4 million Canadians were living with Diabetes and that number is expected to rise to 3.7 million by 2019; with approximately 90% of those being Type 2.  Diabetes is the leading cause of blindness, end stage kidney disease and non-traumatic amputations in Canadian adults.

Diabetes and its serious complications increase government costs and puts a great deal of pressure on Canada’s publicly funded healthcare system; with the estimated economic burden of $12.2 billion in 2010 for Diabetes alone. This is projected to increase another $4.7 million by 2020.

The Silent Killer

The onset of Type 1 Diabetes is sudden however the onset of Type 2 Diabetes often goes undetected. Many people don’t have any symptoms for as long 6 -10 years and will only get diagnosed as a result of developing Diabetes-related complications. Type 2 diabetes for that reason is often called “the silent killer”.

What is Diabetes?

Diabetes is a disease characterized by high blood sugars (hyperglycemia) resulting from either defects in the production of insulin, insulin action or both. Insulin is the hormone produced and secreted by the pancreas that transports blood sugars to the cell to be either stored or utilized for energy.

There are two common types of Diabetes: Type 1 and Type 2.

Type 1 Diabetes is an autoimmune disease in which the person’s own antibodies attacks the pancreas and destroys the insulin producing beta cells. The onset usually occurs in childhood or adolescence but can occur at any age. It used to be called Juvenile Diabetes.

Type 2 Diabetes is metabolic disease that is characterized by a combination of insulin resistance (the body not being able to use insulin effectively) and beta cell dysfunction (the pancreas is unable to make enough insulin). The onset is usually after the age of 40, but it is now increasingly been diagnosed in children.

Comparison of Type 1 and Type 2 Diabetes

TYPE 1

TYPE 2

Pathogenesis

Genetic predisposition and environmental influences that triggers an autoimmune destruction of pancreatic beta cells

Genetic predisposition and insulin resistance with insulin deficiency.

Risk factors

No defined risk factors

Older age, obesity, family history of diabetes, physical inactivity, race/ethnicity

Insulin production

Minimal or absent

Progressive dysfunction of pancreas

Rate of progression may be affected by glucose control

Age of onset

Primarily children, adolescent, but up to any age

Primarily over the age of 40. But now seen in younger ages

Body type

Usually lean

70-80% are obese

20-30% are lean

Chronic complications

Blindness, nerve damage, kidney failure, cardiac complications, amputations.

same as Type 2

Treatment

external insulin is required

Lifestyle interventions

May require diabetes pills and/or insulin

Blood sugar levels and lab results guide the type of treatment required

CHART ADAPTED FROM BUILDING COMPETENCY IN DIABETES EDUCATION: THE ESSENTIALS

 

Preventing Diabetes

Preventive measures for Type 1 Diabetes are still in the experimental stages and no clear screening tool has been developed yet.  However, such is not the case for Type 2 Diabetes.

Obesity has become epidemic across Canada and a growing number of people have lifestyles that have them sitting for long periods of time, with little activity.  The incidence of Diabetes is increasing with waist circumference.

So what can be done?

  • Studies have shown that reducing body weight by as little as 5 -10% can significantly reduce the risk for Diabetes and other health complications
  • As little as 30 minutes of moderate intensity physical activity, 5 days a week is recommended by the Canadian Diabetes Association
  • Along with being active, preventing or delaying the onset of Diabetes should focus on adopting a lifestyle which includes healthy food choices including whole grains, vegetables and fruit, lean protein and using fats which are mono- or polyunsaturated

Following these recommendations does not need to mean eating is boring or difficult! Many tasty and popular foods can be eaten while following these guidelines, including many varieties of sushi, Asian ‘stir fries’, Mediterranean foods like hummus or Greek salad and South Asian dishes.

Want to know more?

If you would like to learn about preventing or delaying Diabetes or how to manage your blood sugar better living with Diabetes, you don’t need to “go it alone”. Nutrition to You’s has Dietitians that specialize in Diabetes prevention and treatment and can support you in learning to make healthier food choices to better manage your health.

Please give us a call or send us a note by clicking here: Contact Us.

References:

2013 Canadian Diabetes Association Clinical Practice Guidelines

Canadian Diabetes Association. in: H. Jones (Ed.) Building Competency in Diabetes Education: The Essentials. Canadian Diabetes Association, Toronto, ON; 2008

Nelms, Marcia et. al. (2007). Nutrition therapy and pathophysiology. Belmont, CA: Thomson Brooks/Cole