Common Type 2 Diabetes Questions
If you have been advised by your doctor that you are pre-diabetic, or if you have been recently diagnosed with Type 2 Diabetes, you likely looking for answers to a lot of questions.
Below you will find some of the common frequently asked personal questions that you too might be thinking about, that we have encountered over the years.
For more general (and sometimes technical) Type 2 Diabetes related information, please check out the Type 2 Diabetes Resource Hub
Q: I am not yet a diagnosed Type 2 Diabetic - how can I reduce the risk of developing it?
A: Prevention is always better than cure. However, given that Type 2 Diabetes can develop over 10 years, and the symptoms not be recognised until they become a problem for the individual (by which time the disease can become advanced), it is important to (1) understand how to spot the symptoms of Type 2 Diabetes (or pre-Diabetes), and (2) take positive action to reduce the risk altogether to begin with (it is never too late to make positive changes!).
Here are some basic tips to help you to reduce the risk of developing Type 2 Diabetes, or to come out of the pre-diabetic range if you do not yet have Type 2:
- Maintain a healthy weight – especially around the belly. Whilst excess weight is NOT a guarantee of developing type 2 Diabetes, being overweight does significantly increase the risk.
- Eat a healthy diet – balancing the major foods groups (carbohydrates, proteins and fats), avoiding processed foods, eating whole foods, reducing the consumption of starchy carbs, sugars and grains can all help reduce the risk.
- Exercise on a regular basis – exercise is good for every system of the body, including your mential health. In relation to blood sugars, regular exercise can help maintain a healthy weight which reduces the risk of Type 2 Diabetes, whilst also helping to reduce blood pressure and cholesterol levels, which in turn helps to maintain a healthly cardiovascular system.
- Stop smoking – by stopping smoking you will reduce the risk of developing many serious diseases, not least of which those assosicated with the complications of Type 2 Diabetes including heart disease, nerve damage and kidney disease.
- Have regular check ups with your doctor – There are 3 well-known ‘silent killers’; high blood pressure, high cholesterol and high blood sugars. They are called silent killers as the symptoms can develop without our knowledge and without symptoms, and only become symptomatic once they become advanced – and by then, a lot of damage can have been done. Having a full health check at least every few years if you are under 40, and then ideally every year or 2 years once over 40 is a good target to aim for.
Q: I am pre-diabetic - does that mean that I am likely to develop Type 2 Diabetes?
A: The simple answer, from our experience, is yes and no.
No, being pre-diabetic does absolutely not mean that you are going to develop Type 2 Diabetes. It should be taken as a warning that things are not well in your body, and it should be taken very seriously and changes in your diet and lifetstyle need to be made. If changes are made and sustained, then there is no reason why you cannot have blood sugars in the normal range in 6 months time.
Yes, you will almost certainly develop Type 2 Diabetes if you continue with the dietary and/or lifestyle habits have led you to the diagnosis.
Ouch! Sorry to be blunt. But that is the sadly reality.
Q: Do I need the help of a nutritionist to manage my Pre-Diabetes/Type 2 Diabetes?
A: In short, no you don’t. Some people have succeeded in coming out of the pre-diabetic range or managing their Type 2 Diabetes through dietary and lifestyle changes. However, it would be remiss of us to say that it is easy, as for most people looking to ‘go it alone’, it can prove to be incredibly challenging.
That is why, in addition to educating you in relation to Type 2 Diabetes and dietary/lifestyle changes, we walk the journey with you – coaching you and keeping you accountable for the decisions you choose and the promises you make.
As the saying goes, “if it was easy, everyone would be able to do it.”
Q: Can I reverse my Type 2 Diabetes?
A: Yes, absolutely. Whilst reversal can never be guaranteed, it is absolutely possible – and achievable in more cases than not.
Q: Should I stop eating sugar altogether?
A:This is loaded question, and the simple answer is no.
Why do we say that? Well, because sugar comes in many forms (check out the piece on ‘sugar’ in the knowledge hub) and it is very difficult to avoid it completely unless you are on a VERY strict (and therefore likely unsustainable) Diet. These sorts of Diets, where large food groups are omitted from a person’s diet are rarely kept to long-term, and can create other health implications as time goes on.
