Understanding type 2 diabetes

Many people are impacted by diabetes in one way or another – either they have a family history, or they know somebody with diabetes, or they may be diabetic or pre-diabetic themselves. After all, diabetes currently affects over 537 million adults (about 10.5% of the global adult population) and is projected to reach 783 million by 2045. This rise is fuelled by factors such as ageing populations, increased obesity rates, increased consumption of processed foods, and lifestyle changes that reduce physical activity. In the UK, around one in five adults is estimated to be at high risk for type 2 diabetes.

Should I be concerned?

There are a number of risk factors for type 2 diabetes – some preventable, others not so.  The main contributing factors are lifestyle-related - diet, activity levels, weight, and other aspects including stress response and sleep. There are other, non-preventable risk factors as well, such as genetics or family history, age, and ethnicity. Certain health conditions like PCOS can raise your risk due to insulin resistance. However, it has been shown that lifestyle has more of an impact on diabetes risk than these other factors.

But I am not overweight?

Although weight is a risk factor, I have seen many clients who are prediabetic and actually underweight or in the healthy weight range. And similarly, there are many medically overweight people who don’t necessarily go on to develop diabetes. So whilst weight is a risk factor, and does correlate with type 2 diabetes in general, it does not account for the whole story, and other lifestyle factors play a big role as well.  

What should I eat?

There is so much information online on how to prevent or manage type 2 diabetes. Many health-conscious people are aware that all carbohydrates, not just sugars, can raise blood glucose levels. Low-carb or keto diets are popular to help reduce blood sugar levels, and although they are very effective in the short term, I have found that for many people they can be difficult to stick to long term.  The truth is that not all carbohydrates are “bad”, and actually, the right types of carbohydrates can even be quite helpful for blood glucose levels and other aspects of health, including gut health and cholesterol levels. One example of that is beans and pulses, as these are high in fibre. Adding high-fibre foods to meals can help smooth out blood sugar variability.

In fact, when people are faced with pre-diabetes or diabetes, one of the first things I get asked is “What can’t I eat?” – the focus is often on what to reduce or avoid. But I like to take the “Add” approach – "What can I add to my diet? What should I be eating more of?" I find this really helps with mindset and steers the client away from the “deprivation mentality” that can often end up sabotaging their efforts – when we think we can’t have something – we end up wanting more of it!

Can supplements help?

Whilst macronutrients like carbohydrates, fats, and protein often get the most attention in diabetes nutrition, micronutrients (vitamins and minerals) also play a crucial role in managing blood sugar levels and overall health. There are key micronutrients like magnesium, chromium, B vitamins, vitamin D, and alpha-lipoic acid that support glucose metabolism, and most of these can be obtained from diet, whereas others, like vitamin D, may require supplementation, depending on the individual. However, with vitamin D, I always recommend testing levels first before supplementing, to ensure the right dose. I would never recommend supplementation without professional advice, especially as certain supplements can interact with medications.

What about exercise?

It could be argued that there is no such thing as a “wrong type” of exercise and that all exercise is good for you. However, for blood sugar levels in particular, there is one form of exercise that stands out above all others – and that’s strength training. We naturally lose muscle mass with age, but muscle tissue actually helps us absorb glucose from the blood, without requiring insulin. If we naturally lose 3-5% of our muscle mass each year from the age of 30-40, then each year we are becoming less effective at using and storing glucose, as we have less muscle tissue available. That could be one of the reasons that the risk of type 2 diabetes increases with age.

The good news is that it has been shown that it’s possible to build muscle mass at any age, with strength training and the right nutrition, and this form of exercise really should form part of any healthy lifestyle, regardless of blood sugar levels.

I know what I need to do, but…

Many people already have some idea of what they need to do but are struggling with actually doing it. I sometimes find that too much information can actually make it more difficult to take action – it’s a concept called information paralysis. It’s when we feel overwhelmed by excess data or too many choices, leading to difficulty in making decisions or taking action. This is where a nutrition professional can help – to help them make sense of the conflicting information and to tailor an approach that suits them.

Every client is a unique individual and a nutritional professional can with them to find a personalised approach that suits their goals, abilities and lifestyle. Some clients are highly motivated and willing to do whatever it takes to reduce their blood sugar levels as quickly as possible. Other clients prefer a softer approach, one that is going to be more sustainable in the long term. The key is to find an approach that works for the individual. There is no one-size-fits-all, and the best plan is the one you can actually stick to!