Type 2 diabetes - 5 simple ways to lower your risk

Diabetes is a highly prevalent condition worldwide. According to the International Diabetes Federation (IDF), around 1 in 10 adults have the condition globally. And at least 90% of diagnosed diabetes cases are type 2.

On the African continent, as many as 24 million adults are currently living with and managing diabetes. That's around 1 in 22 people. In South Africa, prevalence is around 11.3% of the adult population. Across the continent, prevalence is predicted to increase significantly - according to the IDF, this could be by as much as 129% by 2045. What's more, at least half of people with the condition will likely go undiagnosed, resulting in further complications and considerable loss of life.

So it's important to understand what diabetes is, how it develops, how serious its impact can be if undiagnosed or mismanaged, and how to manage applicable risks. Knowledge is power and that can be lifesaving.

What does it mean if you are diagnosed with type 2 diabetes?

There are three main types of diabetes (diabetes mellitus): type 1, type 2 and gestational diabetes (which occurs during pregnancy).

In type 2 diabetes, the pancreas does not produce enough insulin (a hormone that regulates the movement of sugar into the body's cells). Also, the body's cells don't respond properly to the insulin and they take in less sugar. This means there is too much sugar, or glucose, circulating in the blood and it doesn't reach all the different cells that need it. These high sugar levels can lead to disorders of the circulatory, nervous and immune systems.

How to identify your potential risk

Key risk factors of type 2 diabetes

• Most often occurs in middle-aged and older adults but can also develop during childhood
• A family history of diabetes
• Overweight or obese
• Physically inactive
• Other health conditions like hypertension (high blood pressure), prediabetes (elevated blood sugar levels) or a history of gestational diabetes during pregnancy

Other signs and symptoms may also signal increased risk

• Fatigue or feeling unusually tired
• Increased appetite/hunger and unexplained weight loss
• Increased thirst and frequent urination
• Blurry vision
• Numbness or tingling sensations - especially in the hands and feet
• Sores that don't seem to heal

Symptoms can develop slowly over several years and may seem barely noticeable at first. But if you can recognise a combination of signs and symptoms early enough, you can implement useful interventions.

One way to do this is through an annual Discovery Health Check or check-up at your GP. This can help you to detect elevated blood sugar levels and prompt further care and treatment very early on - even before type 2 diabetes develops. The Health Check also screens blood pressure and cholesterol levels, and includes a body mass index assessment, an HIV test and a non-smoker's declaration.

As a Discovery Health Medical Scheme (DHMS) member, your Health Check gives you access to more screening protection through the WELLTH Fund, a once-off, additional risk benefit for you and your family. A Health Check automatically unlocks this benefit and makes available a comprehensive basket of healthcare services to help you take better care of yourself and prevent severe or chronic illnesses.

Active ways you can lower your risk and take extra care of yourself

When you know your risk, you have a better idea of how to respond. You can lower your risk of type 2 diabetes or improve overall condition outcomes by adjusting your healthcare and lifestyle habits.

Here are some things you can do for yourself

1. It starts with what you eat and how much: Choice is key, so opt for a low-GI (low-glycaemic index) diet. This helps you avoid foods that will raise your blood sugar levels too high, too quickly.
   • This includes sweetened beverages or breakfast cereal, sweets and chocolate, but also less obvious options like white bread, white rice and white pasta. Highly processed foods are a no-go. You can swap these out for multigrain or wholemeal versions, for example swapping white rice for brown rice and wholewheat varieties of pasta. The higher fibre content will also take longer to digest, liberating sugars slowly. This gives you sustained energy levels for longer.
   • Make sure to include protein in every meal. For instance, you can have chicken with brown rice and vegetables.
   • Other good options include grains like barley, quinoa and buckwheat; pulses like chickpeas, lentils and butter beans; and proteins like salmon, mackerel and herring.
   • You can reduce your calorie intake by eating smaller portions at mealtimes.
   • Increase your water intake every day, as this contributes to improved blood sugar management, and limit or avoid alcohol consumption, which does not.
2. Eating well helps you manage your weight and even lose some: Managing your weight and nutrition better will help keep your blood pressure, blood sugar and cholesterol levels in check. Excess weight can increase the risk of developing type 2 diabetes by as much as seven times. If needed, losing between 7 and 10% of your weight can reduce your risk significantly.
3. Get into a physically active routine: As little as 30 minutes a day can make a big difference. If you're not very fit, walking for 30 minutes every day is a good place to start. This will improve your muscle function because insulin and glucose can be better absorbed and utilised. It's a good idea to talk to your healthcare provider about different activities that can help in your quest to achieve your goals - for instance, depending on if you need to lose weight or better manage a healthy weight. It's always a good idea to start slowly and build up an activity routine that's most right for you.
4. If you smoke, stop: High levels of nicotine can disrupt all your efforts to regulate levels of insulin effectively. So smoking is counterproductive.
5. Take your prescribed medications as recommended by your doctor: These can include pills or injections. You can even be prescribed a combination of medications to best manage your blood glucose. A combination can include medications to help manage other health conditions like hypertension and high cholesterol too.

Getting supportive care for diabetes

What should you do if your Health Check shows elevated blood glucose levels?

Firstly, don't panic. Detecting elevated levels is part of the importance of screening. Your next step is a more thorough evaluation, which may involve a series of diagnostic blood tests, at your GP or primary healthcare provider's consulting rooms.

If your levels are not found to be high enough for the diagnosis of diabetes, you may still benefit from diabetes disease prevention. As a DHMS member, we'd encourage you to join the Disease Prevention Programme and get access to a Premier Plus GP, Discovery Health Coach and a Dietitian in our network. Together, you and your supportive healthcare team will be able to actively manage your risk, ensure that you receive highly coordinated healthcare and, ultimately, improved outcomes. In short, this team will help to ensure that you never develop diabetes.

Find out how to join the programme here.

What should you do if you've already been diagnosed with type 2 diabetes?

Once again, don't panic. Diabetes is a manageable condition and you can improve your quality of life with strategically implemented lifestyle changes and a holistic approach to healthcare. Support is not far from reach, so we'd encourage you to register for the Diabetes Care Programme as an added benefit to your medical aid plan.

On the programme, you and your primary healthcare provider will have access to numerous monitoring tools to help you manage your diabetes. You'll be able to track your progress in a personalised way and identify what's needed to better manage your condition daily. This way you can improve your health outcomes and overall quality of life. The programme also unlocks additional cover for specific needs. So if you will benefit from the guidance of a dietitian or biokineticist, the Diabetes Care Programme will help connect you to the care you need. And help to cover it too.

Find out how to register for the programme here.