Canadians can cut diabetes risk



Although he’s been as much as 100 pounds overweight for a long time and has always had a large — and largely indulged — appetite, his blood sugar levels have consistently registered in the normal range. Ditto for his blood pressure and blood cholesterol. His wife, Alison, 63, is not so lucky. She developed type 2 diabetes at age 52 and despite oral medication has a tough time keeping her blood glucose in line.

“I can only attribute escaping diabetes to good genetic luck, not good planning,” says Alex, a retired television production technician in Toronto. “However, I did do a lot of physical work in my job, lifting and carrying technical equipment, and until 10 years ago, I played a lot of recreational sports such as hockey, soccer and baseball.” He thinks that his high physical activity levels may have helped ward off a condition that currently affects about four million Canadians and is poised to strike five million more.

Thanks to a damaged knee, Alex’s sporting life has dwindled to playing a few sets of doubles tennis a week. But he’s drastically cut down on the after-game drinking of his younger days and has lost 35 pounds — courtesy of a healthier, low-fat diet with no refined starches or junk food. “My only snacks are nuts and fresh fruit,” he says.

Alex’s story is a happy one. But with 4.2 million Canadian diabetes diagnoses expected by 2020, it behooves us all to learn more about this life-threatening condition and know the ways to reduce our risk. Diabetes worsens quality of life, shortens length of life and can lead to heart disease, stroke, blindness, kidney failure and amputation. Some 90% of diabetes cases in Canada are type 2, a largely lifestyle-related condition (with some genetic aspects) in which the body becomes resistant to the signals of the pancreatic hormone insulin to take glucose out of the blood and safely store it in cells for future energy.

Canadian Health spoke with Dr. Mary Catherine MacSween, a diabetes specialist at the Moncton Hospital in New Brunswick, for a diabetes update. “There are some new risk factors and at-risk groups emerging,” she says.

What New Risk Factors Have Come to Light?

Too little sleep is turning out to be quite significant. Sleep deprivation leads to hormonal changes and overeating as well as to fatigue, which reduces physical activity. The sedentary, computer-bound jobs held by many of today’s young people are also having an impact. The Amish, who are often overweight but physically active, take 17,000 steps a day and are much less prone to develop diabetes. The typical office worker takes only 4,000 steps a day and is therefore more prone to diabetes.

Are New Groups of At-Risk People Being Identified?

New immigrants to Canada who traditionally ate a different diet and engaged in more exercise in their former countries can develop diabetes if they adopt our habits. (See “Diabetes in Canada”, below) Some of these newcomers may also have had more sun exposure in their ancestral homelands, and their vitamin D levels may drop when they move to a cold northern country like Canada. Lower vitamin D levels are associated with a higher risk of type 2 diabetes.

Being a suburbanite may also increase risk. Research using postal codes has found that people who live in the suburbs have more diabetes than people who live downtown. Downtowners drive less and walk more than suburbanites.

One of the fastest-rising groups with diabetes is women ages 25 to 45. So more babies are being exposed to diabetes in the womb and therefore growing up with risk factors. Prevention is the answer, starting with preconception counselling for women who plan to become pregnant.

Diet And Diabetes

Michelle Corcoran is a registered dietitian and certified diabetes educator at a rural diabetes education centre in New Brunswick. “In reducing the risk of type 2 diabetes, healthy food choices and exercise are paramount,” she says.

Weight Control

Weight Control
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The more body fat you have, the more resistant your cells can become to your own insulin, which can raise your blood sugar levels. A healthy weight translates to healthier blood sugar levels. To ward off weight gain and reduce “bad” low-density lipoprotein cholesterol, eat lower-fat foods such as lean meats, poultry and fish. Eat higher-fibre foods such as legumes, whole-grain breads and pastas and more fruits and vegetables. Reduce your consumption of fruit juices, refined starches and sugary and processed foods. Especially beware of gaining belly fat, the intra-abdominal kind that is risky for both diabetes and heart disease. The good news is that even a small amount of weight loss can improve blood glucose.

Exercise

Exercise
©2011 Thinkstock

Physical exertion promotes a healthier weight by using up blood glucose for energy and making the body more sensitive to the glucose-storage message of insulin. Adults are advised to spend 150 minutes a week (a half-hour a day) doing moderate exercise. Taking a brisk daily walk is an excellent and cheap way of accomplishing this. Adding resistance training with light weights or resistance bands will build muscle mass, which burns off fat faster.

Coffee

Drinking at least two cups of coffee a day, even decaf, helps to reduce the risk of type 2 diabetes, perhaps because of antioxidant acid compounds in coffee.

Alcohol

Alcohol
©2011 Thinkstock

Last year, a large Dutch study reported that moderate alcohol consumption appears to reduce the risk of type 2 diabetes. This year, the Harvard Men’s Health Study found a similar effect for male occasional drinkers.

Breastfeeding

A growing body of evidence suggests that the risk of diabetes may also be reduced in women who breastfeed.


Diabetes In Canada

An aging population, rising obesity rates, sedentary lifestyles and new Canadians from ethnic groups at naturally higher risk — these factors are driving an explosion of type 2 diabetes in Canada.

2.7 million Number of Canadians diagnosed with diabetes (7.6% of the population)

90% Proportion of these who have type 2 diabetes, a largely lifestyle-related condition, versus type 1, which is an autoimmune disease

4.2 million Number of Canadians expected to be diagnosed by 2020 (10.8% of the population)

1 million Number of Canadians with undiagnosed diabetes

5.4 million Number of Canadians living with pre-diabetes

72,000 Estimated number of Canadian deaths each year from diabetes-related causes

$11.7 billion Annual costs to Canada of diabetes

$16 billion Estimated costs of diabetes by 2020 if current trends continue.

— Canadian Diabetes Association


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