Type 2 Diabetes Mellitus (T2DM)
Important note: All information given are just guidelines and prevention options may vary to treatment options. You must consult a medical practitioner before altering, adding to or influencing current treatment or individual practices in any way shape or form.
- Typically the onset of this disease has been after age 40 however there has been a considerable decline in that age in the past decade due to the increase in sedentary lifestyles and obesity levels among children.
- 90% of all Diabetes cases are of Type 2 in relation.
- Inactivity and obesity are the main causes.
- T2DM arises from insulin receptors on cell surfaces of certain body tissue, especially muscle tissue. Blood glucose is not readily transferred into these cells – patient develops hyperglycaemia as a result (high glucose levels in the bloodstream). The pancreas attempts to increase insulin output to compensate-however eventually limits its ability to do this. Over time this continual pressure on the pancrease to overproduce insulin leads to pancreatic functioning failure, leading to a reduced overall insulin output – mimicking symptoms and treatments of Type 1 Diabetes Mellitus.
- Key Point: Avoid – obesity, diet rich in animal and other solid fats, high Glycemic Index (GI) foods and inactivity/sedentary behaviours.
- If associated with obesity T2DM often disappears as weight is lost!
- Medication that decreases glucose production by liver – metformin.
- Medication that increases the ability of the pancrease to release insulin – glipizide
- Medication that increases the body’s response to its own insulin – rosiglitazone.
- Eventually it may be necessary to inject insulin in T2DM, as nothing else may be able to control blood glucose.
- Key Point: Regular physical activity helps the muscles take up more glucose.
- Key Point: Regular meal patterns, emphasis on control of energy, low GI foods consumption and ample fiber intake are necessary in the prevention, maintenance and/or treatment of T2DM.
Note: Most nuts fulfil the last 2 goals of low GI foods and ample fiber content.
- Distributing Carbohydrates (CHO) throughout the day is important – helps minimising high and low swings in blood glucose levels.
- Moderate alcohol consumption is fine.
- Diagnosing T2DM – Plasma Glucose Concentrations (PGC).
Diabetic – Fasting >7.0 PGC 2 Hour Post Glucose Load – >11.1 PGC <7.0 Fasting and <7.8 2 Hour Post Glucose Load PGC is considered normal.
- Hypertension is common as well as high VLDL (very low density lipoproteins) and low HDL (high density lipoproteins) cholesterol levels.
- Role of Insulin – Stimulates glucose uptake and metabolism by muscles and adipose cells. Also inhibits glucose output by the liver and stimulates amino acid uptake and protein synthesis.
- Insulin resistance places a greater demand on the pancreatic capacity to produce insulin, which declines with age, leading to the development of diabetes.
- As the percentage of central abdominal fat increases, insulin sensitivity decreases which means the ability of insulin to lower circulating glucose concentrations is more difficult resulting in greater glucose concentrations in
- HaemoglobinA1C (HbA1C) – changes are steady over time and do not change during day-to-day functioning. Is the key marker to Glycemic control. Reflects mean glucose over the past 2-3 months.
- Total energy – Reduce to cause energy deficit (Approx. 500 kilocalories per day = 0.5 to 1 kg loss per week). Important to note it is not the reduction in energy that is important but the deficit when comparing energy expenditure and intake!
- Fats – Saturated, Polyunsaturated and Monounsaturated intake should be <30% total daily intake.
- CHO – should account for 55-60% of total dietary intake.
- Physical Activity: Skeletal muscles are the biggest net user of glucose (energy) – major site of circulating glucose. Muscle contractions elicit insulin like effects on glucose uptake.
- Recommended guidelines to undertake in 30 min/day of moderate intensity physical activity on most if not all days of the week. Can be cumulative – i.e. Three 10 minute bouts of exercise throughout the day. Individuals should also enjoy some vigorous exercise whenever possible on most if not all days of the week.
*Simple things like taking stairs instead of elevators really do help!
- Key Message: Decrease total fat intake, increase overall fiber intake and increase exercise levels!
- Increase consumption of foods rich in soluble fiber.
- 2 pieces of fruit at least per day – with the skin on preferably.
- 5 vegetables serves per day (1 serve = half a cup).
- Eat lentils and legumes as regular foods.
- Average dietary intake from most Australians is approximately 23 grams of fibre per day. Recommended daily intake is 30-35grams per day.
- High CHO and fiber diets equal improved glycemic control and decreased insulin output, however this is often difficult to achieve and/or maintain.
Filed under: Useful Informations
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