Type 2 Diabetes, The Invisible Killer

The paunch: an inevitable and yet ultimately innocuous fact of life eventually facing most men in the UK, you might think. But as you notice that slight thickening of the waist and dimpling around the kidneys, a chemical process is underway with the potential to change your life, if you ignore it that is. Although you don't know it yet that spreading midriff is poisoning your metabolism and may, by the time you hit your mid-forties have set you on the road to a premature death from the irreversible complications of the world's current invisible epidemic: Type 2 diabetes.

This is just a warning. It is not meant to alarm, merely cause you to take note - and action. If what you are about to read causes concern, and it should be, then console yourself with the knowledge that you can do something about it before it happens. The thing to remember with diabetes is that, perhaps more than any other disease, it's down to you, mainly what you eat and if you exercise.

Have you noticed you're buying jeans with a bit more room? The first signs are relatively mild. A 37-inch waist or more and you could be joining the ever-swelling ranks of diabetics, now an unnerving 1.8 million, with a more worrying 1 million still undiagnosed lust in the United Kingdom. About 70% will die from heart attacks or strokes, hundreds a year will go blind, while 1000 will suffer kidney failure. Crucially though the incidence of diabetes in the UK has risen by 450 per cent since 1960 and the acceleration continues.

Worldwide statistics are equally alarming and help explain the UK's figure. Diabetes affects 150 million people in every corner of the world, not just in Western societies where obesity is rife. By 2025, the World Health Organisation predicts the number of diabetics worldwide will reach 300 million. Each year, the disease claims more lives than breast cancer or AIDS, and is the fourth most common cause of death in developed countries. One study estimates treatment of diabetes accounts for 9 per cent of the health care budget in the UK, that's a staggering 9893 pounds sterling every minute.

The Government puts the cost at a mind blowing 4 billion punds sterling and likely to rise to 10 per cent within six years. It is without doubt the world's most alarming - and yet ultimately preventable health crisis.

So what is happening?

As your nascent gut gradually expands, toxic fatty acids (that's beer and burgers) radiate from within, lowering "good" HDL cholesterol levels and materially changing the structure of arteries, which can contribute to high blood pressure. What's more, your burgeoning midriff is among the causes of insulin resistance, where the hormone fails to properly convert blood glucose into energy, leaving levels dangerously high. The pancreas goes into overdrive to produce more insulin.

Alarmingly 10 years before your Type 2 diabetes is even diagnosed you are displaying four of the defining characteristics (obesity, low HDL cholesterol, high blood pressure, insulin resistance) of metabolic syndrome - the condition that puts you at risk of developing the world's fastest-growing illness. Then, as you age, the continual assault of toxic compounds on your pancreas reduces its ability to produce enough insulin - known as insulin deficiency. As you near 45, it stops and pancreas cells begin to die.

Although diabetes can often be prevented, it remains incurable despite vast medical resources. Most money goes on managing the illness with tablets or self injected insulin, regular monitoring for deterioration, hospital aftercare for those who have hypos (dangerously low blood sugars) and surgery when things go wrong. A pioneering treatment, islet cell transplantation is now available, in which insulin producing beta cells from a donor are injected into a (Type 1 only) diabetic's liver. However, this is only suitable in certain cases and the potential side effects (including deterioration of kidney function) mean it is recommended only for seriously ill patients.

The problem is the tell-tale symptoms of this silent epidemic often go unnoticed until it's too late. Tiredness, thirst, frequent urination and infections as the glucose in your blood rockets are all indicators.

People with the initial symptoms of Type 2 diabetes don't go to the doctor as they feel they are only minor irritations that will pass, and nobody like wasting the doctor's valuable time, but by the time you do, your body has been ravaged by an invisible disease for a decade and the damage has been done.

Frightening, isn't it? Well, yes; but it needn't be, not if you follow the simple steps to protecting yourself. They involve a more sensible diet and exercise regime - it's that easy. And if you're unlucky enough to develop diabetes despite taking these steps, it needn't ruin your life.

The boxer Sugar Ray Robinson was diabetic, as are Joe Frazier, the golfer Jack Nicklaus. Britain's greatest ever Olympian, Sir Steve Redgrave, still managed to pick up a few gold medals despite being a sufferer.
Type 2 diabetes is caused by many malfunctions, imbalances and deficiencies, a lot of which can be attributed to modern living.

The only treatment is a change in lifestyle. Some doctors believe you can treat type 2 diabetes with a lot of exercise and no medication at all. Exercise makes you more insulin-sensitive, so if you're fit you can make much better use of the small amount of insulin you actually have.

If that insulin is not really working and your blood sugars are high, and then you add exercise, they will come back to normal. Exercise can be the treatment and the prevention. Exercise also helps keep diabetes at bay or under control by regulating glucose levels and preventing blood pressure from rising. Diabetics should get advice from a doctor about precisely the kind of exercise that is best for them. Light running, swimming and walking are all heartily endorsed.

You will probably be advised to spread your exercise schedule over a week, half an hour a day is far more beneficial than three hours once a week. In the same way, the simple step of eating more healthily and regularly can limit the damage the disease inflicts.

Although weight loss is advisable, a low-carbohydrate diet to achieve it is no good here. Regular meals based on starchy foods such as bread, pasta, potatoes, rice and cereals will help control blood glucose levels. Go for carbohydrates with a low glycaemic index (GI) - sweet potatoes, wholemeal bread, long-grain rice, all which give slow-release energy and help keep blood sugars low.

Those with a family history of diabetes should also go for annual check-ups. If both your parents have Type 2, the chances of you developing it are 75 per cent, if either your mother or your father has it; the chances are 20 per cent. It's here that perhaps the most pernicious aspect of the current diabetes problem reveals itself.

Although anyone can get diabetes, those of Afro-Caribbean or South-east Asian origin are three to five times more likely to do so than Caucasians. More than 20 per cent of Indian men over the age of 50 have diabetes, and some ethnic groups are even more prone. Clearly, then, there is more to the illness than being fat, lazy, greedy and indifferent.

It's likely that the world's steady conversion to a Western diet of processed foods high in fat, sugar and salt is responsible. Combined with an increasingly sedentary lifestyle (an office job, driving instead of walking), again copied from the West, poor diet seems to affect some populations worse than others. Although some scientists believe that genetics may have a big part to play in type 2 diabetes it can't be denied that up to half of all cases might be eliminated if weight gain in adults could be prevented, in other words if we ate healthily and took more exercise.

The invisible epidemic need not claim you. Take note and take action.