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Diabetes & Strategies for Prevention

The number of people with diabetes in Canada is increasing at near epidemic rates. It has been estimated that by the year 2010, over 3 million Canadians will be afflicted by this condition. This PROfile® health brochure has been designed to inform you of the lifestyle choices that will reduce your risk of developing type 2 diabetes.

First, we need to understand the factors that increase our risk for type 2 diabetes. These can be broken down into modifiable (we can do something about them) and non-modifiable (e.g. we don't have any choice in who we are related to!) risk factors.

Modifiable Risk Factors

Overweight (especially if most of the weight is carried around the middle)
High cholesterol or other fats in the blood
High blood pressure
Little or no exercise in daily routine

Non-Modifiable Risk Factors

Age 40 and up
Parent or sibling with diabetes
Aboriginal, Hispanic, Asian, South Asian, or African descent
Been told that you have impaired glucose tolerance, impaired fasting glucose, or "prediabetes"
Have complications linked with diabetes (such as heart, kidney or disease, numbness in hands and/or feet, trouble getting or maintaining an erection)
Gave birth to a 9 lb (4 kg) or bigger baby
Had diabetes during pregnancy (gestational diabetes)
Have been diagnosed with polycystic ovary syndrome, schizophrenia, or acanthosis nigricans (velvety, darkened patches of skin)

When Should I Be Tested for Diabetes?

If you are 40 years of age or older, the Canadian Diabetes Association suggests you should be tested for diabetes at least every three years. If you have any of the non-modifiable or modifiable risk factors listed on the previous panel, you should be tested earlier and more often. Finally, if you experience any of the following symptoms, you should call your doctor and get tested for diabetes.

Unusual thirst
Frequent urination
Extreme fatigue or lack of energy
Blurred vision
Frequent or recurring infections
Cuts and bruises that are slow to heal
Tingling or numbness in hands or feet

Reducing the risk of developing type 2 diabetes therefore includes adopting a healthy diet, engaging in adequate amounts of exercise and keeping your weight under control.

Diagnosing Type 2 Diabetes

The Canadian Guidelines for Diabetes defines the following categories for fasting (not having eaten for 8 hours) blood sugar values:

Less than 6.1 mmol/L = Normal
6.1 - 6.9 mmol/L = Impaired fasting glucose
7.0 mmol/L or greater = Diabetes diagnosis

Note: Diagnosis may be made by other means. Usually, more than one test is needed to confirm a diagnosis. You should have your blood sugar tested at least once a year if you fall into the Impaired Fasting Glucose category.

A Healthy Diet Using Canada's Food Guide

Canada's Food Guide to Healthy Eating is an excellent resource for designing a diet that is healthy and nutritious. It is available at most public health units, many health professional establishments and on the world wide web at: www.hc-sc.gc.ca/fn-an/food-guide-aliment/index_e.html

The Food Guide has 5 basic principles:

Enjoy a variety of foods.
Emphasize cereals, breads, other grain products, vegetables and fruits.
Choose lower fat dairy products, leaner meats and food prepared with little or no fat.
Achieve and maintain a healthy body weight by enjoying regular physical activity and healthy eating.
Limit salt, alcohol and caffeine.

The recommendations for a healthy diet promoted by the Canada Food Guide are based on food groups:

Grain Products: 5-12 servings per day

Vegetables and Fruit: 5-10 servings per day

Milk Products: 2-4 servings per day

Meat and alternatives: 2-3 servings per day

Examples of 1 serving:

Grain Products:
30g cold cereal, 1/2 bagel

Vegetables and Fruit:
1 medium size vegetable or fruit

Milk Products:
1 cup milk, 50g cheese

Meat and alternatives:
50-100g poultry or fish

The side of food containers will often list the food groups contained and the quantity of each that represents one serving of each food group.

Canada's Physical Activity Guide for Exercise

An active lifestyle reduces the risk of diabetes by promoting a healthy weight and improving metabolism. 'Canada's Physical Activity Guide' is an excellent resource for ideas of the types and amounts of exercise that are appropriate for individual circumstances. The guide can be found on the world wide web at www.paguide.com

The Guide recommends a variety of activities from three different activity groups which include:

Endurance activities (e.g. walking, swimming, hiking, skating, dancing, cycling, tennis)
Flexibility activities (e.g. stretching, gardening, golf, yoga, bowling, dancing, curling)
Strength and balance activities (e.g. climbing stairs, weight training, piling wood)

You should always start an exercise program slowly and engage in activity 4-7 days/week. If you have a medical condition, consult with your doctor before starting an exercise program.

What Is My Ideal Weight?

The risk of developing type 2 diabetes increases dramatically in people who become overweight or obese. Weight categories are usually based on a figure known as Body Mass Index (BMI). The number is obtained as follows:

weight (kg)/height (m)2

For example, if you weigh 60 kg and are 150 cm (1.5 m) tall, your BMI = 60/1.52= 26.7 kg/m2

BMI of 18.5-24.9 is desirable for most people
BMI of 25-27 is termed 'overweight' in Canada
BMI greater than 27 is termed 'obese' in Canada

Talk with your doctor or dietitian about strategies for reducing weight if you fall into the overweight or obese categories.

Where to Find More Information

The Canadian Diabetes Association

National Office:
15 Toronto St., Suite 800
Toronto, Ontario M5C 2E3
Phone: 1-800-226-8464 for the regional office
nearest you or visit their website.
www.diabetes.ca

American Diabetes Association

ATTN: National Call Center
1701 North Beauregard St.
Alexandria, Virginia USA 22311
Phone: 1-800-342-2383
e-mail: AskADA@diabetes.org
www.diabetes.org