Understanding Type 2 Diabetes

According to the Ministry of Health, currently there are over 250,000 people diagnosed with diabetes in NZ, with the clear majority of those being type 2 diabetes. That’s around 5% of the population, and of course, this doesn’t take into account the number of undiagnosed which is thought to be roughly another 100,000 people.

The Ministry also states the current cost of diabetes to the country is approximately 2.1 billion dollars. With recent predictions of a 70-90% increase over the next 20 years, and bearing in mind that this is only the quantifiable financial cost (not taking into consideration the emotional toll or loss of productivity in the workplace), these figures paint an alarming picture. Therefore, it is very clear, action must be taken if we wish to avoid the predicted impacts of type 2 diabetes in New Zealand.

One of the best ways to create lasting change is by building knowledge. So read on to learn more about type 2 diabetes, its symptoms, causes and what you can do to help manage this disease. Please note; all of the information provided in this article is intended as a guide only; always consult medical professionals for assistance with diabetes and other medical concerns or conditions.

What Does Being Type 2 Diabetic Mean?

Type 2 diabetes is the most common form of diabetes in New Zealand and around the world. It is a disease that is identified by high blood glucose (sometimes called blood sugar) levels that are consistently elevated.

Why are the blood sugar levels so high? When you have Type 2 diabetes, your body does not respond well to insulin—at first, needing to produce more than usual for it to perform its job of allowing glucose to enter the cells where it is stored for energy—and later facing the dilemma of never being able to produce enough. This is called insulin resistance.

The pancreas releases insulin to regulate how much glucose enters the cells, but for those with Type 2 diabetes, due to their insulin resistance, producing and regulating the production of insulin is an issue. As a result, the body doesn’t make enough insulin and not enough glucose gets drawn out of the blood and into the cells, meaning high levels of sugars build up in the blood.

Common Symptoms Of Type 2 Diabetes

While symptoms vary according to the individual, and in fact, sometimes there can be no symptoms at all, early diagnosis of diabetes is always beneficial. According to Diabetes NZ, some of the typical symptoms of diabetes to look out for are:

• Feeling tired and lacking energy
• Feeling thirsty a lot
• Going to the toilet often
• Frequent infections
• Getting infections that are hard to heal
• Poor eyesight or blurred vision
• Often feeling hungry

If you have some or any of these symptoms it is best to schedule a visit to your doctor. As part of the diagnosis of diabetes, you will likely be required to get blood tests done. The blood tests are a very simple procedure, and the results will be sent directly to your doctor.

What Is The Difference Between Type 2 Diabetes And Type 1?

There are two types of diabetes, type 1 and type 2. The main difference between type 1 and type 2 diabetes is that people with type 1 diabetes don’t produce any insulin. Whereas people with type 2 diabetes can produce some insulin, but their body doesn’t respond as it should and/or they don’t make enough insulin.

For further clarification, type 1 diabetes is an autoimmune disease where the immune system destroys the cells that make insulin. Type 1 diabetes develops quite quickly, and the cause is largely unknown. Because the body is unable to make any insulin (which regulates glucose levels in the blood) type 1 diabetes results in uncontrollable levels of blood sugar which can lead to very serious consequences. Being diagnosed with and managing type 1 diabetes is very different to type 2.

Type 2 diabetes is usually considered a progressive disease, meaning it gets worse over time without proper treatment and/or lifestyle changes. For this reason, many people may not realise they have type 2 diabetes for some time. If not corrected, the cells that produce insulin in the pancreas will continue to get damaged or even die, and your body is then able to make even less insulin to balance your blood glucose. For the purposes of this article, we are only discussing type 2 diabetes and its associated causes and characteristics.

