Last Updated on Tuesday, 17 November 2009 12:07 Written by Chris Cheyette MSc BSc RD

The number of people being diagnosed with diabetes in the UK is increasing dramatically. 

Diabetes UK reports that there are 2.6 million people currently diagnosed, with around a further half million who do not know they have diabetes. Recent figures show that in the last year the number of people diagnosed in England alone was 125,000. 

There are a number of reasons for this increase but an aging population and a huge escalation in the number of people who are overweight and obese are key.

It has been estimated that adults with a body mass index (BMI) of more than 35 are 30-40 times more likely to develop Type 2 diabetes compared to those with a BMI of less than 22.   In fact, obesity increases the risk of diabetes more than any other disease.  Around 90% of those who are diagnosed with diabetes are thought to be overweight or obese.

What is Type 2 Diabetes?

Type 2 diabetes develops when the body is unable to regulate the sugar level in the blood stream.  This happens because the body is either not producing enough insulin (the hormone which clears away sugar), or because the body cannot properly use the insulin it makes.

Type 2 diabetes can sometimes be treated by diet alone.  However, it is a progressive disease and may need treatment with diet and tablets, or diet and insulin.  It is usually diagnosed in people over the age of 40 years, but if you are from a black, Asian or ethnic minority group, this is above 25 years of age. 

You are more at risk of Type 2 diabetes if:

• You have a family history of diabetes.

• You are overweight – this is defined as having a body mass index of over 25.

• You have a large waist circumference – 35 inches or over for Asian men; 37 inches or over for white and black men; 31.5 inches or over for all women.

• You have high blood pressure.

• You have had a heart attack or stroke.

• You have polycystic ovarian syndrome (PCOS).

Can Type 2 Diabetes be Prevented?

The good news is that if your risk is identified early on, you can dramatically reduce the chance of developing diabetes.  Around 90% of people diagnosed with Type 2 diabetes are overweight or obese.  The Finnish Diabetes Prevention Study (2001) showed that people who were likely to develop diabetes were able to reduce their risk by around 60% by increasing their physical activity and losing around 7% of their body weight. 

If you are overweight, here are some top tips for reducing your risk and getting in shape:

Get Moving

A 2004 report by the Department of Health estimated that adults who are physically active have a 50% reduced risk of developing chronic diseases such as coronary heart disease and Type 2 diabetes.

Being active each day helps to keep your weight under control, reduces body fat and also uses up excess glucose in your blood stream.  Ideally you should aim to do at least 30 minutes of moderately intense activity (where you get a little out of breath) each day.  This does not have to be jogging or at the gym; just begin by thinking of ways to increase your everyday activities.  This could include getting off the bus a couple of stops early, walking up escalators, or going for a brisk walk each evening. 

Increase your Fibre Intake

Most of us do not get enough fibre in our diets.  Choosing more high fibre carbohydrates can help to fill you up for longer, reduce cholesterol and also slow the absorption of glucose into the blood stream.  High fibre options include porridge, all-bran, granary bread, beans, lentils, fruit, vegetables and wholemeal spaghetti.

It is important to note that if you increase your fibre intake, you should also increase your fluid intake by having around 2 to 2.5 litres of fluid per day.  This will help to prevent you feeling bloated and constipated.

Portion Control

Understanding portion sizes is crucial to weight loss.  By choosing food groups in the right proportion, it is possible to reduce calories and reduce your waistline. 

In 2003, a study in the USA found that between 1977 and 1996, the number of calories per serving increased by as much as 133%.

The Food Standards Agency recommends that we should have a third of our food intake from starchy carbohydrates; a third from fruit and vegetables; and the remaining third from meat, fish, eggs and dairy sources.  This is shown in Figure 1.

 

The pictures below, taken from the Carbohydrate & Calorie Counting book Carbs & Cals, show how you can easily lower your calorie intake by reducing your food portions (Figure 2) or switching to a healthier alternative such as kiwi instead of crisps (Figure 3).

Drink Alcohol in Moderation

If you are trying to lose weight and reduce your waist size, a great way to start is by reducing your alcohol consumption.  Alcohol may provide you with a great night out but it’s not only your head that can suffer; it contains no beneficial nutrients, so all you get is a lot of calories.  There is also the potential for long-term damage to your liver and high blood pressure if you over-consume on a regular basis.  Look at the picture below (Figure 4) to see just how many calories are in popular alcoholic drinks. 

Get some Support

Making changes to your lifestyle and diet can be difficult.  Long-term changes take hard work, so it’s a good idea to ensure that you don’t set yourself up for failure.  Be realistic about what changes you want to make, and try to do a couple of small changes at a time.  It is always worthwhile enlisting the help of a friend, relative, partner, slimming group or health professional.  This will enable you to discuss your progress, get advice and keep your motivation going.

Conclusion

The above information will hopefully point you in the right direction of how you can start to make some lasting and important changes to your health.  You can also contact your GP or practice nurse to discuss other help available for weight loss, or if you think you may be at risk of diabetes and have not yet been checked.

For more detailed information about diabetes, signs, symptoms and treatments, visit www.diabetes.org.uk.

Authours Bio:

Chris Cheyette MSc BSc RD is a registered dietitian, specialising in diabetes.  He works full-time in the NHS, and is co-author of a new book called Carbs & Cals: a visual guide to Carbohydrate Counting and Calorie Counting for people with Diabetes. For more information visit www.carbsandcals.com

References:

Department of Health, 2004. At least 5 a week. London: Department of Health

Field, A.E., Coakley, E.H., Must, A., Spandano, J.L., Laird, N., Dietz, W.H., Rimm, E., Colditz, G.A., 2001. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 161 pp.1581-1586.

Nielsen, S.M., Popkin, B.M., 2003. Patterns and Trends in Food Portion Sizes, 1977-1998. JAMA 289 pp.450-453

Tuomilehto, J., Lindtrom, M., Eriksson, J., Valle, T., Hamalainen, H., Ilanne-Parikka, P., Keinanen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., Salminen, Uusitupa, M., 2001. Prevention of Type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New Eng J Med 344 (18) pp.1343-1350