Diabetes: A treatable condition that too often goes untreated

12/05/2019

The prevalence of type 2 diabetes continues to increase worldwide. Globally, it’s expected to double in the next 20 years. In Canada, diabetes affects about 8% of the population overall, and 1 in 10 adults. About 90% of these cases are type 2.

Despite the fact that it’s a growing problem, there have been significant advances in our understanding of the condition, how to prevent it, and what to do to improve outcomes for those who are diagnosed. The introduction of Metformin has been a huge advance, as has the more recent focus on risk prevention that has many physicians prescribing anti-cholesterol medication to diabetes patients who don’t currently have high cholesterol.

Read: Blood pressure and heart health - It's all about risk

Yet outcomes for diabetes patients remain highly variable, and they depend a great deal on a patient’s behaviour post-diagnosis. The typical 55-year-old man who is newly diagnosed can expect to live another 21 years if he’s a non-smoker and keeps his blood pressure, cholesterol levels, and blood sugar within a healthy range. However, the same man stands to lose eight years if he smokes, and fails to keep those key indicators at optimal levels.

Butting out is best

Smoking is not only a risk factor for heart attack, stroke and a number of cancers, but it also plays a big role in the prognosis for diabetes patients. While it doesn’t affect blood glucose levels, with our current understanding of diabetes risk factors, smoking can compound the inherent risk of heart disease that is associated with diabetes. And so, while quitting smoking is a good idea for someone without diabetes, it becomes essential for someone with the condition.

Get moving

As with many other health conditions, diet and exercise are also critical to reducing the risks associated with type 2 diabetes. Diabetes Canada recommends that patients living with the condition get at least 150 minutes a week of moderate-to-vigorous exercise, including both aerobic exercise and resistance training, like weight lifting. That’s 30 minutes, five times a week. In addition, it’s also recommended that diabetes patients maintain a generally active lifestyle. That includes avoiding sitting or lying down for extended periods.

Read: Helping your teenage kids get off the couch

You are what you eat

In terms of diet, Diabetes Canada, like every other health advocacy group, recommends drinking water instead of juice, alcohol, or pop. It also advocates portion control, replacing processed foods with fresh fruits, vegetables, and whole grains, and trying to replace some of the proteins you would usually get from meat with lower-fat options like legumes.

There are two other diet recommendations that are very specific to diabetes. One is to space out meals and snacks, in order to keep your blood sugar levels steady throughout the day. You should never go more than six hours without eating something. Experts also recommend that diabetes patients choose more vegetables than fruits.

Read: Kids nutrition is nutrition for life

Together, regular exercise and a healthy diet can go a long way controlling those key health indicators that are so critical to avoiding dangerous complications associated with diabetes. Namely, blood sugar, blood pressure, and cholesterol.

Making the most of your medication

Of course, lifestyle changes alone are generally not enough to avoid the dangerous fluctuations in blood glucose levels that ultimately lead to heart disease, blindness, and other devastating outcomes. And that brings us to the importance of taking medications as directed.

A 2016 study found that among patients with type 2 diabetes, between 38% and 93%, were not adherent to their medication, meaning that they did not take their medication as prescribed. The most common definition of non-adherence requires a patient to refill their prescriptions on time at least 80% of the time. This is a fairly reliable definition given that a patient can’t take their medication if they don’t have it to take. It is important to note that medication non-adherence results in many cases in negative health consequences for the patient which may even lead to hospitalization. In many instances, the non-adherent patient may end up requiring additional medications due to deterioration of their medical condition.

Failing to pick up prescriptions, or letting a few days pass between running out and picking up a fresh bottle of pills, means patients are spending too much time with blood sugar levels (and possibly blood pressure and cholesterol, too) that are not in the optimal range. Unlike some other conditions, the damage done in those few days can be irreversible and can literally shorten your life.

With the advancement of medical science, a certain amount of apathy can set in, and we can be led to believe that the doctors are taking care of us. When it comes to diabetes especially, doctors and pharmacists can only help guide us. It is our responsibility to take care of ourselves.

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