Risk Factors For Type 2 Diabetes

What causes type 2 diabetes? The likely causes of developing type 2 diabetes can be summarised into two broad categories; genetics and lifestyle choices. Let’s take a look at what this means in real-life terms:

• Being Overweight.Although not everyone with type 2 diabetes is overweight, it is widely accepted that obesity is one of the most common causes of type 2 diabetes especially if you carry most of your weight around your waist.
• Sedentary Lifestyles. Consistent inactivity in both your job and personal life is the second most common cause of type 2 diabetes, making it essential to incorporate exercise into your daily routine. Exercise helps with mental wellbeing while also helping maintain or reduce body weight, and it also makes your muscles use more glucose (lowering glucose levels in the body).
• Family History. Genetics also plays a part in determining common causes behind those who develop type 2 diabetes. This is why family members such as grandparents, parents, brothers or sisters with existing diabetes are taken into account when making a diagnosis.
• Another purely genetic cause, people of Maori, Asian, Middle Eastern or Pacific Island descent are thought to be more prone to developing type 2 diabetes.
• Existing Medical Conditions. There are numerous medical conditions that may contribute in some way to developing diabetes. High blood pressure is an excellent example of an existing medical condition that leaves people pre-disposed to type 2 diabetes, as is having previously had gestational diabetes.
• A diet high in processed food, sugar and salt is thought to be a prominent determining factor in developing type 2 diabetes. This is due to a whole host of factors, too many to go into here, but poor nutritional value and associated weight gain are good examples of the side effects of consistently making unhealthy food choices.
• Research shows the risk of type 2 diabetes increases as we age, especially after 45 years of age.
• Lack Of Quality Sleep. Working long hours or shift work affecting the normal circadian rhythms can make it difficult to maintain good eating and sleeping routines. Something as simple as not getting enough time in the direct sunlight, which can affect serotonin levels – can be a contributing factor to poor quality sleep.  
• It is possible stress can also play a part in increasing the likelihood of developing diabetes as it often leads to poor food choices, a physically inactive lifestyle and other medical conditions that may prevent leading a healthy lifestyle.

What Is Gestational Diabetes?

Gestational diabetes is when a mother develops diabetes during pregnancy. The good news is that gestational diabetes usually resolves itself after giving birth. The bad news is it can cause complications during the pregnancy, lead to a greater chance of developing postnatal depression after the birth and create a greater predisposition to developing type 2 diabetes later in life.

The Difference Between Diabetes And Prediabetes

Prediabetes is a kind of warning signal prior to developing diabetes, it is usually picked up from blood tests that show elevated blood sugar levels. To be classified as prediabetes, the blood sugar levels are almost there but not quite high enough to be considered diabetic. Research for those with prediabetes shows that type 2 diabetes is likely to develop within ten years without intervention.

Pre-Diabetic? What You Can Do To Avoid Becoming Diabetic

The important thing to remember with prediabetes is that progressing to type 2 diabetes isn’t inevitable. For many people, the right lifestyle changes such as weight loss, increased exercise and healthier eating can aid in bringing blood sugar levels back to a more normal range.

In daily life, this could mean making healthier and more informed food choices, getting regular exercise, focusing on sleeping well, and making time for relaxing and enjoying life. Now, this is obviously easy to say, and we all have the best of intentions, but putting all of these intentions into regular practice can be a bit more challenging.

A good way to go about making changes to your lifestyle is to take a step back taking in the big picture, as it were. Are there positive changes that you can easily make? Maybe going for a regular walk in the evening with a friend. Taking the time to read food labels or doing a course on understanding the ins and outs of better nutrition to help with food purchase decision-making.

Having made a good start, now look for changes that could be considered a work-in-progress. This could be as simple as learning to cook healthier food. A quick online search (try Diabetes NZ) and you can find any number of recipes designed specifically for people with diabetes – why not add these to your food routine, slowly building more and more of them in. Or you could seek out pre-made foods that are diabetic friendly such as cereals and other whole food type meals.  

Finally, you will need to single out some of the big stuff that may require some pretty important life decisions. This could mean changing jobs to avoid shift work or long hours, sedentary days or nights, or looking at ways to heal or improve existing medical conditions.

