Control weight for diabetes prevention
“My kids revolted on me, I was so crabby,” laughs Art Burgess when remembering his symptoms before he was diagnosed with diabetes.
The 72-year-old physical education instructor from Victoria, B.C., also found he was tired and needed to use the washroom frequently. But he didn’t connect it to the disease. It was only after a checkup that he discovered the reason.
Sometimes there are few or no symptoms of diabetes. But the most common telltale signs are:
- Extreme thirst or hunger.
- Weight loss or changes in appetite.
- Frequent infections.
- Frequent urination.
- Blurred vision.
- Slow healing of cuts or sores.
- Extreme tiredness.
Diabetes could double
More than 1.5 million Canadians have diabetes and a third of them don’t even realize it. Among older Canadians, the numbers are even higher:
- It’s estimated that 15 per cent of people between the ages of 40 and 75 are affected.
- The figure rises to 20 per cent after age 75.
Doctors say the diabetes caseload in Canada could double in the xt 10 to 15 years, as the boomer population ages.
At the same time, the level of obesity is on the rise-and that’s one of the strongest risk factors for developing the disease.
Too much glucose
But while diabetes is on the rise, so is our understanding and treatment of it. Diabetes is an abnormally high level in the blood of a sugar called glucose. It occurs because of problems with insulin, a hormone that allows glucose to enter the body’s cells, where it’s burned for energy or stored for future use.
Type 2 diabetes accounts for about 90 per cent of the cases, typically hits after age 45. The pancreas makes insulin but the body can’t use it properly, so blood sugar builds up.
Doctors measure blood sugar with a standard scale, using a blood test. A level of between four and six is normal. A level of seven or higher means you have diabetes. That extra glucose leads to many serious health problems including heart disease, blindness and infections.
High glucose risks
In the last couple of years, researchers have come to realize that as soon as glucose levels creep above six, the risk of heart disease and strokes rises dramatically.
“It used to be you either had diabetes or you didn’t,” says Dr. Hertzel Gerstein, a professor of medicine at McMaster University in Hamilton.
“Now we realize we should be striving not just to control diabetes but to optimize glucose levels.”
Gerstein says 40 to 50 per cent of all Canadians have higher-than-normal glucose levels because insulin isn’t doing its job properly. It’s a condition known as impaired glucose tolerance (IGT).
Treating related problems
People with high blood sugar also tend to have several other problems. They tend to be overweight and get little physical activity. About 70 per cent have high blood pressure. Most have low levels of HDL, the “good” cholesterol.
This cluster of problems, sometimes referred to as Syndrome X, could hold the key to control and prevention of diabetes. It’s already established that dealing with Syndrome X problems can prevent or delay the damage caused by diabetes. Now researchers are asking whether treating those problems can prevent diabetes altogether. So far the answer appears to be yes.
Cutting the risk
A Finnish study published in the New England Journal of Medicine in May 2001 looked into what would happen if people with IGT adopted a healthier lifestyle. Researchers worked with 522 middle-aged, overweight people.
Half received counselling to lose weight, exercise and improve their diets by cutting fat and increasing fibre. The other half continued with their lives as before. After four years, those who changed their lifestyle cut their risk of diabetes by 58 per cent.
Another similar study is scheduled for publication in Canada this fall.
In the meantime, there is plenty people can do to improve their chances of warding off diabetes or minimize its damaging effects. The number one rule is keep trim.
“Obesity is the strongest predictor of diabetes,” says London Dr. Stewart Harris of the Centre for Studies in Family Medicine at the University of Western Ontario in London.
Doctors gauge obesity with the Body Mass Index, which measures weight in relation to height. A BMI of 18.5 to 25 is generally considered healthy, but research shows the risk of diabetes starts to climb at 22.
Equally important is where the extra pounds are distributed. Fat collected around the waist carries a much higher risk than fat collected lower down-the apple shape compared to the pear shape.
Tips and tactics
- Be active for at least 20 to 30 minutes a day. Start with simple stretching exercises to increase your flexibility. Then walk, work in the garden, dance or swim.
- Check your blood pressure regularly.
- Reduce fat intake and increase your fibre by choosing whole wheat bread, and fruit and vegetables with the skins left on.
- Drink plenty of water.
- Eat three regular meals a day.
“A lot of elderly people skip breakfast and don’t eat proper meals,” says Ingrid Belinsky, a diabetes educator at the Medicine Hat Diabetes Education Centre in Alberta. Blood sugar tends to be lower with regularly spaced meals.
Lifestyle change positive
If it sounds like a lot of work, there’s a bright side, says Janice Bobryk, a retired nurse in Medicine Hat, Alta., who was diagnosed with diabetes three years ago.
71-year-old Bobryk lowered her blood pressure, cut her cholesterol and keeps active with walking, dance and swimming. Not only is her diabetes well under control, she also says she’s enjoying life more.
“I’ve got more energy and I’m enjoying being much more active. I just feel great.”