Once considered a disease of minor importance, diabetes is now viewed as one of the major threats to human health. In South Africa, over 8% of adults aged between 20 – 79 years have diabetes and, frighteningly, it’s believed that up to 80% of all diabetes goes undiagnosed in Africa.
And it’s getting worse. In 2000, diabetes was estimated to directly affect 171 million people worldwide and to account for at least 3.2 million deaths – or six deaths every minute. In 2007, the International Diabetes Federation (IDF) predicted that by 2025, some 380 million people would have diabetes, with approximately 70% living in low and middle income countries. By 2013, the IDF revised this estimate and their data reveals that 382 million people already have diabetes.
“What is causing this epidemic?” asks Dr Peter Hill, from Met-S Care and a specialist in Metabolic Syndrome, a cluster of chronic conditions that include, amongst others, increased blood pressure, a high blood sugar level (or Type 2 diabetes), excess body fat around the waist and abnormal cholesterol (low HDL cholesterol) and high blood fat levels (triglyceride). “Poor lifestyle and unhealthy diets are a major factor behind the increase.”
“However, it’s important to note that approximately 90% of all Type 2 diabetes can be prevented by modifying lifestyle and adopting an appropriate ‘Food as Medicine’ approach. Prevention, rather than treatment, is the most cost-effective way of addressing this very serious chronic disease.”
There are two main types of diabetes. Type 1 diabetes is an autoimmune disease that often occurs in childhood, although adults can also develop this type of diabetes. Type 2 diabetes accounts for between 85% and 95% of all diabetes. It is a condition of Metabolic Syndrome and a result of insulin resistance rather than simply of high blood sugar. It is a major risk factor for other serious chronic diseases including heart disease, dementia, some cancers, kidney disease and depression.
How do you know if you’re at risk of developing diabetes? Males with a waist circumference greater than 102cm have a 22 times greater risk of developing diabetes, while women with a waist circumference greater than 89cm are 32 times more likely to develop diabetes.
“Other risk factors include, amongst others, increasing age, a family history of diabetes, a sedentary lifestyle, hypertension, impaired glucose tolerance and even ethnicity,” says Hill. “However, increasing exercise and improving your diet has been shown to reduce the risk of developing Type 2 diabetes in people in high-risk groups. High carbohydrate diets are a well-known contributing factor to increased insulin resistance, which in turn is associated with obesity, and Type 2 diabetes.”
Insulin resistance means that cells have lost some of their sensitivity to the hormone insulin. Insulin is secreted by the pancreas in response to a rise in blood sugar (glucose), which comes mainly from starch, sugar and other refined carbohydrates. “Bread, pasta, biscuits, cakes, breakfast cereals, sweets and chocolate, sugar sweetened beverages, fruit juice as well as the overconsumption of some fruits and vegetables are just some of products that drive our insulin levels,” he says.
Re-establishing an insulin balance is key in terms of managing and preventing diabetes, and restricting the amount of carbohydrates in your diet is one of the most effective interventions for reducing all of the features of Metabolic Syndrome.
“When it comes to tackling the increase in diabetes and other lifestyle diseases, consumer education and self-care is essential. While medical care remains important, people need to be educated and empowered to be able to take charge of their own health,” advises Dr Hill.