Diabetes

Diabetes is a condition caused by the pancreas either not producing enough of the hormone insulin, or failing to produce any of it at all. It can also be caused when the body fails to react properly to insulin. If left untreated, diabetes can lead to many health problems, some of which are life-threatening. 

Diabetes is one of the leading causes of blindness, kidney failure, heart attack, stroke and non-traumatic lower limb amputation in Uganda. According to the International Diabetes Foundation, in 2021, an estimated 716,000 adults in Uganda had diabetes. According to the World Health Organisation (WHO) 89 per cent of Ugandans with diabetes may not realise they have it and therefore, not be taking the medication they need. This means, by the time they see a doctor, they may be suffering complications that are difficult to treat.

Type 1 diabetes

Type 1 diabetes is what’s called an autoimmune disease. This is where the body’s own immune system attacks certain cells in the body by mistake. In type 1 diabetes the immune system targets and destroys cells in the pancreas that produce insulin. This type of response involves a genetic predisposition (diabetes in the family) but is thought to be triggered by an environmental factor.

Various factors that trigger type 1 diabetes include viruses and some proteins found in cow’s milk. It is now widely accepted that early and adolescent exposure to cow’s milk (including infant formula) may be a trigger for type 1 diabetes in some people.

Find out more about why people develop type 1 diabetes and how to manage the condition better through diet here.

Type 2 diabetes

Most people with diabetes have type 2 diabetes. It’s the one that usually develops in adults and is strongly linked to lifestyle and being overweight or obese. Fat around the tummy especially puts people at increased risk because it releases chemicals that can increase insulin resistance. Unhealthy diet and lifestyle tend to cause weight gain but even if you don’t carry much extra weight, your body might be suffering the consequences. That’s because excess fat doesn’t just get stored under the skin but also in muscle and liver cells where it interferes with sugar metabolism and makes insulin unable to do its job.

Type 2 diabetes used to occur mostly in people over the age of 40, but it now affects people at a much younger age because of soaring rates of childhood obesity.

Unhealthy diets, high in animal fat (mainly from meat, dairy and eggs), cholesterol, sugar and processed food and lack of physical exercise are largely to blame for the diabetes epidemic. Meat consumption is linked to type 2 diabetes, whereas vegetarians and vegans are at a much lower risk. Moreover, animal products in general contribute to weight gain because they contain considerable amounts of fat, too much protein and no fibre. On the other hand, vegans are much more likely to be a healthy weight.

If you have type 2 diabetes, you can significantly improve your health or even reverse the condition through a wholesome vegan diet. This means cutting out meat and dairy while eating more fruit, vegetables, wholegrains, pulses, nuts and seeds. See our success stories here.

Gestational diabetes affects some women during pregnancy and there are other rarer types of diabetes, too.

Symptoms

Early symptoms of diabetes include urinating more frequently than usual, particularly at night, feeling thirsty, feeling more tired than usual, experiencing unexplained weight loss, genital itching or thrush, blurred vision and cuts and wounds taking longer to heal.

Prevent and reverse diabetes with diet and lifestyle changes

The good news is, diabetes is preventable and for those who are already affected, it can be managed and even reversed through changes in your diet and lifestyle. More and more health professionals now recommend a healthy plant-based diet and many people with type 2 diabetes have been able to reduce their medication or come off it entirely.

Insulin – sugar is not the villain

The hormone insulin allows glucose in your blood to enter your body’s cells to provide energy. When working properly, it acts as a key opening cell doors to allow in glucose but with diabetes, the lock is jammed. In all types of diabetes, glucose can’t get into your cells efficiently and so builds up in your blood to a point where it can damage your heart, eyes, feet and kidneys.

Despite popular belief, sugar isn’t the villain. Type 2 diabetes is usually, but not always, linked to increased body weight as when your diet contains too much fat, tiny droplets of it are stored under the skin and in muscle and liver cells. When it reaches a certain level, it reduces the cells’ ability to react to insulin – this is called insulin resistance.

Studies show that insulin resistance in muscles and liver is strongly linked to the amount of fat they store. If you’re obese, it’s more likely your muscle and liver cells will store fat but you don’t have to be overweight for this to happen and unfortunately, the problem doesn’t always show.

Unhealthy fatty diets are the problem

Diets, high in meat, dairy, fatty and processed foods can cause the build-up of fat droplets in your cells. On the other hand, wholefood, plant-based diets protect against this – which is why vegans are 50 per cent less likely to develop diabetes, have more efficient blood sugar control and higher insulin sensitivity than any other dietary group.

