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 rose from 295,039 to 453,491, an increase of 53.7%. Today, according to Diabète Québec, 880,000 Quebecers live with diabetes, or about 10% of the population. Of these, 90% have type II diabetes.
Usually, type II diabetes develops in adults. However, due to the increase in the rate of childhood obesity, it has become increasingly common among children and adolescents. This underlines 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 causing abnormally high levels of glucose (sugar) in the blood, also called hyperglycemia. Insulin is a hormone produced by the pancreas that helps control the level of glucose in the blood by stimulating the transport of glucose to cells where it is converted into energy, then used or stored. However, in type II diabetes, even if the pancreas continues to secrete insulin, its production is insufficient due to the insulin resistance developed by the body. This is because with insulin resistance, 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
There are different factors that can increase the risk of developing type II diabetes. These factors include in particular:
- Be 45 years olds
- Have a sedentary lifestyle
- Being obese or overweight
- Have a family history of type II diabetes
- Belong to certain ethnic groups (Blacks, Hispanics, Asian Americans or Native Americans)
- Have a history of high blood pressure
- Have dyslipidemia (dyslipidemia is defined by a blood profile where the lipid level is abnormal)
Symptoms of type II diabetes
People with type II diabetes can be asymptomatic for several years before being diagnosed. Otherwise, symptoms can include:
- An increase in the frequency and volume of urine
- Increased thirst
- Blurred vision
- A great weakness
Complications of type II diabetes
Type II diabetes is a chronic disease that affects the blood vessels. They become narrower which limits blood flow to many organs. Among the organs that can be affected are:
- The heart (e.g. heart attack)
- The brain (e.g. stroke)
- The eyes (e.g. blindness)
- The kidneys (e.g. chronic renal failure)
- Nerves (e.g. foot ulcers)
High blood sugar also affects the immune system, making people with type II diabetes more susceptible to bacterial and fungal infections.
Diagnosis of type II diabetes
The diagnosis of type II diabetes is made by measuring the level of glucose in the blood, called blood sugar. This measurement can be carried out by various tests. The main diagnostic tests include:
Fasting blood sugar
≥ 126 mg / dL or 7.0 mmol / L
Oral hyperglycemia (OGTT)
≥ 200 mg / dL or 11.1 mmol / L
Glycated or glycosylated hemoglobin (HbA1c)
Treatment of type II diabetes
The treatment of type II diabetes involves several aspects, including lifestyle modification and sometimes medication:
- Physical exercise
- Weight loss in case of overweight or obesity
- Disease education
- Different medications and sometimes insulin
The goal of treatment is to control blood sugar levels, which helps reduce symptoms and the risk of complications. Lifestyle modification, including diet and exercise, is a key part of treatment. This is because some people with type II diabetes may avoid or stop taking medications if they can control their blood sugar through diet and physical activity alone. Smoking cessation and moderation of alcohol consumption are also recommended.
Nutritional approach for type II diabetes
Diet modification is important in the treatment of type II diabetes. This is because nutritional therapy can reduce glycated hemoglobin (HbA1c) by 1% to 2% and even more in combination with other aspects of treatment. In addition, diet is one of the main factors causing blood sugar fluctuations. Therefore, education of the role of diet in the management of diabetes by a dietitian is advised. This teaching may include the impact of diet on blood sugar levels, sources of carbohydrates, different types of carbohydrates (e.g. fiber, simple sugars, complex carbohydrates), meal planning, carbohydrate counting, balanced plate, the basics of a healthy diet 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 sugar control and meet nutritional needs.
Dietary recommendations for type II diabetes
Recommendations for the nutritional treatment of type II diabetes are based on the 2018 Canadian Guidelines for the Treatment of Diabetes and advice from Diabetes Canada. These recommendations may include:
- Lose weight in overweight or obese individuals.
- Distribute the macronutrients while respecting the benchmarks: between 45 and 60% of the energy for carbohydrates, between 15 and 20% of the energy for proteins and between 20 and 35% of the energy for lipids. The distribution should be individualized according to the preferences and treatment goals of each individual.
- Maintain a regular meal and snack schedule to optimize blood sugar control.
- Distribute food intake in a balanced way throughout the day.
- Added sugars can replace other sources of carbohydrates in a meal, but their amount should not exceed 10% of daily energy intake.
- Follow the recommendations of Canada's Food Guide.
- Aim for an intake of 30 to 50 grams of fiber per day with a third or more coming from soluble fiber which helps lower cholesterol. Fiber also allows for better glycemic 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.
- Adopt a food model such as the Mediterranean, vegetarian or vegan diet (See the article:Let's demystify vegetarianism and its nutrients to consume) And DASH (See article:High blood pressure: 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 in order to achieve better long-term grip.
- Cooking from unprocessed or minimally processed foods (See article:Processed foods and the NOVA classification).
- Pay attention to the quality and quantity of carbohydrates.
- Favor unsaturated fats (nuts, seeds, certainvegetal oils, avocado, oily fish), limit saturated fat and avoid trans fat to reduce the risk of cardiovascular disease.
- Opt for lean animal proteins and consume more vegetable proteins (legumes, tofu, tempeh, soy, edamame, nuts, seeds, etc.)
- Favor water as a daily drink. Avoid or limit sugary drinks.
- If consumed, limit the amount of alcohol.
- Consult a dietitian to obtain individualized recommendations based on the unique needs of each individual and to increase adherence to the prescribed diet.
Prevention of type II diabetes
Finally, lifestyle changes can usually prevent the development of type II diabetes. Indeed, in overweight people, a weight loss of about 7% of the initial weight in combination with a practice of regular physical activity (eg: walking for 30 minutes per day) can greatly (> 50%) reduce the risk of type II diabetes.
To learn more about prevention, and get tested to know your risk of developing type II diabetes, visitdiabetes prevention.ca website.
In case of doubt or the desire to take charge, support from health professionals (doctor, dietitian, kinesiologist, etc.) is strongly recommended.
- https://www.merckmanuals.com/fr-ca/accueil/troubles-hormonaux-et-m%C3%A9taboliques/diab%C3%A8te-sucr%C3%A9-ds-et-troubles-du-m% C3% A9tabolism-de-la-glyc% C3% A9mie / diab% C3% A8te-sucr% C3% A9-ds
- https://www.merckmanuals.com/fr-ca/professional/troubles-endocriniens-et-m%C3%A9taboliques/diab%C3%A8te-sucr%C3%A9-et-troubles-du-m%C3% Carbohydrate-metabolism / diab% C3% A8te-sucr% C3% A9query = Diab% C3% A8te% 20sucr% C3% A9% 20 (DS))
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- Blais, Chantal. November 2018. Nutritional treatment of type 1 & 2 diabetes in adults. Clinical Nutrition 2054 Endocrinology. Montreal: University of Montreal.al.