Author, Lisa Spriet, RD

Because diabetes affects 1 in 3 Canadians, it is essential to find out if you should be concerned about prediabetes or type 2 diabetes. Read this Q&A style interview with Lisa Spriet, RD about type 2 diabetes and increase your knowledge of health facts. 

What Does It Mean To Be Pre-diabetic?

Based on “random blood glucose test”, “fasting blood sugar levels”, “Oral Glucose Tolerance Test (OGTT) and/or “Hemoglobin A1C” test, your doctor may have expressed that you have elevated blood sugars, which is a common way to express you are pre-diabetic. This is estimated to affect 6 Million Canadians and the rates are increasing. Pre-diabetes can lead to type 2 diabetes, but through lifestyle changes, many people with pre-diabetes can prevent or delay diabetes.

What Is Type 2 Diabetes?

Diabetes occurs when your body can’t properly manage blood sugar, leading to high blood sugar levels and type 2 diabetes, previously called adult-onset diabetes, is the most common type. With type 2 diabetes, your body first stops responding to a hormone called insulin, although for some people with type 2 diabetes their bodies also do not make enough insulin. The role of insulin is to move sugar from your blood into your cells. If your body doesn’t respond to insulin or if you don’t have enough insulin, your blood sugar levels continue to rise after eating meals (primarily with carbohydrates). High blood sugar levels can cause damage to our blood vessels and nerves and diabetes. 

What Are Normal Blood Sugars?

There are a few ways of measuring blood sugar levels to assess your diabetes risk and how your body is responding to carbohydrates you consume. Unless you have a home glucose monitor, most people have blood work done to look at a few markers, including fasting blood glucose (FBG), random blood glucose (BG), glycosylated hemoglobin (HbA1C or A1C*) and oral glucose tolerance test (OGTT). While lab values may vary depending on the lab you go to, here is a list of the ‘normal’, at-risk and diabetes numbers: 

If you do have type 2 diabetes, blood sugar goals are a little bit different:

* A1C is a measurement of your average blood sugar control for the last two to three months and approximately 50 percent of the value comes from the last 30 days.

What Causes Type 2 Diabetes?

Type 2 diabetes is ‘multifactorial’ meaning that the development is usually based on a number of factors. Some factors are modifiable in that we have some control over them, while other factors are not. Here are a few of the main contributing factors:

Diet: What one eats is one contributing factor that is typically modifiable, meaning people have control over what they put into their bodies. One myth about diabetes is that it’s caused by eating too much sugar. While a high sugar intake may contribute to obesity (see below), in itself eating a high amount of sugar doesn’t cause diabetes (not that I’m saying it’s a good thing!).

Dietary factors that may contribute to developing type two diabetes include having a high intake of processed foods, including sugar-sweetened beverages and processed red meat. Overall diet quality counts and the diets that are associated with the lowest risk of type two diabetes are those that are high in whole vegetables and fruits, whole grains, legumes and nuts and seeds. Eating too many calories, no matter what foods they come from, may contribute to diabetes by contributing to obesity. 

Obesity, specifically excess fat around your waist: Obesity is often classified using something called body mass index (BMI), which is a simple comparison of height to weight. However, it does not take into account muscle mass versus fat mass, or where that fat is stored in your body. For diabetes, we know that fat accumulation around your waist increases your risk. Having a waist circumference above 102 cm for men and 88 cm for women greatly increases the risk of type two diabetes

Physical activity: Physical inactivity, as defined as getting less than 150 minutes per week of moderate to vigorous activity, is one of the leading causes of diabetes. Research is now showing that having a sedentary lifestyle, even if you do exercise, also contributes to developing type 2 diabetes. 

Other factors that may contribute include genetics and heritage, medications, personal and maternal history of gestational diabetes, and polycystic ovarian syndrome. 

Is Type 2 Diabetes A Heritable Condition?

We do know that there are certain versions of genes that can make one more at risk of developing type 2 diabetes (we look at some of these genes with Nutrigenomix genetic testing). However, none of these genes directly cause diabetes and even if you have elevated risk based on your genetics or family history, there are still many things that you can do to prevent diabetes. 

Can Type 2 Diabetes Be Cured or Reversed?

Cured? Technically no. Once you are diagnosed with type 2 diabetes you are considered to have diabetes. However, we do know that lifestyle interventions (diet and physical activity) can reverse diabetes for some people, meaning that they can keep their blood sugars in normal ranges without medication. In fact, we’ve created a Healthy Blood Sugar Program that has helped people reverse pre-diabetes and diabetes. 

What Are The Impacts of Type 2 Diabetes?

Having diabetes, especially if blood sugars are not kept in target ranges, increases your risk of:

1. Cardiovascular disease, including heart attack and stroke
2. Loss of eyesight
3. Destruction of nerves and reduced blood flow, which can lead to amputation
4. Kidney failure & dialysis
5. Foot ulcers (sores)

In general, having type 2 diabetes can reduce lifespan by 15 years. However, with early intervention, all of these can be prevented or delayed. 

Can Type 2 Diabetes Be Prevented?

Yes! For most people, type 2 diabetes is very preventable. 

NutriProCan Diabetes Prevention and Management Program is something you can start today, regardless of your ability to participate in physical activity. https://nutriprocan.ca/services/diabetes-prevention-and-management-program/