Type 2 Diabetes Management: Diet, Exercise, and Lifestyle

Understanding Type 2 Diabetes

Diabetes is a chronic health condition with significant implications for public health systems worldwide. It is determined in part by genetic constitution, daily activities, and lifestyle choices. Diabetes is rapidly becoming a national epidemic (Canadian Diabetes Association, 2014). The Centers for Disease Control and Prevention (CDC) (2014) reports that between 1990 and 1998, the incidence of diabetes rose by 70% in the population aged 30–39, by 40% among those 40–49, and by 31% in the 50–59 age group. From 2006 to 2011, the number of new cases of diagnosed diabetes showed no significant change. Even more concerning is the fact that it is estimated as many as 33% of the population with Type I diabetes and up to 55% with Type II go undiagnosed (Statistics Canada, 2010). This paper explores how diabetes affects quality of life and evaluates current published literature on diet and lifestyle in the prevention of Type 2 diabetes.

All around the world, millions of people are affected by diabetes. This disease is caused by defective carbohydrate metabolism. It causes large amounts of sugar in the blood and urine, and it can damage the kidneys, heart, eyes, and limbs, and can endanger pregnancy (National Diabetes Information Clearinghouse, 2014). Today, there are more than nine million Canadians living with diabetes or pre-diabetes (Canadian Diabetes Association, 2014). The literature supports the existence of three main types of diabetes.

Type I diabetes is a disease in which the pancreas loses its ability to produce insulin. Type II diabetes accounts for 90 percent of the diabetic population and primarily affects people above age 40. Gestational diabetes, which affects women during the third trimester of pregnancy, is the third main type. Some causes of diabetes are heredity, being overweight, and problems with beta cells, which are located in the pancreas. Although Type II diabetes is mostly seen in adults, poor diet, inadequate nutrition, and lack of exercise have led to an increasing number of children and adolescents developing the condition.

The Role of Nutrition in Diabetes Management

Type II diabetes mellitus is a metabolic disorder in which cells in the body do not recognize or respond to the insulin produced. Insulin is a hormone that converts sugar, starches, and other foods into the energy that humans need every day (CDC, 2014). Insulin is essential for the body to metabolize glucose for energy. Without glucose, cells can literally starve. Heredity plays a stronger role in Type 2 diabetes than in Type 1 diabetes, but the nature of these genetic factors and how they are inherited are not yet fully understood (American Diabetes Association, 2002). Diabetes occurs more frequently in some populations, including African Americans, Hispanic/Latino Americans, American Indians, and Alaska Natives (CDC, 2014).

According to the literature, diet plays a major role in the prevention of Type II diabetes. Because sugar concentration in the blood is a major factor for diabetics, understanding the sugar content and metabolic impact of fats, proteins, and carbohydrates is essential. If blood sugar levels remain high for an extended period, diabetes develops. A person with this disease must understand exactly what they are eating and how foods are broken down to fully appreciate the implications of their diet on their body.

Carbohydrates, Proteins, and Fats: Blood Sugar Impact

From a dietary perspective, the primary goal is to control sugar in the bloodstream in such a way that insulin can manage it efficiently. More than any other food, carbohydrates affect blood sugar levels. Understanding and managing carbohydrate intake is therefore central to diabetes prevention and management.

Carbohydrates are the body's main source of energy. Starches and sugars are carbohydrates and are both broken down into glucose at approximately the same speed. Starches are found in breads, cereals, pasta, lentils, peas, potatoes, and beans. Sugars are found naturally in fruits, vegetables, and milk. Foods with added sugars include syrups, candies, jams, and desserts. Carbohydrates raise blood sugar much more rapidly than fats and proteins (Health Canada, 2011).

Protein is the second major nutrient needed by the body. The body uses protein to build and repair body tissue. Proteins are found in foods such as meats, eggs, cheese, peanut butter, and tofu. The best sources of protein are those low in fat, such as lean meat and skinless poultry. Proteins contain enzymes, some of which are responsible for breaking down starches into sugars (Gray, 2011). Importantly, proteins slow the release of sugars into the bloodstream, helping to maintain more stable blood glucose levels.

Exercise, Medication, and Lifestyle Factors

Fat is the third major nutrient needed by the body. Although fats are sometimes perceived negatively in nutrition, they are actually important to human health. They carry fatty acids and vitamins throughout the body and can be either solid or liquid in form. Fats are found in cheese, margarine, butter, meat, milk, and vegetable oils. All fats are high in calories, which can be a concern for weight management. Like proteins, fats slow the release of sugars into the bloodstream (Gray, 2011). The importance of all three nutrients is that each plays a role in the interaction of sugars in the body, which directly affects blood sugar levels. Understanding each type of food consumed is essential to keeping blood sugars in check.

In addition to diet, medication and exercise play key roles in controlling diabetes. Currently, there is no known cure for Type II diabetes. Scientists have yet to determine exactly what causes it, but they do know it results from multiple factors (CDC, 2014). These factors vary from person to person and can include being overweight, defective beta cells, insufficient beta cells, and heredity. The complexity of the disease underscores the need for individualized treatment approaches.

Regular exercise is of great importance for diabetics. It helps keep blood sugars within a normal range. When exercising, cells in the body become more sensitive to insulin, making insulin more effective (CDC, 2014). Consequently, individuals who must inject insulin daily may need to inject less insulin if their bodies are using it more efficiently. Obesity is a major cause of Type II diabetes and can create insulin resistance. In preventing Type II diabetes, regular exercise burns calories and helps maintain healthy weight and stress levels.