3 Ways To Help Manage Type 2 Diabetes

Having been diagnosed with diabetes, the ongoing goal is to better control blood glucose levels and improve the body’s use of insulin. What you can do to achieve this is by focussing on all aspects of your health and wellbeing, but primarily this will include:

• Weight Loss. One of the main things you can do to improve the body’s use of insulin is to maintain a healthy body weight.
• Healthy Diet, And Exercise. A greater awareness of good food choices and achieving regular exercise work together to help maintain healthy blood glucose levels.

1. Diabetes And Weight Loss

Why is losing weight so important for people with diabetes? Obesity is a widely accepted major risk factor for developing insulin resistance, and we have already learned that insulin resistance is a significant factor in developing type 2 diabetes.

Everybody has different ideal healthy weights based on height, body mass and other factors. However, the Ministry of Health makes the following recommendations regarding adults losing weight for diabetes.

“Aim for 5-10% loss of total body weight if the patient is overweight (BMI > 30 kg/m2 OR BMI > 25 kg/m2 with waist circumference > 88 cm in women or > 102 cm in men) by developing an individualised weight management plan”

Managing your weight is an integral part of managing your diabetes however, tackling weight management issues usually requires a very individual approach best handled by professionals such as dietitians, nutritionists and doctors.

Watch your portion sizes, here at Te Atatu Toasted, we make it easy, you can request a portion cup when you order your cereal online.

2. Healthy Food Choices For Diabetics

Eating healthily offers two main advantages, it aids in losing weight and helps maintain general health and wellbeing. For these reasons and others food is vital in managing diabetes, but it pays to keep in mind that it is not the complete answer – think of more as an important piece of the puzzle!

The Ministry of Health recommends a diabetic’s diet should contain regular meals with a focus on “a moderate amount of nutrient-dense and low glycaemic index (GI) carbohydrates” spread throughout the day, a reduced sugar intake, reduced saturated and trans fats and at least 30 g of dietary fibre per day.

Different dietary strategies mentioned by the Ministry of Health are; very low-energy diets (VLED) with meal replacements, the Mediterranean Diet, the dietary approach to stop hypertension (DASH) diet, intermittent fasting, the Low GI Diet, vegetarian diets, very-low-carbohydrate (Keto) diets and commercial weight loss programmes. It is important to note; that their website also states there is no conclusive evidence that one dietary strategy might be more effective than another and that an individual’s approach to losing weight and eating healthier will depend on a number of factors.

For the purposes of this post and to put it in more generalised food terms, a healthy diet for people with diabetes should consist of mainly wholefoods. Examples might include whole grains, seeds and nuts, fruit, vegetables and protein. See here for more information on healthy food choices for diabetics.

Our Top 8 Healthy Food Tips

Here are our top 8 healthy food tips for type 2 diabetes (Please keep in mind any dietary changes or advice should be discussed with your doctor, nutritionist or registered dietitian).

1. Look For Low GI Carbs. Some carbohydrate foods are digested more slowly (low glycaemic index), which avoids spikes in blood glucose levels. These types of slow-release carbs are better for people with diabetes, examples include; wholegrain breads, wholegrain cereals (for example, traditional rolled oats or low sugar, complex-carb heavy muesli), whole grain pasta, brown or basmati rice and legumes (dried or canned peas, beans, lentils, and chickpeas).
2. Combine Your Protein And Carbs. Eating protein in conjunction with complex carbohydrates can help provide a more gradual and even energy (sugar) release into the bloodstream.
3. Fresh Or Frozen Only. Always go for fresh or frozen fruits and vegetables, dried are very sugar intensive, and some tinned fruit have added sugar so you will need to read the nutritional label to ensure you are not unwittingly eating extra sugar.
4. Learn About Your Fruits. For a person with diabetes, the best fruits are low sugar low glycaemic index. Generally speaking, this means kiwifruit, berries and some citrus as these are lower in sugar than say a banana, apple, or pineapple.
5. Stick To Healthy Fats. Incorporating healthy fats into each day, such as those from avocados, nuts, seeds and olive oil, is a great way to aid in feeling fuller (meaning you will likely eat less) as well as providing a plethora of extra health benefits.
6. Whole Foods Only. Stay away from highly processed foods, it may help to think about it this way - is this food still intact the way nature made it? Choose only cereals and breads with very little or no added sugars.
7. Avoid Tea, Coffee And Alcohol. As with most healthy living recommendations, it is always best to stick with plain old water.
8. Ask Yourself Is It Hunger Or Habit? If you are struggling with dietary commitments and losing weight, it can be a good idea to analyse whether you are in fact, eating because you are hungry or whether it’s just that time of day and mostly out of habit.
9. Get More Exercise!

