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About Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes in the UK, and is caused by problems with the hormone insulin. Our bodies need insulin in order to use glucose, the basic fuel for the cells.

Glucose comes from the food we eat and is absorbed through the digestive system into the bloodstream. Insulin then moves it from the blood to the cells, where it is converted into energy.

If we don't have enough insulin - either because the body does not produce enough, or if it does, the cells don't respond to it as they should - glucose builds up in the blood.

This can cause two problems. Your cells are starved of energy, which is why people with undiagnosed or uncontrolled diabetes can lose weight and feel exhausted.

And over time, uncontrolled high blood glucose levels can damage your kidneys, nerves, heart - or eyes. In fact, some people discover they have type 2 diabetes only when they go to the optician.

However, most people discover they're diabetic during a routine urine test. You may have been feeling more tired than usual, or needing to go to the toilet more often, or have an unquenchable thirst - the last two are signs that the body needs more water to produce urine, which is the way it gets rid of excess sugar.

Type 2 diabetes can occur as we get older, but it is most common in overweight people.

Unlike those who suffer from type 1 diabetes - they don't produce any insulin at all and have to inject themselves with it - type 2 diabetics can often control their blood glucose levels by eating healthily, staying fit and losing excess weight.

The less weight you carry, the better the body's response to the insulin that your pancreas does produce.

Sometimes, type 2 diabetics need medication to stimulate the pancreas. But regardless of whether you are on medication, it's important to slim down gradually and healthily if you are overweight.

All of this may sound tricky, but your diet will be almost the same as it should be for the rest of us - healthy and balanced, with plenty of starchy carbohydrates, especially wholegrain and low glycaemic index foods such as porridge oats, lentils and beans.

You should also have lots of fresh fruit and vegetables.

Plenty of water is also key, and moderate amounts of lean meat, fish and some lower-fat dairy products.

You need to keep your fat intake down - this means choosing lean cuts of meat and using semi-skimmed or skimmed milk.

Not overdosing on animal fats is particularly important - diabetes increases your risk of developing heart disease and you don't want a high cholesterol level to exacerbate the problem.

Saturated fat, found in foods such as butter, cream, fatty meat, cheese, pastries and cakes made with butter, can increase levels of what's known as bad LDL (low-density lipoprotein) cholesterol, so you need to watch these.

And avoid foods that contain hydrogenated fats (e.g. some processed pastries and spreads — look for the word hydrogenated on the label), as these may contain transfats, which have an even more detrimental effect on your LDL levels.

Choose skimmed milk, low-fat yoghurt, cheeses that are naturally lower in fat, such as Edam, or just eat smaller amounts of the higherfat cheeses.

Sometimes we forget that there is no difference between a large amount of a lower-fat food and a small amount of a higher-fat food.

I'd rather have a small amount of a higher-fat cheese, but it takes willpower to stop at just a little.

It is suggested a little natural Greek-style yoghurt is better than more of a watery no-fat yoghurt, especially as no-fat yoghurts are often high in added sugar.

And you want to avoid this, as sugar is quickly absorbed into the body and can cause your blood sugar level to shoot up.

The best sorts of fat are olive oil, hemp oil and other types of vegetable oil, such as rapeseed, which can be found in health-food stores as well as some supermarkets.

Other good fats include nuts and nut oils, as these are rich in polyunsaturated and monounsaturated fat, the healthiest type. But do watch how much you have, as fat of any sort is calorie-loaded.

Diabetics need to stick to foods that produce small, slow rises in blood sugar levels. For this reason, it's best to minimise the amount of foods high in added sugar, such as biscuits, cakes, ice cream and chocolate.

However, the old advice that type 2 diabetics need to avoid anything that's sweet isn't true - you can have a little.

But it's better to save it until after a meal, as the body can cope much better with something sweet on a full rather than empty stomach.

This is because the proteins from the first course, such as meat or fish, slow down the absorption of sugar.

The best sweet food is fresh fruit, as not only is the sugar natural, but the fruit also provides vitamins and minerals.

You don't have to stick to less-sweet fruits such as apples and pears - bananas, pineapple, mango or grapes are fine, in moderation.

You shouldn't eat two large ripe bananas in one go, or tuck into a large bowl of pineapple on an empty stomach, as these fruits have high GIs and could send your blood sugar level a little high.

It's advisable to have a selection of different types of fresh fruit, some with low GIs. Alternatively, add plain yoghurt - and definitely aim for five portions of fresh fruits and vegetables each day.

Finally, you don't need to bother with special diabetic products such as chocolate and biscuits. Not only are they expensive, but they frequently contain a type of sugar substitute that can have a laxative effect.

They also make you feel as if you have a problem, requiring you to be on a special diet, which isn't the case.