Posts Tagged diabetes

Type 2 Diabetes

Type 2 Diabetes

Here are some disturbing statistics related to diabetes. Type 2 diabetes accounts for approximately 90% of all diabetes cases.

“The number of people diagnosed with and dying from diabetes continues on a relentlessly upward trajectory, with no signs of abating”. This statement was made by officials at the International Diabetes Federation (IDF) and the European Association for the Study of Diabetes (EASD) 47th Annual Meeting (Sept 2011).

Ann Keeling, CEO of the International Diabetes Federation, describes diabetes as a global catastrophe!!

So, what are the latest stats for diabetes?

In 2003 there were 150 million people worldwide with diabetes and it was predicted that by 2025 there would be 300 million. Well guess what, as alarming as that prediction was at the time, it was nothing compared to the reality. In 2011 there are already 366 million people worldwide with diabetes. This is a 30% increase on the 2010 figure of 285 million. This year 4.6 million deaths will be attributed to diabetes.  This means one person will die from diabetes every 7 seconds!

What causes type 2 diabetes?

Type 2 diabetes is largely a lifestyle disease. The current statistics for diabetes are very alarming and personally I find them very disturbing because I know that in the majority of cases type 2 diabetes can be prevented with the correct lifestyle and diet. I also believe that it can be reversed if appropriate changes are made.

Obesity is a major risk factor for the development of type 2 diabetes. It is no wonder we are seeing such an astronomical increase in the incidence of type 2 diabetes when we consider the explosion in the number of people who are overweight or obese.

Genetics play a role but only a small one. The condition will not develop without the adverse impact of environmental factors such as diet and lifestyle.

What can be done for type 2 diabetes?

Nutrients and herbs

There are many nutrients that are essential for the maintenance of healthy blood sugar levels and normal glucose metabolism. These include chromium, magnesium, many of the B Complex vitamins and others. A diet high in sugar and refined carbohydrates can deplete the body of these essential nutrients. Alcohol, caffeine and excessive fluid loss will also cause significant losses of these nutrients.

Many herbs can be very beneficial for reducing sugar and carbohydrate cravings, improving the way the body metabolises sugar, improving fat loss and improving blood sugar levels. Many are also beneficial for reducing the unhealthy factors associated with diabetes including high cholesterol and triglycerides, high blood pressure and circulatory problems.

These nutrients and herbs are often prescribed to kick start the process of weight loss and make it easier for you to embark on a healthy eating regime without having to battle cravings for fat producing foods. The actual prescription for each individual may be slightly different because individual metabolism, health needs and preferences are taken into account.

The use of natural medicines is not a substitute for a healthy life style

You can take control of the situation easily and quickly. If you have been diagnosed with type 2 diabetes or metabolic syndrome, which often precedes type 2 diabetes, you can improve your health significantly by making the appropriate dietary and lifestyle changes.

  • Fat loss is of major importance. Even if you are slim, you could be carrying a little extra weight around the middle. This can increase your risk of developing type 2 diabetes. As little as 5 to 10% weight loss can make a big difference.
  • Exercise not only helps with fat loss it also helps transport glucose into the cells. Regular moderate exercise is fundamental to good health. It should always be something you enjoy and should suit your age, statue and capabilities. A combination of cardio and resistance is best.
  • The food you eat has a huge impact on your health. It will improve or damage your health depending on what you eat and how it is prepared.
  • Eat lots of fresh vegetables, avoiding too much of the high starch vegetables such as potatoes and corn. In summer salads are great, or you can steam, stir fry or bake your vegetables. Aim at 3 cups per day and if you eat more that’s great.
  • Fruit is good but should be eaten in moderation (2 to 3 pieces per day) because it is high in natural sugars.It is a good idea to combine a piece of fresh fruit with a few nuts eg almonds (only a 3 or 4). This slows down the absorption of the sugars in the fruit and gives you a more even blood glucose and energy curve. Minimise the very sweet, starchy fruits such as bananas.
  • Protein is important for improving muscle mass, particularly in conjunction with moderate exercise. Fish, lean meat, free range chicken and eggs and low fat dairy products are good sources of animal protein. The main vegetable sources of protein are the legumes such as chick peas (in homus), lentils, red kidney beans, adzuki beans, soy beans and related products such as tofu and tempah. Nuts, seeds and grains also provide some protein. Non-animal sources of protein do not contain all the essential amino acids, so vegetarians need to have a wide variety of these foods every day in order to obtain enough complete protein.
  • Avoid processed foods. These are often loaded with sugar and/or fat and are a source of empty kilojoules that do nothing to improve your health. They encourage overeating, make you feel sluggish and are a major cause of excessive weight gain.
  • Foods that have a low Glycaemic Index (GI) are beneficial providing they are healthy! Many foods that are marketed as low GI are not healthy and will not help you lose weight eg ice cream, chocolate spreads.
  • Glycaemic Load (GL) is also a consideration. It is determined not only by the GI of the food but the size of the total meal. The higher the glycaemic load the higher your blood sugar will be.

