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What Is Type 2 Diabetes And Is It Preventable?

Type 2 diabetes is mainly caused by a poor lifestyle such as a bad diet and lack of exercise. So how can you prevent or even reverse it?

Is prediabetes preventable?

Type 2 diabetes is becoming increasingly common, mainly because of an increase in sedentary lifestyles and the prevalence of obesity. So, how can you prevent it and is prediabetes diagnosis reversible?

What Is Type 2 Diabetes?

Type 2 diabetes is when the body is unable to control the level of glucose in the blood resulting in high blood sugar levels.

What Causes Type 2 Diabetes?

Type 2 diabetes is caused when the body is unable to make enough of the hormone known as insulin, or the insulin doesn't work properly so blood sugar levels keep rising.

Insulin is made by the pancreas and it releases the hormone insulin in response to rising blood glucose levels. When we eat, the glucose in our food is absorbed into the bloodstream. The release of insulin allows the circulating glucose to be taken up by our cells, that use it for energy. As a result, the release of insulin slows down and the blood glucose levels return to normal.

In people with type 2 diabetes, the pancreas can become worn out as a result of insulin not working properly or less insulin being produced by the body.  This leads to high higher blood sugar levels.  This puts some people with type 2 diabetes at risk of hyperglycaemia if the condition is not managed.

According to Diabetes UK approximately 90% of people in the UK with diabetes have type 2 which is a serious condition, lifelong condition.  However, it is preventable.

Type 2 diabetes can be caused by:

  • The pancreatic beta cells having trouble producing insulin. So, they may produce some, but not enough to meet the body’s needs; or
  • The insulin doesn’t work as expected. In this case, insulin receptors are insensitive and don’t respond to the insulin in the bloodstream, so blood glucose levels remain high.

Complications Of Type 2 Diabetes

Prolonged increases in blood glucose levels are harmful to the body, particularly the blood vessels. When the blood vessels become damaged, blood is unable to travel effectively around the body, so vital nutrients and oxygen may not reach these parts. Consequently, nerves can also become damaged and when both blood vessels and nerves are damaged in one area of the body, complications can arise.

Complications of type 2 diabetes include:

  • Eye problems
  • Heart attacks
  • Kidney problems
  • Nerve damage
  • Foot problems

What's The Difference Between Type 1 and Type 2 Diabetes?

Type 1 diabetes is when your body attacks the cells in your pancreas preventing it from producing insulin which controls your blood sugar levels.  Whereas type 2 diabetes is when the body is unable to make enough insulin.  It is not known what causes type 1 diabetes but symptoms develop much more quickly than type 2 diabetes.

Type 2 Diabetes Risk Factors

Lifestyle plays a part in type 2 diabetes and being overweight is considered a risk factor, along with age, ethnicity and high blood pressure.  Having a parent or sibling with diabetes also increases your risk of developing type 2 diabetes.  Key risk factors are:

  • Age - those 40+ years of age (25+ years of age for south Asian people)
  • Weight gain and obesity, especially around the middle
  • Being of Asian, African-Caribbean or black African ethnicity
  • Having a close family member with diabetes
  • High cholesterol and triglycerides
  • Hypertension (high blood pressure)

“Being overweight is the most significant risk factor for developing type 2 diabetes and is associated with 80% to 85% of risk.”, Emma Elvin, Senior Clinical Advisor at Diabetes UK.

Type 2 Diabetes Symptoms

Type 2 diabetes symptoms can be tricky to identify as they develop slowly over time, however, symptoms include:

  • Increased thirst
  • Tiredness/fatigue
  • Unexplained weight loss 
  • Needing to urinate more frequently, particularly at night
  • Itchy penis or vagina, or getting thrush more regularly
  • Wounds and cuts taking longer to heal
  • Blurred vision

Is Type 2 Diabetes Reversible?

Type 2 diabetes is a lifelong condition and needs to be managed through diet, exercise and medication.  However, according to Diabetes UK, type 2 diabetes can be put into remission by losing weight and following a low-calorie diet as prescribed by your healthcare professional.  Surgery is also an option for some people to put type 2 diabetes into remission.  

What Is Prediabetes?

Prediabetes isn't a condition but a term used to describe high blood glucose levels.  Levels have to be higher than the normal range but not yet high enough to diagnose type 2 diabetes.  It is estimated that one in three adults in England have prediabetes.

“Prediabetes is a term that some healthcare professionals use to describe when your blood glucose levels are higher than normal, but not high enough for you to be diagnosed with Type 2 diabetes. Prediabetes isn’t a clinical term that is recognised by the World Health Organisation, but some healthcare professionals use it to help them explain that someone is at increased risk of Type 2 diabetes”, Emma Elvin, Senior Clinical Advisor at Diabetes UK.

The best way to identify prediabetes is with a blood test that measures HbA1c.  Unlike blood glucose tests which measures blood sugar levels at the time of the test, HbA1c blood tests provide an average measurement of blood sugar levels over the last 2-3 months.  This means it's a much better way to identify prediabetes and to monitor type 2 diabetes.

As prediabetes predisposes individuals to type 2 diabetes and is a critical stage in its development, it's good to understand if it can be reversed.

Is Prediabetes Reversible?

