Being diagnosed with Type 2 Diabetes can be a challenging time for both the patient and the physician, and for many people it is an emotional period which many find overwhelming. Now, with over 90% of all diabetes cases being Type 2, GPs across the country are finding themselves having this conversation more and more.
To shed light on this doctor, patient conversation, Dr Matt Capehorn LighterLife’s medical director, has shared insight into the most common diabetes related questions doctors currently get asked.
1) It’s just a touch of sugar diabetes, isn’t doctor? Everyone in my family has it. It’s not a problem is it?
We do not like it when patients refer to “sugar diabetes” because it gives the wrong impression that diabetes is just about sugar. With Type 1 Diabetes the pancreas, which is the organ responsible for producing insulin, is damaged and unable to produce enough of it to control the sugar in what we eat. In Type 2 Diabetics it’s because the body becomes resistant to the effects of the body’s insulin effects. We now know that in approximately 85% of patients with Type 2 diabetes this resistance is caused by the effects of dangerous “visceral” or tummy fat that lies in and around your organs, like the liver. Reducing weight and increasing certain types of physical activity has been shown to reduce this type of fat, and recent studies, such as the DiRECT study (funded by Diabetes UK) has shown that Very Low Calorie Diets, like Lighterlife, can result in sufficient weight loss to result in a “reversal” of the diabetes.
Patients often have no symptoms at diagnosis and so feel that it is not an issue, and as a result do not make sufficient lifestyle and behaviour changes, or address factors like weight and physical activity. Over time this can result in very serious consequences like retinopathy (leading to blindness), nephropathy (kidney damage), and neuropathy (nerve damage to feet) together with an increased risk of limb amputation and cardiovascular disease.
2) Can I still eat sugar if I am diabetic?
You do NOT have to avoid sugar if you have Type 2 Diabetes. Obviously, if your body is struggling to lower sugar levels after eating, and prolonged high levels of sugar (hyperglycaemia) leads to the long-term complications of diabetes, it is worthwhile trying to reduce sugar intake. However, some sugars that are naturally occurring, such as those in fruit, dairy etc can be enjoyed as part of a nutritionally balanced diet. The only sugars you should try to reduce are those refined sugars in processed foods, snacks, and fizzy drinks (which can cause a sudden rise in sugar levels) etc. If you make necessary dietary and lifestyle changes, or take medication as prescribed, you should be able to manage your sugar levels correctly and still be able to enjoy a balanced diet with sugar. The most important dietary aspect with Type 2 Diabetes is to reduce your weight back down to a healthy weight, and this is best done by reducing calories in, rather than restricting certain food types (which only makes you crave them more). A Total Dietary Replacement diet like Lighterlife is ideal, especially as it is nutritionally complete.
3) Am I automatically going to end up on insulin?
No. Patients with Type 1 diabetes do not produce enough insulin for their body to manage sugar levels and they do need to have insulin. However, patients with Type 2 Diabetes can often be managed very well without ever having to consider insulin treatment. They key is good sugar level control, and how we manage the condition depends on the average level of your blood sugar over the previous few months, taking by an HbA1c blood test (taken by your GP/nurse). This tells us if your sugar levels are in a good place, and if they are not, changes can be made to improve them. If you work with your healthcare professionals then changes can be made to prevent you ever needing insulin because of poor control of your sugar levels, however it is worth remembering that the longer you keep the dangerous visceral fat in your liver you may start to produce less insulin, more like a patient with Type 1 diabetes. This emphasises the need to focus on your weight and getting back to a healthy BMI as early as possible after diagnosis. Lighterlife can help with this.
4) Am I definitely going to end up blind, with kidney failure and losing a limb one day?
No. The long-term complications of diabetes are all related to a consequence of long-term high sugar levels. You may be able to put your diabetes into remission with adequate weight loss. Patients with diabetes do not die from these complications, fatalities come from cardiovascular disease, which again is much more likely with poor sugar control. However, good sugar control reduces risks again, so work with your healthcare professionals to stay healthy.
5) Is there a “cure” for diabetes?
At present we have to rely on numerous ways to keep our average sugar levels is our body in the healthy range as much as we can. We now understand the role of weight, visceral fat, and physical activity much more, and lifestyle and behaviour change can massively improve the way we manage diabetes. The recent DiRECT study is very exciting because initial trials suggest that patient who do very well on Very Low-Calorie Diets, such as Lighterlife, can “reverse” their diabetes, result in normal average sugar levels, and in effect put their diabetes into “remission” which is the closest thing we may have to a “cure”. If you do not have diabetes, and are worried about getting diabetes, current evidence suggests that by far the best way of preventing it is to focus on reaching and staying at a healthy weight.