Type 2 Diabetes
What is it?
Type 2 diabetes is an endocrine condition in which the levels of glucose (sugar) are too high in the blood. This can result in short and long-term complications which can impact physical and mental health and wellbeing. In a healthy person, a hormone called insulin, made in the pancreas is present. Its job is to help glucose get from the blood and into the cells where it is used to make energy. In a person with type 2 diabetes, there is either not enough insulin or it doesn’t work as effectively as it should. Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people.
A diagnosis of type 2 diabetes is not definite. With the right adjustments to your diet and lifestyle and careful monitoring, you can manage your diabetes. However, because there are so many complications caused by having high levels of glucose, people with diabetes have to check their blood glucose regularly.
Tests, results and medications
In most cases, lifestyle changes are sufficient to reduce blood-sugar levels and keep diabetes under control. The main thing you can do to help lower your blood sugar is to keep as active as possible and eat a healthy and balanced diet. However, there are several medications which can also be used to help control blood sugar levels. The most common medication prescribed is Metformin tablets.
There are several different blood tests which can be done to test your blood glucose. The main test used is called a glycated haemoglobin (HbA1c) test. This test identifies how much glucose is joined to the haemoglobin in the blood. Haemoglobin is the substance which carries oxygen in the blood and it also gives it its red colour. By measuring how much glucose is bound to this haemoglobin, the test can show a 2-3 month view of blood sugar instead of the limited view given from a traditional blood glucose test. The healthy range for this varies between people but you should get your target from the nurse.
If you have type 2 diabetes and you’re overweight, finding a way to lose weight is important as it really improves diabetes management. This is because it can help to lower your blood glucose and reduce your risk of other complications.
The simplest way to do this is to eat a wide variety of different foods. These should include fruits, vegetables and some starchy foods. Portion sizes are important to think about when you have type 2 diabetes, as it helps with managing weight loss. Remember, portion sizes are different for everyone, so what’s right for someone else might not be right for you. Additionally, try not to reduce portion sizes too quickly as this will make you feel hungry after meals and can lead to snacking.
While no foods should be avoided completely, instead try to enjoy everything in moderation.
Foods to eat more of
- Healthy carbohydrates
All carbs affect blood glucose levels so it’s important to know which foods contain carbohydrates. Choose the healthier foods that contain carbs and be aware of your portion sizes. It is also important to cut down on foods which are low in fibre such as white bread, pasta, rice and highly-processed cereals.
Swap processed carbs for whole grains such as brown rice, wholemeal pasta, whole oats or pulses like beans and lentils. Try unsweetened yoghurt and milk too.
- Fruit and veg
We know eating fruit and veg is good for you. It’s always a good thing to eat more at mealtimes and have them as snacks if you’re hungry. You might be wondering about fruit and if you should avoid it because it’s sugary? The answer is no. Whole fruit is good for everyone and if you have diabetes, it’s no different. Fruits do contain sugar, but it’s natural sugar. This is different to the added sugar (also known as free sugars) that are in things like chocolate, biscuits and cakes.
Fruit and veg can be fresh, frozen, dried or tinned (in juice, not in syrup). And it’s best to eat it throughout the day instead of one bigger portion in one go.
- Healthy fats
We all need fat in our diet because it gives us energy. But different types of fat affect our health in different ways. Healthier fats are in foods like unsalted nuts, seeds, avocados, oily fish, olive oil, rapeseed oil and sunflower oil. Some saturated fats can increase the amount of cholesterol in your blood, but these are mainly found in animal products.
It’s still a good idea to cut down on using oils in general, so try to grill, steam or bake foods instead.
Foods to eat less of
Eating lots of salt can increase your risk of high blood pressure, which in turn increases risk of heart diseases and stroke. And when you have diabetes, you’re already more at risk of all of these conditions. Try to limit yourself to a maximum of 6g (one teaspoonful) of salt a day. Cooking from scratch will help you keep an eye on how much salt you’re eating. You can also get creative and swap out salt for different types of herbs and spices to add that extra flavour.
