The annual campaign held by the International Diabetes Federation each year on November 14th seeks to keep this escalating health issue in the global spotlight, amid growing concern for the threat diabetes poses to public health. This year is the start of a 5-year programme to address the need for education and prevention initiatives to support the global diabetes community which currently stands at 285 million people .
Diabetics are largely responsible for the ongoing maintenance of their health, with over 95%delivering their own care . They also have two to four times the risk of developing heart disease or stroke than the general population, as well as being highly susceptible to conditions such as nephropathy (damage to the kidneys) and peripheral neuropathy (diabetic nerve damage). The prognosis also gets worse with time; sufferers who have chronic diabetes are about 50% likely to experience some kind of nerve damage. Fortunately, diabetes sufferers can influence and manage their condition, and minimise the associated risks with the right lifestyle, diet and exercise.
According to a study published this spring in the Archives of Internal Medicine, the vast majority of new cases of diabetes in older adults could be prevented by following a moderately healthier lifestyle.  The Harvard researchers identified that a combination of five lifestyle factors accounted for 90% of new cases of type 2 diabetes in people aged 65 and over. Risk factors included physical activity, diet, smoking habits, alcohol use and body fat (using a calculation of body mass index – BMI – and waist circumference), and that each of these factors was independently associated with diabetes risk.
The researchers also noted that diabetes risk can be lowered considerably, without people conforming to a perfect ideal of healthy behaviour, and that even modest lifestyle changes can have a huge impact on risk. In this study, each one additional lifestyle factor reduced the incidence of diabetes by approximately 35% on average in the low-risk group. Combining low-risk groups in terms of activity level, dietary habits, smoking and alcohol intake, with not being overweight, offers the highest level of protection, reducing diabetes risk by 89%.
Although this study researched lifestyle factors in older adults, because it involved both sexes from community-based populations, the authors argue that the significant benefits of lifestyle are like to apply to the general population.
More and more reliable evidence is coming to light suggesting that our lifestyle and diet are pivotal in terms of minimising our risk of developing type 2 diabetes, which is a growing threat to public health. If diabetes and its complications are largely preventable then this implies a certain degree of responsibility to take avoiding action. Our typical approach to illness in the West is to look to our doctor for help when our health is compromised, and accepting lifestyle adjustments is something we may consider when we see the warning signs. The chances are, however, that taking action at this stage may be a case of ‘too little too late’.
Dr Nina Bailey comments, “As a nutrition scientist my interest lies in the nutritional and medicinal properties of food in bringing about changes to our health. Since diabetes is strongly linked with inflammation the number one food I would suggest prioritising is oily fish. Rich in the beneficial omega-3 fatty acids EPA and DHA, fish has a multitude of properties which make it extremely helpful for diabetics. The omega-3 EPA in particular, is converted to natural anti-inflammatory substances call eicosanoids, and these are very powerful in maintaining inflammation and immunity.
“The link between diabetes and high rates of coronary artery disease, heart attack and stroke can be explained in part by increased inflammatory substances including cytokines and inflammatory prostaglandins. As well as reducing these levels with EPA from fish or fish oil, it is important to reduce those foods which promote levels of inflammation. The prime culprits to avoid are red meat, dairy, other foods rich in saturated and trans fats, processed meats and sugar.”
Fish also offers many other benefits for people with diabetes, including the protection of cardiovascular health by thinning the blood and minimising the risk of heart attacks, preventing the deterioration of the myelin sheath surrounding nerves, which reduces the risk of neuropathy, as well as stimulating the growth of nerve fibres, protecting against high-risk problems such as Alzheimer’s.
 Mozaffarian, D. Lifestyle risk factors and new-onset diabetes mellitus in older adults, Archives of Internal Medicine, (2009), 169(8): 798-807.