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January 31, 2012

Heading off diabetes

Don’t become one of the millions of Canadians with type 2 diabetes. A few simple steps can help reduce your risk.

Chuck Pusateri is throwing everything he’s got at type 2 diabetes, despite the genetic odds stacked against him. “My grandfather had diabetes, so did my dad and my uncle -- I’ve sure got diabetes in my family history,” says the 59-year-old Victoria, B.C. native.

So when he found out his blood sugar levels were high when heading into heart surgery six years ago, he knew the odds had caught up to him. “When the nurse came up after the surgery to show me how to inject insulin, I woke up to the fact I had to do something,” he says. With type 2 diabetes, glucose (sugar) builds up in the blood instead of being used by the body for energy. It’s caused by factors such as genetics, obesity and a sedentary lifestyle. It’s different from type 1, which is caused by a malfunctioning pancreas that fails to produce the sugar-controlling hormone insulin, causing the same glucose build-up.

As Pusateri was on the cusp of full-blown Type 2, he decided to take action. He retired from his job, began working out at the gym most days of the week and slimmed down 20 pounds. He started taking Metformin, a drug that increases the body’s sensitivity to insulin. He also changed his diet, eating smaller meals throughout the day to keep his blood sugar level stable.

"I don’t eat a lot of French fries,” says Pusateri, who is confident the steps he’s taking will help prevent the disease.

Are you at risk?

Type 2 diabetes is disease that tends to sneak up on people, says Dr. Ian Blumer, chair, Clinical Practice Guidelines Dissemination and Implementation Committee, Canadian Diabetes Association, and the author of six books on managing diabetes, including Diabetes for Canadians for Dummies.

But there are certain factors which increase your risk of becoming one of the 9 million Canadians who have diabetes or pre-diabetes:

  1. Being overweight. A high body mass index or BMI (a measure of body fat calculated from height and weight) raises your risk.
  2. Increasing age. The older you are, the higher your chances of developing the disease.
  3. Being inactive, which can increase the amount of insulin in your body.
  4. A strong family history. The more close relatives you have with Type 2, the higher your odds.
  5. Having gestational diabetes in pregnancy.
  6. Having polycystic ovarian syndrome, which causes a hormonal imbalance.
  7. Your cultural background. Being Asian, South Asian, Aboriginal, Hispanic or African -- the Canadian Diabetes Association reports these populations are at higher risk of the disease.
  8. Taking anti-psychotic drugs to treat mental illnesses such as schizophrenia. These medications have been linked to insulin resistance, a condition in which insulin becomes less effective at reducing blood sugar.

The trick is to stop pre-diabetes in its tracks before your body stops using insulin effectively, or else risk complications such as eye and nerve damage, kidney failure, and a higher risk of heart disease, stroke and amputation.

What most people don’t know, says Blumer, is that through tiny changes, their risk can go down. “I think a lot of people have a pessimistic attitude,” he says. “They think if they’re going to get diabetes, it’s going to happen and there’s nothing they can do to prevent it, but that’s often not the case.”

“Up to 50% of type 2 diabetes cases can be prevented or delayed with healthier eating and increased physical activity,” says Randi Garcha, spokesperson for the Canadian Diabetes Association.

Blumer advocates starting small. Losing weight -- just 1 to 5% of your body weight -- puts a significant dent in your risk. “Losing just 10 pounds if you’re 200 pounds makes a big difference,” he says.

And you don’t have to become a gym bunny to put in the 30 or more minutes a day/five days or more a week of exercise that the Public Health Agency of Canada recommends. Blumer suggests breaking your exercise into manageable chunks -- a brisk, 10-minute walk at lunch, some weight training at the gym or at home. “It doesn’t have to be a massive change,” he says.

He doesn’t advocate completely denying yourself sweets, either. “It’s not as if you have one chocolate bar you’re going to get diabetes,” he says. It’s excess calories on an ongoing basis that put you at risk.

And if people feel they’re going nowhere despite trying to diet and exercise, Blumer says doctors will occasionally prescribe drugs such as Metformin. These medications can delay the onset of the disease.

Above all, says Pusateri, take action rather than pretending type 2 diabetes will go away.

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