Diabetes: measures that make a difference

Although type 2 diabetes is on the increase, experts say it’s never too late to lower your risk.

When actress Halle Berry shimmies down the red carpet, she always looks the picture of health. Yet, former Bond girl Halle, 44, suffers from type 2 diabetes – an illness the onset of which is often associated with obesity and ageing. “I fell ill – dramatically,” Halle has explained. “I felt I needed energy but I didn’t really know what was wrong. One day, I simply passed out, and I didn’t wake up for seven days.” She was just 23 years old.

Type 2 diabetes occurs when the amount of glucose in the blood is too high as the body cannot use it properly. This is because the pancreas is not producing enough insulin to help glucose enter the body’s cells, or the insulin that is being produced does not work properly (this is known as insulin resistance).

Type 1 diabetes – where no insulin is produced at all because the insulin-producing cells in the pancreas have been destroyed – cannot be prevented or cured, although it can be treated using daily insulin injections. Cases of type 2, however, can be easier to predict, avoid and manage. There are nearly three million cases of diabetes in the UK, with another 850,000 believed to be suffering but as yet undiagnosed, the vast majority of which are type 2.

According to charity Diabetes UK, type 2 tends to develop in adults over the age of 40, or over the age of 25 for those with a south-Asian or African-Caribbean heritage. Risk factors include a family predisposition to the condition, a history of high blood pressure or heart disease, and being overweight — especially around the middle.

The International Chair on Cardiometabolic Risk (ICCR), an international academic group based in Canada, confirmed this in February, revealing the results of the largest, standardised study ever conducted on abdominal obesity as a risk factor for cardiovascular disease and type 2 diabetes. The study shows that individuals with prediabetes have more abdominal fat than those without the condition, and that even when their body mass indexes (BMIs) are low, people with Asian ethnicity are more prone to abdominal fat accumulation. ICCR scientific director Jean-Pierre Després says: “Waist circumference is a simple but effective way to assess abdominal fat.”

Diabetes UK clinical advisor Deepa Khatri agrees: “If your waist size is greater than 37 inches for a man (35ins for a male of south Asian ethnicity) or 31½ inches for a woman, then your chance of getting type 2 notably increases,” adding that our increasingly sedentary lifestyles, fewer home cooked meals and increased junk food consumption are to blame. Type 2 is a serious issue, because although you can control the condition through diet, exercise and medication, as Halle Berry does, if left unchecked, it can lead to permanent nerve damage in the eyes and limbs, in some cases leading to blindness, amputation or coma. It is also a risk factor for heart disease and stroke.

So how can we all reduce our risk? “Look at the way you eat,” says Deepa Khatri. “Keep your diet low in sugar and fat, take regular exercise, and keep your weight and waistline at a healthy level.” “Eat three meals a day spaced regularly: you need to keep blood sugar levels stable,” says Boots nutritionist Vicky Pennington. “And don’t be afraid of carbohydrates or starchy foods – they contain essential nutrients. Just opt for those high in wholegrain or high fibre, or vegetable-based sources, such as potato. “If you have foods with added sugar, keep these as a treat; that also applies to any specially labelled ‘diabetic’ foods. These are not for everyday consumption. “You need to think of your whole lifestyle – not just daily blood sugar levels – as people with diabetes are at higher risk of heart disease.

So cut down on saturated fat — go for monounsaturates such as olive or rapeseed oil — and eat lots of fruit and veg, watching the portion size of sweeter fruits such as grapes. “Include more peas and beans, reduce salt, and try to eat fish twice a week, one portion of which should be oily fish. Alcohol should only be taken in moderation and never on an empty stomach, as it can make blood sugar levels drop.”

As part of any lifestyle changes, those with type 2 need to quit smoking. Harmful to all, smoking leads to complications in diabetes sufferers as they already have impaired circulation. In patients with diabetes smoking can increase nerve damage and raise blood pressure, contributing to increased risk of heart attack and stroke. It’s also crucial to know the symptoms of diabetes, explains Deepa Khatri. “Diabetes comes on silently: by the time you notice changes in your body, it will be under way,” she warns. “Sufferers feel tired, urinate frequently at night, suffer thirst and blurred vision. Simple wounds may be slow to heal. If any of these signs rings a bell, see your GP and ask for a test.” Researchers at the Peninsula Medical School in Devon have developed a home urine test, which should make detection faster and easier in future.

The good news is that, although the condition is not curable, with careful management, glucose levels can be brought to normal. Says Vicky: “Think of the overall health picture: you’ll manage blood sugar levels and reduce your general risk of ill health.” As Halle Berry has confirmed: “I went into hospital on my last breath, and came out feeling a hundred times better. I can honestly say that I am a healthier person than I was before I was taken ill.”

Telegraph UK

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