There are, of course, sugars that aggravate blood glucose levels and cause them to rise quickly, and these must be avoided.
Q: What foods have a good (and bad) effect on my blood sugar levels?
A: Your diet will hugely work for you or against you when trying to manage your blood sugar levels.
Choosing whole, natural foods will help stablise blood sugars and, in many cases, start to bring them down. Foods including non-starchy vegetables, green leafy vegetables, lean proteins and healthy fats all play a role in overall health, not just in stablising blood sugar levels.
Processed foods, sugary food and drink, fried foods, sweets, chocolate, refined grains, bread, starchy vegetables and sugar (the list goes on!) on the other hand will work towards raising blood sugars to sometimes dangerously high levels for those with Type 2 Diabetics.
Q: What am I going to be able to eat if I work with i-Nutrition?
A: Real, proper, nutritious food.
Q: What are the different types of medication for managing Type 2 Diabetes?
A: There are a number of different types of medication available for the management of Type 2 Diabetes, and your doctor may prescribe one or more of the following depending on your situation:
- Metformin – This is the most commonly prescribed medication for the management of Type 2 Diabetes, and is often the first medication offered. It works by decreasing the production and release of glucose from the liver, and increasing insulin sensitivity. Common side effects include diarrhoea, stomach upset, and gas.
- Sulfonylureas – These stimulate the Pancreas to work harder, to make it produce and release more inuslin. Within this group are Gliclazide, Glipizide, Glibenclamide and Glimepiride. Common side effects include low blood sugar levels (hypoglycemia), weight gain, upset stomach and digestive issues.
- DPP-4 Inhibitors – Similar to Sulfonylureas , DPP-4 Inhibitors stimulate the Pancreas to release more Insulin by destroying DPP-4, an enzyme that in turn destroys the hormone Incretin. Incretin is a hormone that is produced in the gut and encourages the body to produce more insulin when it is required and at the same times helps to reduce the amount of glucose being produced by the liver. Side effects include headache, upper respiratory tract infection, and upset stomach.
- GLP-1 Receptor Agonists – These help to lower blood sugar levels by, again, increasing Insulin secretion and also by slowing down digestion. Within this group are exenatide, liraglutide, lixisenatide, albiglutide, and dulaglutide. Side effects include nausea, vomiting, diarrhoea, and weight loss.
- SGLT-2 Inhibitors – Unlike all of the above, SGLT-2 Inhibitors reduce blood sugar levels by bringing the kidneys in to play, and preventing them from reabsorbing glucose. In turn, this leads to the body excreting glucose through the urine. Side effects include genital yeast infections, urinary tract infections, and dehydration.
Q: Will I have to take medication for the rest of my life?
A: Yes, possibly, but not definitely.
And yes, almost certainly if you don’t make the necessary changes required to halt the advancement of the disease. The complications associated with Type 2 Diabetes, we feel, should wake a person up enough to take action for the benefit of their short, medium and long term health. Unsure of what the health complications are with advancing Type 2 Diabetes? Take a look here.
On a positive note, there are countless cases of individuals going in to remission and full reversal where medication levels have been dropped by their doctor over time, and eventually stopped altogether.
Whether you do, or do not, take action is your choice – and our choices in life have a habit of catching up with us sometime in the future, for better or for worse.
Q: Will I need to inject with, or take, insulin?
A: The vast proportion of diagnosed Type 2 Diabetics will NOT take insulin. However, in some cases, oral medications can be poorly tolerated or the Type 2 Diabetes itself can become so advanced that taking insulin becomes the only option.
If you work towards reversal of your Type 2 Diabetes and change your diet and lifestyle, the chances of you having to take Insulin to help manage blood sugar levels is very small.
Q: Will I need to take regular fingerprick blood sugar tests?
A: No, if you choose to, you can rely on your 6-monthly HBA1C test results (well, it should be six monthly as the HBA1C test only measures average blood sugars over the previous 90 day or so (for more info on HBA1C, click here). However, we have seen in more and more cases doctors extending the HBA1C testing frequency to 12 months or more.