Simply by eating correctly and partaking in regular moderate exercise you stand a good chance of preventing type 2 diabetes, or reversing it if it already exists.



Leave a Comment

Vitamin D Deficiency is Common

Vitamin D Deficiency is Common


In Brief

  • Vitamin D deficiency is common in Australia
  • In many cases Australians do not receive adequate vitamin D from casual sun exposure
  • Vitamin D is essential for healthy, strong bones and is protective against cancer
  • Postmenopausal are at greatest risk of osteoporosis and vitamin D deficiency significantly increases the risk
  • Many women I see in my clinic have low levels of vitamin D
  • All adults should be checked routinely for vitamin D deficiency, particularly those in the high risk groups discussed below
  • Vitamin D supplementation may be necessary



What is vitamin D?

Vitamin D is a fat soluble vitamin, also called calciferol and sunlight vitamin. Although small amounts of Vitamin D can be obtained from some foods (see below), the majority of our vitamin D is produced by the body when UV radiation in sunlight hits our skin and reacts with a cholesterol-like substance in the skin. It is the only vitamin that is manufactured in body and is also considered a hormone. After being produced in the skin vitamin D enters the circulation and travels to liver and kidneys where it is synthesised into its active form.


Prevalence of vitamin D deficiency in Australia

The prevalence of vitamin D deficiency in Australia varies, however according to an article in the Medical Journal of Australia it is much higher than previously thought. Studies have shown that vitamin D deficiency is common in the elderly with up to 76% having a marginal deficiency. Other studies have shown that up to 43% of younger adults have inadequate vitamin D levels. The highest rates of severe deficiency occur in dark-skinned, veiled, and pregnant women with a deficiency incidence of up to 80%.


The importance of vitamin D

Adequate levels of vitamin D are essential for healthy, strong bones. Therefore its importance increases in menopausal and postmenopausal women, who are already at risk of developing osteoporosis due to decreased oestrogen levels.


Vitamin D is necessary for calcium absorption and for regulating calcium and phosphate concentrations in the blood, which ensure normal mineralisation of bone. Without sufficient vitamin D bones can become weak and the incidence of fracture may increase.


Ensuring healthy bones is not the only job of vitamin D. It also plays important roles in the health and functioning of the immune system, neuromuscular function and in the reduction of inflammation. In addition, vitamin D plays a role in the prevention and treatment of type 1 and type 2 diabetes, hypertension, glucose intolerance, autoimmune thyroid disease and multiple sclerosis.


Vitamin D deficiency and increased cancer risk

Vitamin D has potent anticancer properties and vitamin D deficiency may be associated with an increased incidence of a number of cancers, particularly those of the gastrointestinal tract.  According to a study published in 2008, low vitamin D status may increase breast cancer risk in post-menopausal women. 4 Vitamin D may also play a role in the outcome for cancer patients.


Vitamin D deficiency in children

In recent times vitamin D deficiency has re-emerged as a significant health issue in children. This can result in seizures (due to low calcium), limb pain, fractures and rickets.


