/ 9 March 2012

Three-pronged plan to tackle diabetes

If you have been diagnosed with type 2 diabetes, you’re hardly alone. It’s been estimated that more than 1.5million South Africans have this form of diabetes. And, according to the World Diabetes Foundation, up to 85% of these people are unaware that they have a disease that can, over time, be life-threatening.

So what is this condition? In a nutshell, type 2 diabetes, which is the version 90% of diabetics have, is a chronic illness that is caused when the insulin produced in your pancreas is not working as effectively as it should. Insulin is the hormone that tightly controls the level of glucose in the bloodstream and helps to convert that glucose into energy in cells throughout your body.

Who should be concerned? Everyone who is overweight, over 40 and not overly keen on visiting the gym needs to have a blood sugar test.

If you have been diagnosed with type 2 diabetes, you are going to have to make some adjustments to your lifestyle to control your blood sugar levels so that you can live as normal a life as possible.

Attacking type 2 diabetes
Basically, your plan of attack against type 2 diabetes needs to be on three fronts: diet, exercise and possibly medication.

When it comes to your diet, your doctor can provide a healthy eating plan. Basically, you need to be on a low-GL (glycaemic load) diet for the rest of your life. But this is not onerous. It just means eating more high-fibre foods such as fruit and vegetables. Also, consume more carbohydrate-rich foods that release their sugar content slowly into the body: brown rice, as well as wholewheat bread and pasta, instead of refined foods that will cause your blood sugar level to spike. Moreover, you need to avoid sugary foods and drinks and get into the habit of checking labels in the supermarket.

Moderate exercise needs to be a daily habit. When you can, walk instead of drive. Take the stairs instead of the lift. If you are going to embark on more rigorous exercise such as running, cycling or joining the local gym, first chat to your doctor, then start slowly and build up gradually.

Drugs to control glucose levels
If your blood glucose levels are still high, your doctor may decide to prescribe medication. There are various drugs that work in different ways, but probably the most commonly prescribed drug for controlling type 2 diabetes is Metformin.

It’s what’s called a biguanide and it works to lower your blood sugar by increasing insulin sensitivity in the muscles so that they use more insulin.

Metformin also increases insulin sensitivity in the liver, causing that organ to release less glucose.

If your condition is more serious, then insulin will be prescribed.

These are the tactics that need to be adopted to try to control type 2 diabetes. But the challenges that come with them are immense. For instance, getting people to change their diet, even slightly, can be a tall order. The fact that 71% of South Africans have never gone on a diet or tried to cut down on their food intake is a seriously worrying statistic.

Exercise is the key to a healthy lifestyle
Getting people to take fitness to heart is another obstacle. Again, the statistics do not bode well as 49% of South Africans do no exercise whatsoever.

The third stumbling block concerns the taking of medication. It is a world-wide phenomenon that many chronic patients stop taking their medication within the first few months of it being prescribed.

Mediscor, in its 2007 review, estimated that 50% of South Africans don’t take their drugs as they should. The reasons for this have been stated in various studies and include forgetfulness (25%), lack of knowledge (15%) and adverse side effects (21%).

A major challenge is that type 2 diabetes is asymptomatic, which means there are no obvious symptoms. These will manifest only when the condition has caused real and irreversible damage to your body, such as blindness, heart attacks, strokes, kidney failure, impotence and the amputation of limbs.

Diabetes will be the topic of Bonitas House Call on March 17 at 9am on SABC2