You can, of course, obtain a fingerprick testing machine and test for yourself on a regular basis, to get to understand the correlation between what you eat/drink and how it affects your blood sugar levels.
You can also invest in a CGM (constant glucose monitoring) system.
How often to test your blood sugar levels
This can vary, but if you are trying to really understand the correlation between what you consume and your blood sugars, and/or you are taking Diabetes medication and/or Insulin, then a few times a day 2 hours after a meal, can be very helpful.
Q: Do I need to worry about low blood sugar levels (Hypoglycaemia)?
A: Most people with Type 2 Diabetes will rarely, if ever, experience Hypoglycaemia, and certainly not on a regular basis. There are, of course, exceptions to this in certain situations – for example if one is injecting Insulin in addition to or instead of oral medication and admisters too much or an inappropriate amount, as the action of Insulin is to drop blood sugars relatively quickly.
As we tell our clients, uncontrolled high blood sugar can kill you over many years, but low blood sugar can kill within hours if left unchecked.
It is therefore important to recognise the symptoms of low blood sugars, either in yourself or in your ability to educate others or perhaps assist someone ‘having a hypo’:
- Shakiness or tremors
- Sweating
- Anxiety or irritability
- Dizziness or lightheadedness
- Hunger
- Confusion or difficulty concentrating
- Headache
- Blurred vision
- Weakness or fatigue
- Nausea or vomiting
(The following is NOT medical advice, but for information only). Immediate treatment might include the adminstering of 15 to 20grams of fast-acting, simple sugar carbohydrates such as a sugary fizzy drink, a glucose tablet, some fruit juice or sweets (such as polo mints). If blood sugars are still low after 5 or 10 minutes, then the above can be repeated and/or the medical services called. Once blood sugars have been restored to normal, a snack or meal that contains a mix of carbs and protein should be consumed to stabilise blood sugar levels.
Q: What is the ideal non-diabetic blood glucose target range?
A: A target range of between 4 and to 6 mmol/L before meals (fasting blood sugars) and less than 8 mmol/L two hours after eating is ideal.
Q: How will having Type 2 Diabetes affect my day to day life?
A: It doesn’t need to if managed properly. However, left unchecked, symptoms tend to worsen as time progresses and, as other Type 2 Diabetes complications come along (see here), an individual’s quality of life can be greatly impacted.
Q: Do I need to change my diet and lifestyle?
A: In all likelihood, yes. In the vast majority of cases, a person’s diet, lifestyle and habits has led them to a diagnosis of pre-diabetes or full Type 2 Diabetes. You simply cannot combat the disease using the same tactics that got you there in the first place.
These changes should be sustainable and form part of a new, healthier way of living – and should include:
- Eating a healthier diet
- Moderating alcohol
- Quitting smoking
- Exercising regularly
- Maintaining a healthy weight
- Monitoring your blood sugar levels
- Managing stress levels
- Getting adequate sleep
- Having regular check-ups with your doctor
Q: What long term complications might I face if my Type 2 Diabetes gets worse?
A: We have written a piece on the long-term complications of (in particular unchecked) Type 2 Diabetes as time progresses, and sadly it does not make for happy reading. However, we believe that knowledge is power, and encourage you to check out the article here).
Q: Are you offering a gimmicky, short term fix that includes meal replacement shakes?
A: Absolutely not! Hopefully by now you will understand that we take the responsibility we have to our clients very seriously, and we go on their journey with them, every step of the way.
We do not sell products of any description nor are we associated with any third party companies. We offer natural and sustainable solutions, based on real food and no gimmicks or quick-fixes.
We believe in balance – getting the macronutrients to work together where you are not taken to one extreme or the other, and introducing natural supplementation where needed to support the reduction in blood glucose.
Find out more about our Pre-Diabetes and Type 2 Diabetes management and reversal programmes here.
Q: What management/reversal programmes does i-Nutrition offer?
A: Depending on where you are in relation to Type 2 Diabetes (at risk, pre-diabetic or diagnosed Type 2 Diabetic), we have a programme that will work for you in heping you achieve your health goals.
Find out more about our Pre-Diabetes and Type 2 Diabetes management and reversal programmes here.
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