Adapting to adding more exercise into your life can be a challenge for many reasons; maybe it’s time constraints, maybe it’s work or family responsibilities or just a lack of energy. Whatever the reason, it is really important to make the effort to increase exercise when seeking to manage your diabetes.

Current recommendations for physical activity by the Ministry of Health for those with diabetes include:

• Moderate to high-intensity aerobic exercise for 150 minutes per week (spread over at least three days with no more than two consecutive days of exercise)
• Resistance-based training at least twice a week
• Not sitting for longer than 30 minutes at any one time

Bear in mind these are generalised recommendations and do not take into account any existing medical conditions or capabilities. For more information on managing type 2 diabetes, see the Ministry of Health’s Type 2 Diabetes Management Guidance here.

9 Ways To Cope With Diabetes Lifestyle Changes

Embarking on a complete overhaul of your lifestyle is pretty overwhelming. Changes and new habits can take a while to adjust to, making them easy to unravel when under pressure or when things go awry. Here are a few practical tips on making your new healthy habits for diabetes management stick.

• Make Gradual Changes. Making gradual changes is a lot easier than going cold turkey. Creating lifestyle changes one step at a time and doing them in such a way as to provide a more sustainable in the longer term. For example, start exercising for just 10 minutes a day or switch from soda or juice to water.
• Plan Ahead. Getting caught out without the right foods at hand can lead to making poor eating choices. When we plan ahead what to eat for the week or when we are away from home, our choices will usually turn out to be healthier and also, as a bonus – cheaper!
• Share The Load. This could be as simple as taking turns cooking, preparing meals ahead of time or having an accountability buddy. Having others you can share the load with means and abundance of moral, emotional and physical support, meaning you are less likely to give up.
• Make Exercise Fun! Making exercise fun can increase the likelihood of you keeping it up. Take a look around your neighbourhood for community classes or group activities that may help you make more permanent exercise changes. For example, organised sports groups, walking groups, or dance classes.
• Seek Out Some Support. For those new to diabetes or just new to managing dietary intake and exercise, making these important lifestyle changes can be a little daunting. Looking out for diabetes management or weight loss programs run by medical professionals in your area is a great start, or you could ask whanau, friends and your workplace to support you on your journey.
• Take Some Time Out.Don’t be afraid to take some time for yourself. Having diabetes means lifelong adjustments to your world, and it will take some time for all of it to become the ‘new normal’.
• Talk To Others. Sharing your thoughts, feelings, and what you are going through with other people who have diabetes can provide valuable insight and help with feelings of isolation. This could mean joining a diabetes support group in your area or getting in touch with distant family or friends of friends.
• Don’t Be Too Hard On Yourself. Learning all of the methods and skills required to manage your diabetes will take time, it is completely normal to expect mistakes to be made and to experience highs and lows. Just stake it one step at a time. Keep in mind counselling could be a good idea if you are really struggling.
• Take It One Step At A Time. Making long-lasting lifestyle changes is an ongoing work in progress. You cannot expect to change everything overnight. Break it up into manageable steps, and allow yourself to feel good about the changes you have made.

While some people with type 2 diabetes are able to control their diabetes through careful management and lifestyle improvements, it may be necessary to include medication and insulin in the treatment plan. See your doctor if you believe you might have diabetes symptoms, or need help managing your diabetes and always seek medical advice before attempting any significant dietary or exercise changes.