Vesanto Melina, MS, RD
“The diabetes time bomb has been ticking for 50 years, and it’s been getting louder.
Martin Silink, President International Diabetes Federation
Nine percent of Americans have diabetes, mainly Type 2 diabetes (the kind that can be reversed). Another 38 percent have prediabetes. So that’s almost half of Americans.
Since 2000, the number of people in Canada with diabetes has doubled. Today, one in three Canadians lives with prediabetes or diabetes. Those 20 years old now have a 50-50 chance of developing the disease. The risk for some indigenous people is 80 per cent. Close to 40 per cent of newly diagnosed cases occur in seniors.
What is Diabetes?
Diabetes is a metabolic disorder that diminishes the body’s ability to usher glucose into cells for use as our primary energy source. To enter our cells, a “gatekeeper” called insulin must let it in. People with type 1 diabetes produce little or no insulin. Over 90 percent of those with diabetes have type 2; they typically produce insulin but their cells have become “insulin resistant”. Here, insulin cannot do its job; blood glucose levels rise as sugar is blocked from entering cells. Over time, body tissues become awash in sugar; health tumbles down a rather predictable slippery slope.
Essentially the product of diet and lifestyle, type 2 diabetes is insidious, often undetected for many years. Its rise runs roughly parallels the rise in overweight and obesity. Risk doubles in those who are overweight; triples in the obese. Excess body fat plays a strong role; fat distribution is perhaps even more significant. Weight around the abdomen (apple-shape) increases risk far more than weight around legs and hips (pear-shaped). Visceral fat, in and around vital organs, is potentially damaging. Once referred to as “adult-onset diabetes”, today, type 2 diabetes occurs in teens and even children.
Diabetes is defined as fasting blood glucose of at least 7.0 mmol/L (126 mg/dl). Pre-diabetes is often manifested as “metabolic syndrome”, characterized by elevated blood glucose 6.1 mmol/L (110 mg/dl) or more), abdominal obesity, elevated blood pressure, elevated triglycerides, and low HDL-cholesterol levels. A cascade of problems ensues, commonly resulting in full-blown type 2 diabetes. Untreated or poorly controlled diabetes is a leading cause of blindness, premature heart attack and stroke, kidney failure, nerve damage, and amputations. Most people with diabetes do not die of diabetes: they die of heart disease, kidney failure, and other complications.
The Luck of the Draw?
Some believe type 2 diabetes to be a matter of bad genes, more than bad habits. While some populations have greater susceptibility, genes serve primarily as a loaded gun. It is almost always diet and lifestyle that pull the trigger. Diabetes can be prevented and reversed.
A meta-analysis reviewed 9 well-designed trials, looking at the relationships between dietary choice and diet. They found significant evidence that the choice of a plant-based diet improves glycemic control, and controls potentially damaging blood cholesterol levels and body weight and adiposity in individuals with diabetes.
A recent resource featuring delicious recipes using plant foods (and without added sugars and fats) is The Kick Diabetes Cookbook by B Davis and V Melina kickdiabetescookbook.com . An excellent option for preventing, treating, and even reversing type 2 diabetes, and other chronic diseases is the CHIP program. CHIP is the Complete Health Improvement Program, developed out of the University of Loma Linda, California; a scientifically validated program (in 18 sessions over 10-12 weeks), proven to reduce your risk factors through lifestyle changes!
Vesanto Melina is a Vancouver-based Registered Dietitian; kickdiabetescookbook.com.
For consultations (online or in person), email firstname.lastname@example.org
- Diabetes Canada www.diabetes.ca
- Buse JB et al. How do we define cure of diabetes? Diabetes Care. 22(11)200: 2133.
- Salas-Salvadó J et al. The role of diet in the prevention of type 2 diabetes. Nutr Metab Cardiovasc Dis. 2011 Sep;21 Suppl 2:B32-48.