Prepared foods and processed snacks tend to be high in salt so should be limited. Look at the traffic light system on the food labels and avoid ambers and reds.
- Added sugar
Sugar is found naturally in fruit, vegetables, milk and milk products – all-important foods for a healthy balanced diet. What we do need to cut down on is the ‘free sugars’ in food and drink. This includes any added or ‘hidden’ sugar as well as the ‘natural’ sugars in honey, syrups and fruit juices. Added sugar is the sugar we add to our food and drink. However, most of the sugar we eat is ‘hidden’ as food manufacturers have put it into a lot of the food and drinks we buy. It’s very easy to be unaware that the amount of sugar you’re consuming is reaching unhealthy levels because it comes in so many forms and in so many products.
Try swapping full sugar drinks for diet or zero versions and swapping sugar to sweeteners in tea and coffee. Also,reduce how many you have.
- Red and processed meats
If you’re cutting down on carbs, you might start to have bigger portions of meat to fill you up. But it’s not a good idea to do this with red and processed meats, like ham, bacon, sausages, beef and lamb. These all have links with heart problems and cancers. Instead try beans, peas and lentils which are also very high in fibre and don’t affect your blood glucose levels too much – making them a great swap for processed and red meat. Most of us know that fish is good for us, but oily fish like salmon and mackerel are even better. These are rich in omega-3 oil, which helps protect your heart. Try and aim to eat two portions of oily fish a week.
Swap red and processed meat for white meats, fish, eggs or beans and pulses. You should aim to have only eaten red meat once or twice per week.
Being physically active and reducing sedentary behaviours is one of the best things you can do to help manage your diabetes. This includes traditional exercise like going swimming or playing sport. But also, small things like moving more when you’re travelling to work or using the stairs instead of the lift. It all makes a difference.
There isn’t one type of activity that’s best for everyone with diabetes. It’s about finding what works for you and depends on lots of things, like what you enjoy, where you are and how much time you have. Think about how activity can fit in with your life, not the other way around. And work towards adding in some more traditional exercise too.
It is recommended to do a mixture of different types of activity because different types have different benefits. Doing the same thing can get boring after a while anyway. Current government recommendations are to do 2.5 hours of moderate intensity exercise per week. For exercise to count towards this target, it needs to last for at least ten minutes. You need to have your heart rate elevated, be breathing slightly heavier (but can still hold a conversation) and become red and warm.
Some examples of different types of exercise and where you can fit it in include:
Get active at home
When you have diabetes, there are loads of things you can do at home to get active.
- Carrying shopping bags
- Standing or walking during a TV ad break
Get active when travelling
When you’re out and about, it’s surprising how a slight change of routine will increase how active you are and help you feel better when you’re living with diabetes.
Get active as a hobby
Start up an active hobby – it’ll help you manage your diabetes and feel good.
- Swimming class
- Cycling club
- Walking with/without friends
Being active regularly is good for everyone but for those with diabetes it has more specific benefits which include:
- Helps the body use insulin better
- Helps reduce blood pressure (high blood pressure increases the risk of complications)
- Help to improve cholesterol levels
- Aids weight loss
- Helps improve HbA1c result
Losing weight, if you are overweight, will make it easier for your body to lower your blood sugar levels. It will also have a positive effect on your blood pressure.
To know if you are overweight, you need to work out your body mass index (BMI). This is an estimation of a healthy weight for your height. It is done by dividing your weight by your height squared. A healthy BMI is between 18.5 and 24.9, overweight is between 25 and 29.9 and an obese BMI is above 30. A note of caution with BMI is needed though – it is only an estimation of a healthy weight and therefore does not take into account the composition of the body, what percentage fat you are and how much muscle, which can in some cases adversely alter your BMI score.