Vitamin D deficiency in pregnant women will result in a deficiency in their infants. Therefore all women considering pregnancy should have their vitamin D levels checked before conception and during pregnancy.


What causes vitamin D deficiency?

The major cause of vitamin D deficiency is inadequate exposure to sunlight. This is a difficult issue because we also know that too much sun exposure can lead to skin cancer and malignant melanoma. It is quite ironic that scientists now believe that vitamin D is protective against skin cancer. Therefore we may be putting a little too much effort (and money) into protecting ourselves from the sun.


Although you may often read that most Australians get enough sun exposure to ensure adequate vitamin D levels, especially in the more northern parts of Australia, this is not the reality and certainly is not what I see in my clinical practice. Almost every woman I have seen who has had a blood test for vitamin D levels has either been on the low side of normal or outside the normal range, exhibiting a deficiency.


How much sun is enough (but not too much)?

It is difficult to find a definitive answer about the optimal amount of sun exposure which ensures adequate vitamin D levels without causing a risk of skin cancer etc. In actual fact the answer will be quite different for different regions of Australia and for different individuals.


Sun exposure should be limited to the early morning and late afternoon and the amount of exposure needs to suit the individual skin type. Very fair skinned people can tolerate less sun that those with olive skin or darker skin. Indeed people with fair skin actually need much less sun exposure for the production of vitamin D because the UV rays penetrate the skin much easier.


In 2006 the Medical Journal of Australia published information on recommended sun exposure times (at 10am or 3pm) for fair skinned individuals aged 19-50 years with 15% of their body exposed to the sun eg face, arms and hands. As you would expect exposure time varied greatly depending on locality. For example in Townsville as little as 10 minutes in summer and up to 15 minutes in winter, whilst in Hobart up to 13 minutes in summer and as much as 166 minutes in winter may be needed to ensure sufficient vitamin D levels based on current recommended daily allowances.


These recommended times are only estimations and are subject to many variations including seasonal differences in UVB levels from one year to another, altitude, skin type, level of cloud cover etc. It is also worth noting that many researchers have suggested that optimal vitamin D intake has been underestimated and that official recommendations are too low.  If this is the case recommended sun exposure times may be too short, however excessive unprotected sun exposure may increase risk of skin cancer.


The best way to ensure that you have adequate vitamin D is to have yearly or twice yearly blood tests to check your vitamin D status. Try to ensure adequate sun exposure without overdoing it. You need to be careful and take your skin type, your location, time of day and season into account. If the exposed area begins to redden slightly it is time to get out of the sun.



Those at most risk of vitamin D deficiency

Older adults

As we age the skin is less able to produce vitamin D and the kidneys are less efficient at converting it into the active form. The risk of vitamin D deficiency is increased for older people who spend most of their time indoors.


People with limited sun exposure

People who are homebound and women who wear veils and/or long robes are very likely to have vitamin D deficiency. Many people get very little or no sun exposure during winter, particularly on their working days. Vitamin D supplementation may be necessary during the winter months.


People with dark skin are also at increased risk of vitamin D deficiency because the increased pigment in the skin (melanin) reduces penetration of UV rays and the production of vitamin D.



Being overweight, particularly if you have a body mass index (BMI) of greater than 30 you are at increased risk of vitamin D deficiency. This is not because vitamin D production is decreased but because the subcutaneous fat decreases the release of vitamin D into the circulation. Even when vitamin D is taken orally through food or supplementation the amount of available vitamin D in the circulation is reduced in obese people.



Dietary sources of vitamin D

Very few foods contain significant amounts of vitamin D. The richest sources are oily fish such salmon, sardines, herring and mackerel. Other foods containing some vitamin D include milk, meat, eggs, cheese and fortified foods.


Most experts agree that it is very difficult to obtain sufficient vitamin D from foods alone and that sun exposure and/or supplementation is essential to prevent vitamin D deficiency.


Comments (2)