Yes. Type 2 diabetes itself is a preventable disease. In many cases, it develops because of a poor lifestyle. Therefore, as prediabetes is an indicator of impending type 2 diabetes, it can be reversed by making lifestyle changes.

Lifestyle Changes To Prevent Type 2 Diabetes

Making some simple changes to your lifestyle can reduce the risk of developing type 2 diabetes significantly as well as reversing prediabetes and also putting type 2 diabetes into remission.

Therefore, the following lifestyle changes can help to reduce your overall risk:

  • Weight loss
  • Reducing alcohol intake
  • Quitting smoking
  • Exercise

How Your Diet Can Help Prevent Type 2 Diabetes

Diet is a major risk factor for the development of type 2 diabetes. Convenience foods such as ready meals, fast food and fizzy drinks are thought to be major contributors because they have high sugar, salt and saturated fat contents.

However, you can reduce your chances of developing type 2 diabetes by making changes to your diet. Diets which don’t cause your body to produce lots of insulin are particularly beneficial:

  • Reduce your carbohydrate intake or choose healthier options:
    • Wholegrain bread, pasta
    • Oats
    • Brown rice
  • Incorporate as many fruits and vegetables as you can into your diet
  • Swap snacks like cakes, sweets and crisps for food such as fruit, nuts and seeds
  • Cut out sugary drinks
  • Aim for 2 portions of oily fish per week
    • Mackerel
    • Salmon
    • Tuna
    • Sardines
    • Herring
  • Avoid processed foods
    • Takeaways
    • Fast food
    • Processed ready meals

Alcohol contains a lot of calories and so it increases your chance of obesity which is a risk factor for type 2 diabetes. Plus, alcohol is responsible for reducing the body’s sensitivity to insulin, a cause of type 2 diabetes. Therefore, although you shouldn’t need to give up drinking alcohol entirely, you should limit your intake. Current advice is no one should drink more than 14 units of alcohol per week.

Exercise And Preventing Type 2 Diabetes

A great way to naturally lower your blood sugar levels is exercise.

Exercise reduces the amount of glucose in the blood because muscles can use it as an energy source, even if there is little or no insulin present. Aerobic exercise at a moderate to vigorous intensity has long been recommended to prevent the development of conditions such as obesity and type 2 diabetes. The body’s insulin sensitivity can be improved after just one week of aerobic exercise.

Adults should aim to complete at least 150 minutes of moderate aerobic activity per week. So, you could perform 30 minutes every day for five days and rest for two, it is important you have rest days to let your body recover. Aerobic activities include:

  • Cycling
  • Brisk walking
  • Swimming
  • Gardening

You should combine this with strength exercise on 2 or more days per week, too. Strength exercises should work your major muscles and you may choose weights or your own body weight using exercises like press ups, pull ups or sit ups.

As you progress you may prefer to incorporate some vigorous aerobic exercise into your programme, 75 minutes per week is advisable instead of 150 minutes of aerobic activity. But this should also be combined with strength training. Vigorous intensity aerobic activities include:

  • Running
  • Swimming laps
  • Playing singles tennis
  • Hiking

Additional benefits of exercise are:

  • Increases good cholesterol and reduces bad cholesterol
  • Better mental health
  • Lower blood pressure
  • Better weight control
  • Strong Bones
  • Better sleep
  • Increased energy levels
  • Stronger muscles

If you have type 2 diabetes or you think you may be at risk, you should speak to your doctor before starting any new exercise. Making changes to your diet and increasing your physical activity levels can help to reduce the risk of developing type 2 diabetes, reverse prediabetes and even put type 2 diabetes into remission.

Summary

An HbA1c blood test is the best way to check for type 2 diabetes. If blood glucose levels are high to indicate prediabetes then lifestyle changes can be made to prevent it developing into type 2 diabetes. In the UK, up to 10% of people diagnosed as prediabetic go on to develop diabetes.  Type 2 diabetes can be reversed through diet and exercise, as well as surgery. 

Making simple yet effective changes to your lifestyle can dramatically reduce the chance of developing the type 2 diabetes and can even reverse prediabetes. The two biggest factors are diet and exercise.

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HbA1c (pre-diabetes)

Our HbA1c blood test measures average blood glucose levels over a 10-12 week period. Gain accurate data on the amount of sugar in your diet and reduce your risk of type 2 diabetes.
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References

  1. Diabetes Digital Media Ltd. (2019). Prediabetes (Borderline Diabetes). Available at: https://www.diabetes.co.uk/pre-diabetes.html
  2. National Health Service. (2014). One in Three Adults in England ‘Has Prediabetes’. Available at: https://www.nhs.uk/news/diabetes/one-in-three-adults-in-england-has-prediabetes/
  3. Rynders, C, A et al. (2014). Effects of Exercise Intensity on Postprandial Improvement in Glucose Disposal and Insulin Sensitivity in Prediabetic Adults. The Journal of Clinical Endocrinology and Metabolism: 99(1), pp 220-228.
  4. Tuso, P. (2014). Prediabetes and Lifestyle Modification: Time to Prevent a Preventable Disease. Perm J: 18(3), pp 88-93.
  5. https://www.diabetes.org.uk/type-2-diabetes

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