It follows that a wholesome, low-fat vegan diet is the best way of preventing and reversing type 2 diabetes. It helps to reduce fat stores in the cells, improves blood sugar control, reduces blood cholesterol, helps to induce weight loss without restricting portion sizes, prevents kidney and nerve damage and helps to lower blood pressure. In several clinical trials, people with type 2 diabetes were prescribed a combination of diet change and mild exercise and as a result, most were able to reduce or discontinue their medication in as little as three weeks!

Plant-based wholefoods tend to contain considerably less fat than animal products – saturated fat in particular. They also contain fibre (meat, fish, eggs and dairy contain none), which helps to regulate blood sugar, as well as many beneficial phytochemicals and complex carbohydrates, which promote positive and long-lasting health benefits.

Much of the fat in animal products is saturated and you don’t need to eat any saturated fat in your diet. By avoiding all animal products, your fat intake will naturally drop and your cholesterol intake will be zero as plant foods contain none. You do need some omega-3 fats which are essential to health. The best sources are ground flaxseeds, chia seeds and hempseeds (1-2 tablespoons) or walnuts (about 10 halves). So don’t avoid nuts completely but be aware of how many you eat.

Protecting your kidneys is a key issue for anyone with diabetes and animal protein from meat, fish, dairy and eggs, can place an additional strain on the kidneys and may worsen any damage already caused. Animal products contain no fibre or healthy carbohydrates while plant foods, supplemented with vitamin B12, contain all the nutrients you need.

The glycaemic index 

The glycaemic index (GI) is a measure of how quickly food releases sugars into your bloodstream after you’ve eaten it. High-GI foods can cause a spike in your blood sugar levels but low-GI foods release sugar more gradually. It follows that eating low-GI foods can help to keep glucose levels steady after eating so try to focus on these rather than high-GI foods.

Low GI foods include: most fruits and vegetables, pulses (beans, peas, lentils, chickpeas and soya), nuts and seeds, sweet potatoes, dried apricots and oats.

Medium GI foods include: wholemeal and rye bread, crispbread, brown rice, basmati rice, quinoa, corn, porridge oats, shredded wheat, pineapple, cantaloupe melon, figs, raisins and baked beans.

High GI foods (avoid as much as possible) include: potatoes, rice cakes, watermelon, pumpkin (in larger amounts), parsnips, white bread, white rice, cornflakes, sweet cereals, dates and sugary foods.

Good Foods to Prevent or Help Reverse Diabetes

  • Vegetables – most green leafy vegetables and root vegetables have a low glycaemic index and contain many essential vitamins and minerals as well as cancer-fighting antioxidants
  • Fruit – it’s a mistake to think that because fruits are sweet, they should be avoided. Most fruit (and dried fruit such as apricots and prunes) have a low glycaemic index – except watermelons and pineapples.
  • Wholegrains – rich in complex carbohydrates, brown rice, wholewheat bread, millet, barley, buckwheat and quinoa are a smart choice for everyone. If you do have diabetes, wholegrain foods can help control blood glucose levels because they tend to have a lower glycaemic index
  • Pulses – peas, beans and lentils – are great foods for so many reasons. Mixing them with your meals increases their low-glycaemic qualities, makes them more filling and adds more protein and iron – as well as being low in fat
  • Nuts and seeds – little and often is key. Almonds, walnuts, chia seeds, flaxseeds and hemp seeds are rich in healthy fats, protein, fibre, vitamins and minerals. They can help regulate blood sugar levels, improve insulin sensitivity and reduce the risk of type 2 diabetes when eaten in moderation. To ensure a good intake of omega-3 fats go for flaxseed (linseed) or hempseed sprinkled on breakfast cereal or added to smoothies or a small handful of walnuts. The body only needs small amounts so the low-fat rule applies even to the ‘good’ fats in nuts and seeds.
  • Cinnamon – research shows that cinnamon can help to improve blood glucose levels and increase insulin sensitivity – sprinkle some on your porridge/posho

Conclusion

What you eat has an enormous effect on your health and if you choose the right diet, it can literally save your life. Studies show that lifestyle is one of the most important factors in the development of diabetes – and it’s never too late to change.

For practical help with changing your diet to one that can help treat your diabetes, see our guide: The Big-D: Defeating Diabetes with the D-Diet.

See the health research on diabetes.