IMPACT OF LIFESTYLE CHOICES ON TYPE 2 DIABETES
Diabetes is one of the most rapidly increasing chronic diseases and is an important public health problem all over the world.7 90 % of all diabetes worldwide is type 2 diabetes, which is a preventable, reversible and manageable condition if you adopt healthy lifestyle habits.7,8 In fact, lifestyle change is the most important aspect of diabetes care, yet most people are not aware of what to do to improve their diabetes management.7,8
Poor lifestyle choices play a prominent role in developing type 2 diabetes, so it stands to reason that changing these lifestyle habits is the cornerstone of its management.9
POOR LIFESTYLE CHOICES:
1
POOR KNOWLEDGE
A study revealed that 92 % of South Africans had poor knowledge regarding the benefits of exercise and weight loss and 73 % had poor knowledge regarding the benefits of a healthy diet in diabetes.9
2
POOR DIET
Studies have shown that high intake of red and processed meats, low intake of whole grains, inadequate fruit and vegetable consumption, low dietary fibre and high consumption of sugar-sweetened beverages substantially contributes to the type 2 diabetes burden.10
3
EXCESSIVE BODY WEIGHT
> 80 % of adults with diabetes are overweight, and nearly half are obese.9
4
LACK OF PHYSICAL ACTIVITY
- Sedentary behaviours, such as inactivity and sitting at work or social gatherings, increase the risk of type 2 diabetes9
- Increased mechanisation and driving have also displaced physical activity in industrialised nations. This trend is on the increase in developing countries9
5
SMOKING
- Current smokers have a 45 % greater risk of developing diabetes than non-smokers9
- Smoking is associated with an increased risk of abdominal fat, which is a risk factor for insulin resistance and diabetes9
6
EXCESSIVE ALCOHOL CONSUMPTION
People drinking one or two drinks/day have a 30-40 % lower risk of developing diabetes vs. heavy drinkers9
LIFESTYLE CHANGES IN THE
MANAGEMENT OF TYPE 2 DIABETES
WHAT?
Increase your knowledge
about diabetes and its
management
HOW?
- Ask your healthcare professional questions
- Seek nutritional advice from a dietician
- Join a gym, a sports club or a walking group
- Invest in a diabetes cook book
- Join a diabetes support group listed under useful resources
- Download free educational material from websites listed under useful resources
WHY?
Knowledge is a powerful tool in the fight against diabetes.9 Educative information can:9
- Help people better understand the risks associated with uncontrolled diabetes
- Motivate people to seek proper treatment and to take care of their condition
- Shift your attitude towards lifestyle modifications to a more positive one
WHAT?
Follow a healthy
balanced diet
HOW?
- Limit carbohydrates to (600kcal/day)8 and add:
- Lean protein
- Non-starchy vegetables
- Dietary fibre
- Healthy fats
Examples of healthy diets include:9,11
- Mediterranean diet
- The diabetes plate-method
WHAT?
You can improve your glucose control by:9
- Eating low-carbohydrate, balanced meals
- Eating most of your carbohydrates early in the day
- Eating your protein and vegetables first and then your carbohydrates 10-30 mins later
- Going for a walk 30 mins after a meal
WHAT?
Make time for regular
physical exercise
HOW?
At least 150 minutes of moderate activity/week OR 75 minutes of vigorous activity/week PLUS resistance training 2-3 times/week9
WHAT?
- Helps the body cells take up glucose and thus lowers blood sugar levels
- Helps with weight loss
- Helps control blood cholesterol and blood pressure
- Improves the physical, mental and social health of people living with diabetes
ORAL DIABETIC MEDICATIONS12-14
Although healthy lifestyle choices are key to managing type 2 diabetes, you may also need to take medication to keep your blood sugar at a healthy level. Sometimes one medication is enough, but sometimes several medications may be needed for optimal control. Each person is different so your doctor will design a treatment plan that works best for you. There are several different classes of diabetic medications that work in different ways to help lower blood sugar levels.12
They include:12,14
TYPE OF MEDICATION
TYPE OF MEDICATION
EXAMPLES
TYPE OF MEDICATION
BIGUANIDE
TYPE OF MEDICATION
- Decreases the amount of glucose produced by the liver
- Makes muscle tissue more sensitive to insulin so blood glucose can be absorbed for energy
EXAMPLES
METFORMIN
TYPE OF MEDICATION
sulphonylureas
TYPE OF MEDICATION
- Stimulates the pancreas to release more insulin
EXAMPLES
GLIMEPIRIDE, GLICLAZIDE, GLIPIZIDE
TYPE OF MEDICATION
THIAZOLIDINEDIONES (TZDS)
TYPE OF MEDICATION
- Helps insulin work better in the muscle and fat
- Reduces glucose production in the liver
EXAMPLES
SITAGLIPTIN, VILDAGLIPTIN, SAXAGLIPTIN, LINAGLIPTIN,
TYPE OF MEDICATION
GLUCAGON-LIKE PEPTIDE 1 (GLP-1) AGONISTS
TYPE OF MEDICATION
- Stimulates the pancreas to secrete insulin
- Blocks the secretion of glucagon by the pancreas
- Slows digestion by slowing down stomach emptying
- Lowers appetite and hunger (brain)
EXAMPLES
SEMAGARD (SEMAGLUTIDE), DULAGLUTIDE
TYPE OF MEDICATION
SODIUM-GLUCOSE COTRANSPORTER 2 (SGLT2) INHIBITORS
TYPE OF MEDICATION
- Works in the kidney to block the reabsorption of
glucose, thereby causing an increase in glucose
excretion in the urine
EXAMPLES
DAPAGLIFLOZIN, EMPAGLIFLOZIN
TYPE OF MEDICATION
ALPHA-GLUCOSIDASE INHIBITORS
TYPE OF MEDICATION
- Blocks the breakdown of starches in the intestine,
which slows the rise in blood glucose after a meal
EXAMPLES
ACARBOSE
TYPE OF MEDICATION
BILE ACID SEQUESTRANTS
TYPE OF MEDICATION
- A cholesterol-lowering medication that also lowers
blood glucose in people with diabetes (mechanism is not well understood)
EXAMPLES
COLESEVELAM
GIP – glucose-dependent insulinotropic polypeptide
Glucagon-like peptide 1 (GLP-1) receptor agonists, such as Semagard, are medications that mimic the GLP-1 hormone that occurs naturally in the body. They are used to manage diabetes through their effect on other hormones such as insulin and glucagon.
INJECTABLE INSULIN
- Basal insulin – inhibits liver production of glucose and prevents raised fasting blood sugar levels i.e. in between meals
- Short-acting insulin – use at mealtimes to prevent the post-meal glucose spikes
QUESTIONS TO ASK YOUR HEALTHCARE PROFESSIONAL (HCP)
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