Living with... Type 2 diabetes
Over the next few months Esquire Middle East‘s resident doctor, Graham Simpson MD, will be tackling the realities of what it is like to live with a disease. The first in the ‘Living with…’ series concentrates on Type 2 diabetes.
Many of us assume, that thanks to modern medicines, some of the more common illnesses are all very manageable. In fact, for many people, medicines are rather ineffective. It should be known that living with disease – even if those medicines help to manage the symptoms – can be a tremendous burden which results in a very unpleasant life indeed.
I don’t intend to use these as scare tactics. All of this is just my attempt to remind you of how important it is to do all you can to keep yourselves healthy through the right lifestyle choices. While genetics no doubt plays a role in whether someone might get a disease or not, it plays a much smaller role than most people realize (usually around 15% give or take). If we are to look at the rising rates of non-communicable disease (NCDs) over the past decades, we can see that these increases are far too dramatic to be attributed to anything other than our poor lifestyle choices, and of those of course diet is the main contributor.
According to the World Health Organisation (WHO), as many as one in five UAE residents are thought to have a potentially fatal non-communicable disease, which include among others cardiovascular disease, cancer, chronic respiratory illness, and diabetes – though I believe those figures to be considerably higher.
Of these diseases, it is diabetes – specifically type 2 – that we are going to look at today. The official figures suggest that one in five people in the UAE are living with diabetes, though I believe the number is much higher – more like one in every three.
Our Western diet high in sugars and grains is the main culprit for these high numbers, but smoking, excessive drinking, high stress levels, and other factors all play a role in the rising rates of type 2.
One in five UAE residents are thought to have a potentially fatal non-communicable disease
While I understand how type 2 diabetes would not necessarily strike fear into our hearts in the same way a disease like cancer would, make no mistake that diabetes has the potential to greatly alter your life for the worse. Let’s now take a look at five of the potentially devastating effects of the disease.
1. Heart attack and stroke: Our hearts are probably not the first thing we think of when we talk about complications with diabetes, but in fact high blood sugar levels play havoc with our blood vessels and can significantly increase our risk of heart attack and stroke. According to the UK’s National Diabetes Audit, diabetes sufferers have a 25% higher risk of suffering a stroke, with heart attack and heart failure risk increasing by 48% and 65% respectively. Given these high numbers it is very important for type 2 diabetics (especially those age 40 and up) to have a coronary calcium score using an EBCT scanner, which we do at Intelligent Health.
2. Sight problems: Damaged blood vessels caused by diabetes can restrict the flow of fluid to our eyes, causing blurred vision and even blindness. And according to the American Diabetes Association, diabetes sufferers have a 40% higher risk of glaucoma and a 60% higher risk of developing cataracts – both of which can cause permanent eye damage. For the type 2 diabetic in particular, regular retina scans are highly recommended (again, also something that we do at Intelligent Health).
3. Sexual dysfunction: One of the most common symptoms of diabetes in males is erectile dysfunction – which is a very common problem across the UAE. Again, it all comes down to those blood vessels that have been damaged by that diet high in sugars and grains, withe the result being a severe restriction of blood flow to the sexual organs. According to figures from WebMD, up to 75% of men with diabetes could experience some degree of sexual dysfunction.
4. Kidney disease: Perhaps the most devastating consequence of diabetic related blood vessel damage is the havoc those injured vessels can cause to our kidneys. When the structure of the blood vessels becomes compromised, the kidney is no longer able to perform one of its most vital functions: cleaning the blood. This leads to complications such as kidney infection and water retention, and according to the National Kidney Foundation of America, up to 40% of type 2 diabetes patients will suffer from kidney failure as a result of this damage.
5. Amputation: It is fair to say that the last entry on our list is perhaps the most extreme. Those chronically high blood sugar levels cause nerve damage – known as peripheral neuropathy – in our extremities, particularly the feet. As a result of this and the restricted blood flow caused by damaged blood vessels, diabetes sufferers can develop foot ulcers and other such infections. Much of the time the individual does not even realize the infection is present, and when left untreated that infection can spread throughout the leg and require amputation. While amputation may seem extreme, it is by no means uncommon, and diabetes is, in fact, the leading cause of amputation throughout much of the Western world.
Tackling Type 2
There is a silver lining to the type 2 epidemic, and this has to do with the fact that for most of those with the disease it is possible to reverse and eliminate, or at least make it a very manageable condition.
But let me be very clear: While medications will work to improve the body’s sensitivity to insulin and help regulate blood sugar levels, if no drastic improvements are made on the lifestyle front, the diabetes sufferer will continue to get sicker. Medications address symptoms, and you cannot punish your body with habit such as smoking and excessive drinking while continuing to eat that silly Western diet.
In my writings I address healthy eating all too often, so rather than going into too much detail I will as usual just point you to my past article on the Paleo Diet. And my readers are always welcome to email me at firstname.lastname@example.org to request a free digital copy of my book on healthy Paleo eating.
But just to drum this point home: The very first bit of advice I give to any of my clients with pre-diabetes or full-blown type 2 diabetes is to never (and I mean never) eat anything other than a Paleo-type diet again. Ever. That of course includes all processed foods. And yes, vegetarians, that same advice goes for you. You don’t have to be a meat eater to be a Paleo eater, you just have to make good use of that vegetable category (we have this extensively covered in my book on Paleo eating so just request a copy and I will send to you).
Once the diet is set the next thing to get in line is your exercise regime. When we exercise, our muscles use up excess glucose as energy, helping the body to regulate insulin more efficiently.
There are of course many more things diabetics can do, and so if you are a type 2 sufferer make it a point to do your homework and learn what is in your control. Just please do not think that you are at the “mercy of genetics” here and that your only recourse are those pharmaceuticals. That is the absolute worst attitude to take and the thinking could not be more incorrect. It is in fact the kind of mindset that will surely result in a worsening of the condition, and with it a much lower quality of life.
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The opinions in the column are by Dr Graham Simpson, and are not necessarily those held by Esquire or Hearst International. Dr Simpson is Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai. He graduated from the University of the Witwatersrand Medical School in Johannesburg, South Africa, and is board certified in Internal Medicine and Emergency Medicine. As a founding member of the American Holistic Medical Association (AHMA) Dr Simpson is also a licensed homeopath.