Obesity is considered the number one risk factor to type 2 diabetes. When fat cells, particularly those around the abdomen, become full of fat they secrete a number or biological products that dampen the effect of insulin, impair glucose utilization in skeletal muscle, promote glucose production by the liver, and impair insulin release by pancreatic beta cells. Other risk factors for type 2 diabetes may include:
- Family history of diabetes (parent or sibling with type 2 diabetes)
- Increased waist/hip ratio
- Age (beginning at age 45)
- Previously identified IFG (impaired fasting glucose) or IGT (Impaired glucose tolerance)
- History of gestational diabetes or delivery of baby over 9 lb.
- Hypertension (blood pressure > 140/90)
- Triglyceride level >250 mg/dL
- Low adiponectin levels, elevated fasting levels
- Polycystic ovary syndrome
Due to a strong genetic disposition, researchers have determined that the Pima Indians of Arizona have the highest rate of type 2 diabetes and obesity anywhere in the world. Other racial and ethnic groups besides the Pima Indians that have a higher tendency for type 2 diabetes include Native Americans, Aborigines, and Pacific Islanders. The Western diet and modern lifestyle of the current generation contributes to heart disease, cancer, and diabetes.
The two types of carbohydrates are simple and complex. Simple carbohydrates, or sugars, are quickly absorbed by the body for a ready source of energy. Eating foods high in simple sugars can be harmful to blood sugar control if you are insulin resistant, experience reactive hypoglycemia or are a diabetic. Currently, more than half of the carbohydrates being consumed are in the form of sugars being added to foods as sweetening agents. Complex carbohydrates, or starches, are composed of many simple sugars joined together by chemical bonds. Vegetables, legumes, and whole grains are excellent sources of high-fiber complex carbohydrates.
Simple sugars are either monosaccharides composed one sugar molecule or disaccharides composed of two sugar molecules. Fructose or fruit sugar is the primary carbohydrate in many fruits, maple syrup, and honey.
The glycemic index is often used as guideline for dietary recommendations for people with either diabetes or hypoglycemia. The illustration shows that the more that a food is processed, the higher the glycemic index. In diabetic patients, evidence from clinical studies also shows that replacing high-glycemic-index carbohydrates with low-glycemic-index carbohydrate will improve blood sugar control.
Figure 1.1. Blood Sugar Response/Glycemic Index of One Food (Wheat) in Different Forms
To reduce the risk of type 2 diabetes as well as heart disease and cancer, the goal is to decrease your total fat intake while increasing your intake of omega-3 fatty acids and monounsaturated (omega-9) fatty acids. A saturated fat is a fat molecule in which all of the available binding sites are occupied with another atom. Fat molecules are made of atoms of carbon, hydrogen, and oxygen. Each atom attaches to the others only in certain predetermined way. The backbone of a fat is a chain of carbon atoms ( C ):
Hydrogen (H) and oxygen (O) atoms can then attach to the carbons. A saturated fat is a fat molecule in which all of the available binding sites are occupied with another atom:
An unsaturated fat has one or more bonding sites left unoccupied; the two neighboring carbon atoms will take up the slack by forming a double bond:
A fat molecule with one double bond is called a monounsaturated fat. Molecules with more than one double bond are called polyunsaturated fats. Margarine and shorting are manufactured from vegetable oils through hydrogenation in which hydrogen molecule is added to the natural unsaturated fatty acid molecules of the vegetable oil to make it more saturated. The type of dietary fat profile linked to type 2 diabetes is an abundance of saturated fat and trans-fatty acids along with a relative insufficiency of monounsaturated and omega-3 fatty acids.
The cell membranes of the human body are constantly under attack by free radicals and pro-oxidants. A free radical is a molecule that contains a highly reactive unpaired electron, while a pro-oxidant is a molecule that can promote oxidative damage.
Part 5: Preventing Type 2 Diabetes
Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)