Jasmine Lee Si Xian, an experienced Dietitian at Tan Tock Seng Hospital, explained that diabetes is a chronic disease where a person has abnormally high blood sugar levels because the body does not respond to insulin effectively, or does not produce enough insulin.
There are 3 main types of diabetes:
- Type 1 diabetes is caused by genetic or unknown factors where the body produces little or no insulin.
- Type 2 diabetes is linked to family history, sedentary lifestyle, obesity, ageing and lifestyle factors (including diet). This is the most common type in Singapore.
- Gestational diabetes happens in pregnant women who have not previously had diabetes but have high blood sugar levels during pregnancy
Sugar is not the direct cause of Type 2 Diabetes. However, eating lots of sugary food is not recommended as it will be converted to excess energy, which gets stored as fat. This in turn increases your weight and thus increases your risk of getting Type 2 Diabetes.
NOT ALL SUGARS ARE CREATED EQUAL
There are two different types of sugar. The first is naturally occurring carbohydrates, which are found in rice, noodles, bread, fruits, starchy vegetables and dairy products, to name a few of the sources. The second is refined sugar, which is found in cakes, chocolates, ice cream, sweetened beverages, white sugar and so on.
"Carbohydrates are released into the bloodstream at a slower rate, leading to a slow rise in blood sugar levels instead of a sudden spike, as they still have to be broken down into sugar,” explained Jasmine. “By comparison, refined sugar is readily absorbed into the bloodstream, leading to a sudden spike in blood sugar levels."
Though carbohydrates sometimes attract bad press, they are in fact the body’s main source of fuel and only source of energy for the brain. When carbohydrates are not available, the body turns to other sources of energy, namely fat and protein. As fat is less efficient for the body to use, protein tends to be used, leading to muscle depletion and a compromised immune system.
Clearly, carbohydrates are an essential part of a healthy diet. However, complex carbohydrates are preferable to simple ones, as they are higher in fibre and thus prevent a rapid rise in blood sugar levels. Some good examples include wholegrain noodles, wholemeal bread, oats and brown rice. They will keep you feeling energised for longer than simple carbs, and won’t lead to the energy slump that typically follows a sugary meal.
THE DIABETIC DOMINO EFFECT
When a carbohydrate is consumed, it gets broken down into sugar in the stomach and is absorbed into the blood stream, increasing blood sugar levels. When blood sugar levels are high, the pancreas produces insulin, a hormone which helps sugar in the bloodstream to enter body cells to be used as energy.
In the body of a person with Type 2 Diabetes, the insulin does not work effectively and sugar remains in the bloodstream. The following symptoms occur:
- Constant hunger, as the body is unable to utilise the sugar as energy.
- Unintentional weight loss, as the body starts burning muscle and fat for energy.
- Frequent thirst and urination, as sugar in the bloodstream draws water out from the body.
Long-term complications include:
- Poor wound healing, as diabetes can affect the nerves and lead to poor blood circulation, which in turn can lead to an increased risk of infection and may result in the need for amputation.
- Damage in various organs such as the eyes, heart, kidney and brain, which may result in heart disease or stroke.
If blood sugar levels remain high, conditions such as Diabetes Ketoacidiosis or Hyperosmolar Hyperglycemic Nonketotic Syndrome can occur. These require immediate medical attention and, if left untreated, can result in a coma or even death.
Diabetics should limit all kinds of food that contain refined sugar. Artificial sweeteners should be used in moderation only, since most have a laxative effect if used in excess.
Jasmine recommends mindful eating for diabetics and non-diabetics alike. Portion control helps keep weight in check, whereas uncontrolled mindless eating can lead to weight gain and obesity, which in turn increases the risk of Type 2 diabetes.
Exercise mind over matter and you won’t get fatter – nor will you get Type 2 diabetes!
With thanks to:
Jasmine Lee Si Xian
Tan Tock Seng Hospital