November is National Diabetes Month – How Can Nutrition Help?
Diabetes is a surprisingly common health problem. November has been designated National Diabetes Month in the United States to draw attention to diabetes and how to manage or prevent the condition.
Diabetes mellitus occurs when the body can no longer adequately control blood glucose levels. There are two types of diabetes with different causes. Type 1 diabetes is considered to be an auto-immune disease in which the cells that normally produce insulin, a hormone that helps to control blood sugar, are destroyed. Type 1 diabetes is insulin dependent, which means that people need insulin. In type 2 diabetes, the body is not able to produce enough insulin to adequately control blood glucose. This can be due to “insulin resistance,” for which the cells do not respond in the same way to insulin, or that insulin production is compromised. Type 2 diabetes can be managed by diet and lifestyle to some extent.
Currently, the CDC estimates that around 26 million Americans had diabetes, and around three times this number were classified as pre-diabetic. Around 2 million new cases are diagnosed every year, according to a CDC fact sheet. There are differences in the rate of diabetes incidence by ethnicity, with Native Americans being the most affected by type 2 diabetes, and non-Hispanic Whites most affected by type 1 diabetes.
There are certain risk factors that mean that some people may want to be tested for type 2 diabetes on a regular basis. Those risk factors include being aged over 45, overweight or obesity, family history of diabetes including gestational diabetes, and a sedentary lifestyle. Weight loss and physical activity help to reduce risk of diabetes, including preventing the progression from pre-diabetes to diabetes. Physical activity has been shown to improve cells’ ability to respond to insulin, and weight loss reduces the body’s need for insulin by reducing body size. In a large clinical study called the Diabetes Prevention Program, people with pre-diabetes who lost only 7% of their body weight and exercised moderately (2 ½ hours per week) halved their risk of developing diabetes in the following years (for details, see a report by Brink). The cost of assisting people make lifestyle change was found to be cost-effective. The Diabetes Prevention Program showed the power of lifestyle change to prevent progression to chronic disease.
Over the years, TalkingNutrition has also reported on recent developments in diabetes research. Some examples:
The National Diabetes Prevention Program provides general resources to individuals and organizations interested in diabetes prevention. Due to the higher incidence of type 2 diabetes in Native American populations, some culturally sensitive resources are available to help via the Native Diabetes Wellness Program.
DPP information on cost-effectiveness: Susan Brink. The Diabetes Prevention Program: How The Participants Did It. Health Affairs, 28, no.1 (2009):57-62. doi: 10.1377/hlthaff.28.1.57 http://content.healthaffairs.org/content/28/1/57.full