Opening the Door to Type 2 Diabetes Management

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insulin sensitivity

With 8 million Canadians currently suffering from type 2 diabetes – a number that is on the rise – there is an urgency to find new ways to prevent, treat and cure the disease. In recent years, science has made strides in catching up with diabetes – partly thanks to the success of clinical trials which have found effective drug therapies for the management of this long-term disease.

 What is Type 2 Diabetes?

Diabetes can be understood as an abundance of glucose, or sugar, in the blood.  Normally, sugar consumed in food is absorbed into the bloodstream where it enters the cells with the help of insulin, a hormone that originates in the pancreas.  During periods of low blood sugars (e.g. after exercising or a fast), the liver will release sugar into the bloodstream so that insulin can ‘open the door’ to let it into the cell where it is used as energy.  However, in patients with type 2 diabetes, blood sugars do not enter the cells due to a lack of insulin, or an inability of the cells to respond to insulin.  As a result, the ‘door’ to the cell remains closed, and sugars accumulate in the blood stream where they can damage organs such as the heart, kidneys and eyes.

Symptoms and Risk Factors

Many patients with type 2 diabetes are asymptomatic (without symptoms).  Among those who present with symptoms, common signs of the disease include thirst, frequent urination, hunger, unintended weight loss, fatigue, blurred vision, slow-healing sores, and infections.

The following have been found to be associated with a higher risk for type 2 diabetes:

  • Age > 40 (high risk)
  • Family history (high risk)
  • Aboriginal, Hispanic, Asian and African ethnicity
  • History of heart disease, hypertension, high cholesterol
  • Overweight and obesity

Prevention

The easiest way to prevent diabetes is by maintaining a healthy diet and exercising regularly.  Reducing fat in the diet decreases risk since the less fat a person consumes, the more receptive their cells are to insulin. It is also important to avoid sugar and saturated/trans fats and consume an adequate amount of fruits and vegetables.  Regular and moderate exercise (such as walking for 30 minutes a day) has been shown to improve insulin sensitivity and blood glucose control.

Treatment

Fortunately for individuals who have already been diagnosed with type 2 diabetes, diet and exercise may still improve blood sugar levels.  Diabetes patients are required to regularly monitor blood sugars (via a finger prick device), especially if they are active since exercise can drastically reduce blood sugar levels and put individuals at risk for a diabetic coma.  Depending on how severe the diabetes is, patients may have to monitor their blood sugar a few times a week or as often as three times a day.

Patients with type 2 diabetes are also often placed on a drug therapy since lifestyle modification becomes less effective as the disease progresses.  Oral medications often work by stimulating insulin release from the pancreas or by preventing the liver from releasing sugar.  If oral medications are unable to adequately lower blood sugar levels, patients may be placed on an insulin therapy.

The Role of Clinical Trials

Given the sheer number of Canadians affected by type 2 diabetes, and the importance of drug therapy in the long-term management of this disease, there is a growing demand for clinical research investigating the effectiveness of varied drug therapies.  Patients who participate in diabetes clinical trials receive benefits such as access to new treatments before they are widely available, and the opportunity to undergo informative assessments of overall health and fitness.  Furthermore, patients benefit from the knowledge that their participation is helping to advance the understanding of this disease for the betterment of millions of Canadians.

Fun Facts

The reason frequent urination is a symptom of diabetes is because the body is trying to get rid of excess blood sugar.

Diabetes has been around for a long time and the ancient Indians referred to it as ‘sweet urine disease’. Don’t worry, they didn’t actually taste the urine, they observed that ants were attracted to some people’s urine more than others.

Did You Know?

Blood sugar levels drop during exercise because muscle contraction stimulates the movement of sugar from the blood into muscle cells independent of insulin.  Furthermore, exercise improves the sensitivity of insulin (i.e. your insulin will work better).  This improvement in insulin sensitivity often lasts for 24-48 hours meaning that if you exercise most days of the week, you can improve your blood sugar levels and insulin sensitivity, even if you already have type 2 diabetes! But, remember, you need to regularly monitor your blood sugar levels.