The number of people with diabetes is growing. Type 2 diabetes is a serious chronic disease. People living in poverty have higher rates of the disease. People from the following ethnic groups are at a higher risk of developing type 2 diabetes-South Asian, East Asian, Black, Indigenous, and Latin American. We, as Bangladeshis are at a very high risk of developing type 2 diabetes.
The good news is that type 2 diabetes can be prevented or delayed. Culturally appropriate and accessible health education with the focus on type 2 Diabetes can prevent and delay the chronic disease. Members of a community can help each other in making changes towards a healthier lifestyle. Regular physical activities, healthy eating and coping with stress are the three components of preventing type 2 diabetes. Walking programmes, community gardens, cooking programmes should be encouraged and organised among community members to prevent diabetes.
What is Diabetes?
Diabetes develops when the body can’t properly use or produce enough of the hormone insulin. Insulin helps glucose (a type of sugar) enter our body’s cells where it can be used as energy. When our insulin doesn’t work well or we don’t have enough of it, we get higher levels of glucose in our blood. There are three types of diabetes:
About 10% of people with diabetes have type 1 diabetes. It cannot be prevented. Most often it is found in children and adolescents. The pancreas does not produce any insulin. As a result, type 1 diabetes patients must take insulin injections. The cause of this type of diabetes is not known.
About 90% of people with diabetes have type 2 diabetes. It can be prevented or delayed, that’s the good news! It usually occurs in adults over the age of 40, but rates are rising in younger people too. For this type of diabetes, the body does not make enough insulin to move the glucose from the blood into the cells or does not properly use the insulin it makes. And glucose builds up in the blood instead of being used for energy. This can lead to serious health problems.
Between 3-20 % of pregnant women develop gestational diabetes, depending on their risk factors. This means, they have high blood glucose during pregnancy. It is a temporary condition that occurs during pregnancy. If a pregnant woman is diagnosed with gestational diabetes, both she and her child are at higher risk of developing diabetes in the future.
Type 1 and Gestational Diabetes cannot be prevented.
Complications of type 2 Diabetes:
· Diabetes can be life threatening. There are very serious complications of type 2 diabetes. It can lead to loss of vision and blindness. Regular eye exams can help detect problems that can be treated if found early.
· Diabetes can damage arteries, which may result in high blood pressure that can lead to stroke, heart failure or heart attack. People with diabetes need to monitor their blood pressure and cholesterol levels.
· Kidney damage can develop in some people with diabetes. If left untreated, it can lead to kidney failure.
· Diabetes can damage nerves, especially in feet. As a result, people may not feel a foot injury, such as blister or cut. It can quickly become infected. This can lead to serious complications such as amputation. It is important for people with diabetes to regularly check their feet and skin for wounds.
Symptoms of type 2 diabetes:
· Being thirsty often
· Frequent urination
· Weight change (gain or loss)
· Feeling tired or having no energy.
· Blurred vision
· Cuts or bruises that are slow to heal
· Tingling or numbness in hands or feet.
In some cases, a person can have diabetes but not have any signs or symptoms.
What can we do to lower our risk of type 2 diabetes?
· Be physically active:
The Canadian Physical Activity Guidelines recommend that adults do at least 150 minutes (2.5 hours) per week of moderate to vigorous aerobic physical activity to achieve health benefits. It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week. Walking is the number one physical activity in Canada. It is easy and can be done by people of all ages, in many places, all year long.
· Eat well:
Healthy eating is not about one food or one meal eaten in a day. It is the everyday pattern of the food you eat that makes up a healthy life style. Canada’s Food Guide describes how much food we need and what foods to choose most often for healthy eating. The healthy plate model according to Canada’s Food Guide is a unique example to eat healthy. Half of the plate should be vegetables; one quarter is grain products and the last quarter of the plate is for meat and alternatives. We should have fruits, dairy products, and a little fat in our meals too.
· Maintain a healthy weight
Maintaining a healthy weight is a step towards better overall health and includes being physically active and eating well.
· Live tobacco-free:
People who smoke or use tobacco are at least 50% more likely than non-smokers to get type 2 diabetes.
· Cope with stress in a healthy way
Stress can affect our physical body, our thoughts, our feelings, and behaviour. There is no right or wrong way to deal with stress. What works for one person may not work for another. Also, depending on the situation we may need different strategies. There are three basic types of coping skills- physical (body) coping skills, mental (mind) coping skills, personal/social coping skills. All three types are useful to help dealing with stress in our lives.
Type 2 diabetes is a serious chronic disease that can cause serious health problems. By taking small steps we can prevent or delay the onset of type 2 diabetes as well as other chronic diseases. Get moving, be physically active, eat healthy, achieve a healthy weight that is right for you, see a health care provider regularly, and find healthy strategies that help you cope with stress, live tobacco free. Getting healthier begins with small steps, add more steps as you go. Every step counts recognise, your successes, large or small.
(This article has been written based on Toronto Public Health’s “Preventing Type 2 Diabetes, One step at a Time” education guide.)
*Mahmuda Nasrin is Diabetes Peer Leader, North York Community House
& TESL Ontario certified Teacher, former professor (English) at King Khalid University, Saudi Arabia and at Khulna University, Bangladesh.