It might surprise you to know that one of the biggest killers on earth isn’t a person or a pathogen. Diabetes causes, each year, around 50,000 cases of kidney failure, 75,000 lower extremity amputations, 650,000 cases of vision loss and around 75,000 deaths annually. It has been described as the new bubonic plague. More than 29 million Americans are living with diabetes today, or around 9 per cent of the population.
So let's break it down, because sometimes it's hard to find the facts.
Diabetes is a condition characterised by elevated levels of sugar in the blood, either because your pancreas isn’t making enough insulin to keep your blood sugar at normal levels (type 1 diabetes), or because your body has become resistant to insulin (type 2 diabetes). Both of these conditions lead to too much sugar building up in the blood, overwhelming the kidneys and spilling into the bloodstream.
The exact causes of type 1 diabetes are not known, but the condition leads to the immune system attacking and destroying insulin-producing cells. This is obviously bad news because these cells are necessary to keep blood sugar levels down. Dealing with Type 1 diabetes requires intervention – specifically injections of insulin to make up for the lack of internal production. This is basically a kind of hormone replacement therapy.
Type 2 diabetes is slightly more straight forward and relies on the concept of insulin resistance, which, as we covered above, is where your body has enough insulin but the insulin doesn’t lower the amount of sugar in the blood. So how does it all fit together? The latest research suggests that there is a combination of carbohydrates, fat and sugar at play which we need to explore.
Let's think about in three steps. The first step happens when we eat carbs. We grab that sandwich, potato or rice meal, and our body goes to work, breaking down the starch into glucose. Over a period of time, that glucose gets transported through the body as blood glucose (step 2) and then gets stored in our muscles for stored energy (step 3). When we work out, we use that stored energy as fuel. Along the way, during step 2, the amount of sugar in our blood is dealt with via insulin, which more or less coats the glucose cells and invites them into our muscles. No insulin, no invite, and the sugar stays in the bloodstream. That’s why with type 1 diabetes, where is no insulin, blood sugar stays so high. The question is why, for people with type 2 diabetes, the insulin isn’t doing the job and inviting the glucose in to be burned. The answer is a complex story of fat and sugar.
Research into type 2 diabetes has found that insulin does not work as well when there is an excess of fat cells in the blood, with this coming both from what we eat and what we wear. Carrying excess body fat is the number one risk factor for the development of type 2 diabetes. In obese people, fat cells spill fat back into the bloodstream, causing a similar effect to what a person has when they eat a particularly fatty meal. So the problem becomes somewhat of a triple banger. An obese or overweight person who has a diet high in sugar or in simple carbohydrates, combined with a tendency to eat high saturated fat meals, causes a lot of blood sugar trying to find a home within muscles, but where the insulin required to deal with it is being impeded by the fat cells. Bottom line, high blood glucose levels and the existence of conditions which give rise to type 2 diabetes.
The good news is that we can actively remove the risk factors for type 2 diabetes by making changes on both the diet side and the exercise side. There are three simple rules. Firstly, lower the blood sugar situation directly by avoiding sugary drinks and simple carbohydrate meals. Secondly, try to shift away from having saturated fats; mainly dairy and meat – at every meal. Thirdly, try to drop some weight with moderate exercise every day. By eliminating the double banger of high sugar and lowering the number of fat cells in the system, we keep our insulin as effective as it needs to be.
Good health means a good life. Go for walk guys, and watch what you eat today. Your life may just depend on it. Stay old man strong.