Diet & Nutrition: Diabetes Drift

                  

Alarming new research shows that within two years of diagnosis, 91% of Canadians with Type 2 admit they’ve slipped back into bad habits

A recent national survey of 1,034 adults living with type 2 diabetes has focused attention on a worrying behavioral trend, which researchers call the ‘diabetes drift.’

The survey, conducted by Leger Marketing and funded by Bristol-Myers Squibb Canada and AstraZeneca Canada, found that a whopping 91 per cent of respondents admitted that they had ‘drifted’ from at least one of the 11 diabetes management behaviours recommended by the Canadian Diabetes Association (CDA).

Diabetes management behaviours recommended by the CDA:

– Don’t smoke
– Check your blood glucose levels regularly and keep them in your target range

– Keep your cholesterol and other blood fats in your target range

– Maintain a healthy weight
– Keep your blood pressure close to target level
– Take your medication as prescribed

– Manage your stress effectively

– Follow a balanced meal plan

– Be physically active
– Take care of your feet

– Regularly visit your dentist, eye care specialist (every one to two years) and doctor

Far from the occasional stress-free indulgence, those surveyed identified frustration/anger (45 per cent), guilt/embarrassment (36 per cent) and depression/sadness (32 per cent) as the feelings most closely associated with lapses in management behaviours. However, despite the propensity to ‘drift,’ 87 per cent of respondents believed that they were ‘managing their disease well’ and 94 per cent agreed that an active, healthy life is possible for those with type 2 diabetes.

The shift from healthy to unhealthy behaviours usually occurred approximately 21 months after diagnosis and the behaviours most commonly affected were: following a balanced meal plan, being physically active and managing stress.

‘There are two contexts in which people drift,’ explains Dr. Stewart Harris, lead investigator for the National Diabetes Management Strategy, who holds the CDA Chair in Diabetes Management at the Schulich School of Medicine & Dentistry.

The first results from the motivational effect of diagnosis. For people who have known for some time that their weight, diet and/or physical inactivity posed serious health risks, ‘diagnosis serves as a wake-up call.’ Over time, ‘as the impact of a person’s diagnosis fades, so does their resolve to eat healthier and exercise.’

To combat this backslide, Dr. Harris recommends establishing a household plan, including a healthier diet and realistic exercise goals. Often, prompted by recent diagnosis, people will decide to purchase a gym membership or adopt a strict fitness regimen. ‘Physical activity should be entertaining,’ says Dr. Harris. If you never enjoyed the gym, try something different. Extend your daily dog walking or take up a sport you enjoyed in your youth.

Drifting can also occur due to a relaxation of sugar control as their diabetes worsens. ‘People balk at the additional therapies [such as insulin] that may become necessary as the disease progresses,’ explains Dr. Harris.

The annoyance or hardship associated with more elaborate treatments should however, be weighed against the health risks of drifting. ‘Heart disease and stroke account for 80 per cent of diabetes-related deaths,’ notes Dr. Harris, ‘and there is very concrete evidence that if people don’t manage their disease it increases their chance of developing further complications.’

These complications include: eye disease, eventually resulting in blindness; kidney disease, progressing to kidney failure; and loss of sensation, particularly in the feet, which is a major cause of non-traumatic amputation.

Diabetes is the third most frequently diagnosed disease in Canada and according to the CDA, by 2010 experts anticipate that three million Canadians will have the disease, with type 2 diabetes making up 90 per cent of diagnoses.

While damage done by drifting cannot be reversed, Dr. Harris emphasizes that ‘intervention at any stage will make a difference,’ reducing the risk of further degeneration.

 –Evan Rosser