Last week I was invited to take part in a survey about the Bear community, and was a little angry when it came to one particular question — as a member of the Bear community, do you suffer with diabetes or anxiety/depression?

Perhaps I am being overly sensitive but I was left with the feeling that the person who wrote the question thought that mental health or diabetes were the only possible health issues from which Bears can suffer. Grrrrr, and that’s not to good grrrr either!

I thought it was a good idea to set the record straight.

What is diabetes?

Every cell in our body uses glucose, a form of sugar, as its fuel to stay alive. Glucose comes from the carbohydrates in our diet such as sugars and fruit but also in starchy foods like bread, pasta and rice. These foods are broken down in the gut and the sugar is transferred to the blood.

Once glucose is in the blood, a hormone called insulin tells the cells to let the sugar in, pulling the glucose from the blood and into the cells.

In diabetes there is a problem with the way insulin works. Either the body does not make enough insulin, or the body has become resistant to insulin, meaning that. despite being present, it is not able to function.

If insulin is not working, glucose levels increase whereby they can cause inflammation and damage to the blood vessels and the body’s organs.

I’m sure you have heard the terms type 1 and 2 diabetes.

Type 1 diabetes is more common in younger people and occurs when there is a sudden reduction in insulin production, usually because of some sort of damage to the pancreas, the organ that produces insulin.

Type 2 diabetes is more common in people who are older and tends to have a more gradual onset. Type 2 diabetes usually starts with ‘pre-diabetes’ and as blood sugar levels start to rise, diabetes is diagnosed.

Pre-diabetes is when the body starts to develop resistance to insulin. Blood sugar levels are still within the normal range, however, larger amounts of insulin are needed to maintain this level.

Pre-diabetes can be identified by mildly raised blood sugars and/or high insulin levels first thing in the morning.

Studies show that if pre-diabetes is not addressed, about one in four will convert to actual diabetes in a three- to five-year period.

The good news is that if there is a change in some of the risk factors for diabetes, this progression can be halted.

What are the risk factors for diabetes?

In type 2 diabetes there are risk factors that we are able to modify and those that we are not. To start, let’s look at the risk factors that we cannot control.

Family history: If one of your brothers or sisters has been diagnosed with diabetes you have a 40 percent chance of also developing diabetes. If one of your parents has diabetes, your risk of diabetes is more than double and this spikes to just under a fourfold risk if both your parents are diabetic.

Ethnicity: People of Aboriginal, Torres Straight Islander, Pacific Islander or Maori descent are at a much higher risk of diabetes and also tend to develop diabetes much earlier in life.

Age: As we get older our risk of developing diabetes increases.

While there is little we can do to change our ethnic background, family history or age there are other risk factors that are able to be changed.

These include:

Your weight, in particular your waist measurement.

When it comes to the Bear community, this is the one risk factor that doctors seem to talk about, frequently completely ignoring the other risk factors that also lead to diabetes.

Yes, it’s true that being more than 20 percent overweight increases the risk of diabetes but perhaps more interesting is the way this weight is distributed.

When men gain weight they tend to store fat in their belly. Unlike fat on the hips and legs, fat in the belly produces many hormones, including those that lead to insulin resistance. Because of this we now understand that men with a waistline larger then 94cm are at an increased risk of diabetes. If your waistline is more then 102cm there is a significantly increased risk of diabetes.

The evidence shows that if you are able to bring your waistline in to at least 94cm you can greatly reduce your risk of diabetes. Even if you are able to go down by one pants-size this can make a difference.

While we understand these risks, it’s also important to note that not everyone with a belly has diabetes and not everyone with diabetes necessarily has a belly.

Exercise is a very useful way of increasing the body’s sensitivity to insulin. We know that people who have at least 30 minutes of physical movement at least five days a week can reduce their risk of diabetes by over one third, even if the exercise does not result in weight loss.

Western diets noted for high consumption of starchy carbohydrates and highly manufactured foods are associated with increased sugar loads on the body meaning higher needs for insulin.

People who eat diets rich in fresh fruit and vegetables, reduced starchy carbohydrates and meats close to their most natural form have a decreased risk of diabetes.

Smoking has been shown to decrease sensitivity to insulin and also increase the size of the belly which, as mentioned above, is also a risk for diabetes.

If after reading this post and you are interested in getting tested for diabetes I recommend you make an appointment with your family doctor.

INFO: Take Dr George’s five-minute diabetes test at www.thehealthybear.com.au/diabetes

By DR GEORGE FORGAN-SMITH

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