Good nutrition – a foundation in diabetes care

When it comes to good nutrition therapy, the Centre for Diabetes and Endocrinology (CDE) states that it has been shown to reduce HbA1c (a standard laboratory marker of diabetes control), by 0.5-2% in type 2 diabetes. This makes the intervention of a registered dietitian guiding healthier food choices potentially more powerful than many of the oral diabetes medications we need to use.

However, as with everything in diabetes care, nutrition should be individualised and guided by a host of factors including your glycaemic (blood glucose), blood pressure and blood lipid control, your body fat composition and distribution, your culture, your religion, your age, other health conditions and your medications and your finances.

The CDE also advises that healthy eating in the context of type 2 diabetes does not mean that you should ‘diet’ - rather work with your dietitian in your diabetes team to help craft a nutritional approach and eating plan that is tailored to your lifestyle and nutritional goals (e.g. reducing your waist circumference and cancer risk and improving your blood pressure and cholesterol profile.

Have three main meals combined with healthy snacks in-between to keep your sugar levels at a healthy level’ must be avoided. Not every individual with diabetes NEEDS to snack.

Prevention is better than cure

People may develop diabetes for various reasons. There is usually an underlying genetic predisposition (which may or may not reflect in family history). Poor lifestyle choices including physical inactivity and unhealthy food choices increase the risk of excess adiposity (body fat), especially problematic around the ‘tummy’ area, and subsequently, type 2 diabetes.

Additional modifiable risk factors for type 2 diabetes include hypertension (high blood pressure), dyslipidaemia (abnormal cholesterol and fat levels in the blood), previous gestational diabetes or delivery of a baby weighing more 4 kg, and impaired fasting glucose or impaired glucose tolerance (also known as ‘pre-diabetes’)

If you have any of these risk factors, screening could benefit you because type 2 diabetes is a largely silent condition (it often does not present with typical symptoms of diabetes), and may thus remain undetected for many years. As a result, half of the people who have type 2 diabetes in South Africa are unaware of its presence, increasing their risk for complications to develop.

The frequency of screening should be guided by your doctor, but all overweight adults at any age with at least one other risk factor for diabetes should be screened. For all other adults, screening for diabetes should start at age 45 and be repeated at least annually if at high risk and every 3 years if at a healthy weight and low in risk.

By making lifestyle changes like improving dietary choices, increasing regular physical activity, losing any excess tummy fat and stopping smoking, you can reduce your risk of developing type 2 diabetes.