A VITAL CONNECTION: Approaching the prevention and remission of Type 2 diabetes

Expert Advice from The Bermuda Diabetes Association

The prevalence of pre-diabetes and type 2 diabetes is on the rise, and the importance of weight loss cannot be overstated in the management and even reversal of these conditions if you are overweight.

Type 2 diabetes is a condition that occurs when your body may not produce enough insulin, or when your body becomes resistant to the insulin it produces. Insulin helps your body use the glucose (sugar) in your blood to give you energy. If you don’t have the right amount of insulin, or if your insulin is unable to work properly, your blood sugar levels will become high, leading to type 2 diabetes. Around 13% of Bermuda’s population has type 2 diabetes, and this rate is higher than the global average of 10%.

The presence of pre-diabetes is a warning sign, indicating elevated blood sugar levels that are higher than normal, but not enough to be classified as type 2 diabetes. When left untreated, pre-diabetes often progresses to type 2 diabetes. It is estimated that over 470 million adults will have pre-diabetes by 2035, and 93 out of 100 people do not even realise they have it.

The good news is that pre-diabetes is reversible. Weight loss plays a central role in this process and is one of the main recommendations for helping those already diagnosed with type 2 diabetes achieve remission. If you are living with diabetes or pre-diabetes, the health benefits of losing 5-7% of your body weight can be considerable.

• Losing weight, if you are overweight allows your body to use insulin more efficiently to regulate blood sugar.

• Reduced fat accumulation, particularly around the abdomen, improves insulin sensitivity and reduces the risk of pre-diabetes progressing to type 2 diabetes.

• Weight loss lowers blood pressure and improves cholesterol levels. This is significant because these are both risk factors for heart disease, and people with diabetes are at increased risk of heart disease by nearly 50%.

• As you lose weight, your body requires less insulin to regulate blood sugar levels. It can reduce the need for diabetes medications and improve overall blood glucose management.

• It is possible for individuals to reduce or even eliminate their dependency on diabetes medications when they lose weight.

• Diabetes-related complications such as cardiovascular disease, kidney disease, and neuropathy can be significantly reduced with weight loss.

• Weight loss improves energy levels. This can contribute to a better quality of life and make diabetes management easier.

• It is important to make healthy food choices. The cornerstone of weight loss success is a balanced, calorie-controlled diet. Put an emphasis on whole foods, vegetables, lean proteins, and whole grains. Limit sugary, sweet foods, processed foods, avoid sugary drinks, and reduce intake of high fat foods.

• Increasing physical activity is a key component to improving insulin sensitivity and helps weight loss by increasing our metabolic rate. Building lean muscle and losing weight can be achieved by combining aerobic exercise and strength training.

• Portion size is an important part of weight loss, and reducing portion sizes is an effective means of managing your blood glucose levels, particularly portions of carbohydrate containing foods.

The Abbott FreeStyle Libre has come as an entirely new concept in glucose monitoring. Instead of pricking your finger, the Abbott FreeStyle Libre glucose monitor provides ‘flash glucose monitoring’ through the scanning of a sensor on your arm. Using this method helps you to determine whether your blood sugar levels are going up, down, or staying stable. You can use this tool to learn how to keep your glucose readings within your normal range if you are living with type 2 diabetes. It is useful for those with pre-diabetes, helping you learn more about what affects your glucose levels which can enable you to make dietary modifications in order to reduce your risk of developing type 2 diabetes.

A good understanding of your glucose patterns is certainly a key component in reversing pre-diabetes and supporting type 2 diabetes remission. Thanks to advances in technology, monitoring glucose levels has become much easier, and glucose monitoring devices like the FreeStyle Libre, now available and used widely in Bermuda, can help people monitor their sugar levels more conveniently, and provide more meaningful data to help make healthy choices which have positive outcomes for weight and glucose levels.

To achieve long-term success with weight loss to reverse pre-diabetes and type 2 diabetes, it is essential to develop healthy habits and make sustainable lifestyle changes. Nutrition education and support with lifestyle changes are important steps to your success. Create a strong support network around you, and for professional guidance and support speak with your GP about a referral to see a Registered Dietitian.

To learn more about our programs, and individual medical nutrition counselling available at the Bermuda Diabetes Association, visit our website www.diabetes.bm.

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