Focus on World Diabetes Day

The annual campaign held by the International Diabetes Federation is held each year on November 14th. The current 5-year programme, launched this time last year, is focused on addressing the need for education and prevention initiatives to support the global diabetes community. World Diabetes Day 2010 is therefore calling on all those responsible for diabetes care to ‘take control of diabetes now’.  For people at high risk of diabetes and the general public, the campaign aim is to raise awareness and to give advice that highlights prevention. For those people who have diabetes, the focus is to improve knowledge of the disease, thereby enabling improved management for the prevention of complications.

A diagnosis of diabetes has immediate impact, imposing many life-long dietary and lifestyle changes.  These changes do not only affect the individual; living with diabetes also impacts on immediate family and friends, and highlights the overwhelming need for education about the condition.   Diabetics have to monitor their blood glucose regularly and in some cases they will need to use medication. The importance of taking regular exercise coupled with significant changes to their eating habits needs to be emphasised and may see dramatic changes in the life of the sufferer.

Managing diabetes successfully is certainly paramount to preventing the myriad associated complications.  Indeed, diabetics have two to four times greater 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% more likely to experience some kind of nerve damage. Not surprisingly, educating diabetes sufferers on how to influence and manage their condition, and use lifestyle, diet and exercise to minimise the associated risks is a major focus that is addressed annually on this day.

There are many simple dietary changes that can be adopted to help manage diabetes.  Using the glycaemic index (GI), which ranks carbohydrates according to their effect on blood glucose levels, is a good method to maintain stable blood glucose levels and is one of the most documented dietary changes recognized as directly beneficial. White sugar and other refined (simple) carbohydrates, such as those found in processed white bread and white pasta, white rice and most convenience foods, rank high on the GI, resulting in constant peaks and troughs in glucose levels.  Avoiding refined foods and sugar, as well as consuming foods with a low GI value, will help to keep blood sugar levels even.  Foods with a low GI, such as high fibre cereals, whole grain products, beans, pulses, brown rice, whole wheat pasta, vegetables and some fruit, consist of complex carbohydrates and are broken down into sugars more slowly, avoiding rapid increases in blood sugar.

Probably less well known is the role of fat, and the contribution of individual fatty acids, such as the omega-3 eicosapentaenoic acid (EPA), in the regulation of insulin sensitivity and therefore in diabetes management.  Potential mechanisms for effects of this fatty acid on insulin sensitivity include: altered structural properties of cell membranes, direct regulatory effects on gene expression, and direct effects on insulin-sensitive tissues.   Given that diabetic individuals have an impaired ability to make omega-3 long chain polyunsaturated fatty acids, increasing fish consumption or supplementing directly with EPA offers many other benefits for people with diabetes.   For example, EPA plays a vital role in the compaction, stabilization, and maintenance of myelin sheaths; supplementation can therefore be of significant benefit in the relief of symptoms associated with neuropathy.  Furthermore, EPA offers cardiovascular benefits that include lowering of blood pressure, triglycerides and cholesterol, high levels of which are a known risk factor for cardiovascular disease, another major complication of diabetes.

The key to maintaining a healthy diabetic diet is simply that of a healthy diet, and one that all of us should adopt.  Indeed, proper dietary management of diabetes includes eating regular meals based on wholegrain varieties of breads, cereals and pasta.  Including plenty of ‘good fats’ in the form of oily fish can help prevent and treat neuropathies and cardiovascular risk factors.   Living with diabetes can be difficult, but managing diabetes doesn’t have to be hard.

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