Type II diabetes

Alimentation Mode de vie Santé
Le diabète de type II
0 comment

There are two main types of diabetes, type I diabetes and type II diabetes.

In recent decades, the number of diabetes cases has exploded. In Quebec, between 2000 and 2007, the number of people diagnosed with diabetes increased from 295,039 to 453,491, a rise of 53.7%. Today, according to Diabetes Quebec, 880,000 Quebecers live with diabetes, representing about 10% of the population. Among them, 90% have type II diabetes. 

In general, type II diabetes develops in adults. However, due to the increase in childhood obesity rates, it has become increasingly common among children and adolescents. This highlights the importance of adopting good lifestyle habits early in life.

Here is an overview of this chronic disease. 

Definition of Type II Diabetes

Type II diabetes is a disease characterized by insulin resistance leading to an abnormally high level of glucose (sugar) in the blood, also called hyperglycemia. Insulin is a hormone produced by the pancreas that helps control blood glucose levels by stimulating the transport of glucose to cells where it is converted into energy, then used or stored. However, in the case of type II diabetes, even though the pancreas continues to secrete insulin, its production is insufficient due to the insulin resistance developed by the body. Indeed, with insulin resistance, the cells do not respond normally to insulin secretion. As a result, the blood glucose level remains high, leading to the symptoms and complications of type II diabetes.

Risk Factors for Type II Diabetes

Different factors can increase the risk of developing type II diabetes. These factors notably include:

  • Be aged ≥ 45 years
  • Having a sedentary lifestyle
  • Being obese or overweight
  • Having a family history of type II diabetes
  • Belonging to certain ethnic groups (Black, Hispanic, Asian American, or Native American)
  • Having a history of high blood pressure
  • Suffering from dyslipidemia (dyslipidemia is defined as a blood profile where the lipid levels are abnormal)

Type II Diabetes Symptoms

People with type II diabetes can be asymptomatic for several years before being diagnosed. Otherwise, symptoms may include:

  • An increase in urinary frequency and volume
  • An increase in thirst
  • A blurry vision
  • A great weakness
  • A dehydration

Complications of Type II Diabetes

Type II diabetes is a chronic disease that affects blood vessels. They become narrower, which limits blood flow to many organs. Among the organs that can be affected are:

  • Heart (e.g., heart attack)
  • The brain (e.g., stroke)
  • The eyes (e.g., blindness)
  • The kidneys (e.g., chronic kidney failure)
  • Nerves (e.g., foot ulcers)

High blood sugar also affects the immune system, making individuals with type II diabetes more susceptible to bacterial and fungal infections.

Type II Diabetes Diagnosis

The diagnosis of type II diabetes is made by measuring the blood glucose level, called blood sugar. This measurement can be performed by various tests. The main diagnostic tests include:

Tests

Diagnostic values

Fasting blood sugar

≥ 126 mg/dL or 7.0 mmol/L

 

Oral Glucose Tolerance Test (OGTT)

≥ 200 mg/dL or 11.1 mmol/L

 

Glycated or glycosylated hemoglobin (HbA1c)

 

≥ 6.5%

 

Treatment of type II diabetes

The treatment of type II diabetes includes several aspects, including lifestyle changes and sometimes medication:

  • Power Supply
  • Physical exercise
  • Weight loss in case of overweight or obesity
  • Teaching on the disease
  • Different medications and sometimes insulin

The goal of the treatment is to control blood sugar levels, which helps reduce symptoms and the risk of complications. Lifestyle changes, including diet and physical exercise, are a key element of the treatment. Indeed, some people with type II diabetes can avoid or stop taking medication if they manage to control their blood sugar through diet and physical activity alone. Quitting smoking and moderating alcohol consumption are also recommended.

Nutrition Approach for Type II Diabetes

Dietary modification is important in the treatment of type II diabetes. Indeed, nutritional therapy can reduce glycated hemoglobin (HbA1c) by 1 to 2% and even more when combined with other aspects of treatment. Moreover, diet is one of the main factors causing variations in blood glucose levels. Therefore, education on the role of diet in diabetes management by a dietitian is recommended. This education may include the impact of diet on blood glucose, sources of carbohydrates, different types of carbohydrates (e.g., fiber, simple sugars, complex carbohydrates), meal planning, carbohydrate counting, the balanced plate, the basics of healthy eating, and various personalized recommendations. Finally, the nutritional approach can also help achieve or maintain a healthy weight, improve quality of life, prevent symptoms and complications, allow better blood glucose control, and meet nutritional needs.

Dietary Recommendations for Type II Diabetes

The recommendations for the nutritional management of type II diabetes are based on the 2018 Canadian Diabetes Treatment Guidelines and advice from Diabetes Canada. These recommendations may include:

  • Losing weight in overweight or obese individuals.
  • Distribute macronutrients while respecting the reference ranges: between 45 and 60% of energy from carbohydrates, between 15 and 20% of energy from proteins, and between 20 and 35% of energy from lipids. The distribution should be individualized according to the preferences and treatment goals of each individual.
  • Maintain a regular schedule of meals and snacks to optimize blood sugar control.
  • Distribute food intake evenly throughout the day.
  • Added sugars can replace other sources of carbohydrates in a meal, but their amount should not exceed 10% of the daily energy intake.
  • Follow the recommendations of the Canadian Food Guide.
  • Aim for a consumption of 30 to 50 grams of fiber per day, with one-third or more coming from soluble fibers that help reduce cholesterol. Fiber also allows for better blood sugar control.
  • Replace carbohydrates with a high glycemic index (white bread, sweets, sugary drinks) with carbohydrates with a lower glycemic index (legumes, whole grains, vegetables, fruits) to optimize glycemic control.
  • Adopting a dietary pattern such as the Mediterranean, vegetarian, or vegan diet (See the article: Let's demystify vegetarianism and the nutrients to consume) and DASH (See the article: Hypertension: How to Control It and the DASH Diet) or emphasizing the incorporation of legumes, fruits and vegetables, or nuts. These models have been shown to be beneficial for type II diabetes. Choose a model based on individual values, preferences, and goals to achieve better long-term adherence.
  • Cooking from unprocessed or minimally processed foods (See the article: Processed foods and the NOVA classification).
  • Pay attention to the quality and quantity of carbohydrates.
  • Favor unsaturated fats (nuts, seeds, certain vegetable oils, avocado, fatty fish), limit saturated fats, and avoid trans fats to reduce the risk of cardiovascular diseases.
  • Choose lean animal proteins and consume more plant-based proteins (legumes, tofu, tempeh, soy, edamame, nuts, seeds, etc.)
  • Favor water as the daily beverage. Avoid or limit sugary drinks.
  • If consumed, limit the amount of alcohol.
  • Consult a dietitian to obtain individualized recommendations according to the unique needs of each individual and to increase adherence to the prescribed diet.

Type II Diabetes Prevention

Finally, a lifestyle change can generally prevent the development of type II diabetes. Indeed, in overweight individuals, a weight loss of about 7% of the initial weight combined with regular physical activity (e.g., 30 minutes of walking per day) can greatly (> 50%) reduce the risk of type II diabetes.

To learn more about prevention and take the test to find out your risk of developing type II diabetes, visit the preventiondiabetes.ca site.

In case of doubt or desire for guidance, support from health professionals (doctor, dietitian, kinesiologist, etc.) is highly recommended.

References

Article written by:

Marie-Noël Marsan, Nutritionist

Tags: Alimentation, Mode de vie, Santé

Leave a comment

All comments are moderated before posting