What is Acquired / Type 2 Diabetes & Why Do We Get It?
By
Family GP & Health with Heart Co-founder Dr Skye Scott shares everything you need to know...
When we eat, our food is broken down into carbohydrates, fats, and protein. These building blocks are further converted into different kinds of fuel for our bodies. Carbohydrates get broken down into glucose and this is released into our blood stream. Glucose is then transported into our cells under the influence of insulin.
When we overstimulate our insulin release, this system stops working efficiently. As a result, the amount of glucose circulating in our blood stream becomes elevated. This is equivalent to adding spoons of sugar to warm water and dissolving the sugar. The more sugar we add, the stickier and more viscous the solution becomes.
Blood containing high levels of sugar does not flow well, blocks vessels, and sets up an inflammatory cascade throughout our bodies.
Being sedentary and carrying visceral fat in our trunks increases our risk of being diabetic.
How Do I Know if I am Diabetic?
This is a silent disease in the beginning. Our bodies are very adaptable. Advanced diabetes can result in weight loss, unquenchable thirst, and increased urination. You don’t want to wait to experience symptoms, so check your sugar annually. A family history will put you at greater risk.
Can I Test for Diabetes?
All adults should check their blood sugar annually. This is a finger prick test and can be done at a minimal cost (R20) at most pharmacies. This test helps us to make a diagnosis of diabetes. A normal fasting sugar is between 4 and 6. Your sugar after a meal should be between 6 and 8, and should return to below 6 within 2 hours.
You can also test your fasting insulin levels. This is a blood test that is sent to the lab. Fasting insulin levels are often an indicator of pre-diabetes and can be elevated long before your blood sugar levels actually change. This test needs to be contextualized and interpreted with your doctor’s insight.
Where is the Sugar?
The short answer is that it’s everywhere. If you want to gain more insight, watch That Sugar Film! Even the fish fingers you feed your children have sugar in them, so read the label!
Remember that carbohydrates are broken down into glucose. So a slice of bread, a cupcake, a bowl of pasta, and a platter of sushi are all broken down into glucose / sugar molecules.
This does not mean that you should never eat carbohydrates. Many of nature’s carbohydrates are full of antioxidants and vitamins. Things like sweet potato, butternut, carrots, and fruit are high in carbohydrates and sugars. Nature’s sources also contain fibre. Fibre slows down the release of sugar into your bloodstream. Refined, processed carbohydrates usually have no fibre and, as a result, dump high doses of sugar into your bloodstream, resulting in insulin surges.
So eat the apple, don’t drink the juice.
Does What I Pair my Carbs with Matter?
YES! If you add fat and protein to your carbohydrate-containing meals, you will slow the sugar release and blunt the insulin spike. Remember that this will also increase your calories; so small portions are in order. Adding fat and protein will slow the sugar release into your bloodstream and keep you feeling fuller for longer.
I Just Ate a Bowl of Carbs - What Can I Do to Help my Body out?
You can move more. Make sure that your carb indulgences happen on active days when you are getting in your steps and exercising. Also ensure that your other meals in the day are low in carbs. Examples of protein are animal products, cheese, and plain yoghurt.
How Much Sugar Should I Consume in a Day?
The recommended daily allowances for men, women, and children are as follows:
Men and women: 25 g (6 teaspoons*) a day
Children: 20 g (4 – 5 teaspoons) a day
*One teaspoon of sugar is 4.19 g
South African Examples:
Sweet Chilli Twister from KFC = 5 teaspoons of sugar
A tablespoon of tomato sauce = 1 teaspoon of sugar
One juice box = 6 teaspoons of sugar (we see these in kids’ lunchboxes all the time!)
One can of coke = 10 teaspoons of sugar
A Small Tangy Russian pizza from Roman’s Pizza = 7 teaspoons of sugar, more than a full daily allowance
A small iced tea from Micky-D’s = 9 teaspoons of sugar – 158% of the recommended daily amount!
What Lower-sugar Substitutions Can I Make?
Juice | Water with lemon or floating fruit pieces |
White toast with jam | Wholewheat toast with avo /peanut butter / cheese |
Cappuccino | Black coffee with almond milk |
Muffin | Seed cracker with cheese |
Sweetened yoghurt | Plain yoghurt with berries |
Cadbury’s slab | Two blocks of 80% Lindt |
Does the 80/20 Rule Apply?
Many factors influence diabetes risk, including genetics, how much you move, what you choose to eat, your hormones, your microbiome, other comorbidities…the list goes on. But, if you are physically active, eating whole foods, keeping active, and not carrying extra weight around your middle, having a treat a couple of times a week is not going to break the bank.
What you choose to feed your body the majority of the time is what creates a landscape for thriving or disease. You can think of your body as a fish bowl. What you fill the bowl with creates an environment for a healthy fish or a sick fish. Our gastrointestinal systems are covered by our microbiomes - worlds of micro-organisms that feast on whatever we feed them. We nurture different organisms with different culinary tastes. There is a school of thought that our sugar cravings are driven by the kinds of bugs with which our biomes are populated. These crave-driving bugs are perpetuated by bad food choices.
Easy Wins:
- Eat smaller portions
- Add protein and fat to your carbs
- Stop drinking empty calories
- Reduce or eliminate alcohol
- Stay hydrated
- Take the stairs every time!
ABOUT THE AUTHOR
Dr Skye Scott is a family GP, and co-owner of Health with Heart - a holistic wellness solution that includes a warm-hearted practice in Sandton; bespoke corporate wellness programmes; unique retreats and medical travel experiences; an educational podcast and portal; and a community outreach initiative. For more information or to get in touch, follow @drskyescott or @health_w_heart on Instagram or @HealthwithHeartDoctors on Facebook, or visit www.healthwithheart.co.za.