Defined by the CDC, “insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.” There are two types of diabetes. According to the CDC, true type, 1 diabetes only represents about 5% of diabetes in the American population. It is caused by the immune system attacking cells in the pancreas, which disrupts insulin production. People with type 1 diabetes need additional insulin obtained through regular injections based on the number of carbohydrates eaten to get those carbohydrates into their cells. Type 1 diabetes used to be referred to as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. What used to be referred to as adult-onset diabetes is now called type 2 diabetes. Just to be complete, there is yet another form of diabetes; gestational diabetes which only affects women during pregnancy.
Being overweight is a significant risk factor of type 2 diabetes, and as Americans have become more and more overweight, cases have more than doubled in the last 20 years. So if you are overweight, type 2 diabetes is something to be concerned about!
A new spectrum model identifies four distinct disease stages along the type 2 diabetes spectrum. Stage 1 is defined as insulin resistance. Stage 2 is defined as prediabetes and represents a glycated hemoglobin (A1C) test of 5.7% to 6.4% or a fasting blood sugar of 100 to 125 milligrams per deciliter (mg/dL). Stage 3 is defined as type 2 diabetes and represents an A1C of 6.5% or a fasting blood sugar of 126 mg/dL or higher on two separate tests. Stage 4 is defined by microvascular complications that affect the smaller blood vessels in the eye, liver, kidney, and extremities. The technical names for these are retinopathy, nephropathy, or neuropathy. These stage 4 complications from type 2 diabetes can involve lost feeling in extremities like toes that can get so bad that you do not feel open sores and wounds that eventually become infected and lead to amputation. Non-alcoholic fatty liver and kidney diseases are also next stage conditions for type 2 diabetics as well as extremely overweight people. Type 2 diabetics can eventually require insulin injections to get circulating blood sugar into their cells.
This new Type 2 diabetes model was designed to trigger type 2 diabetes lifestyle mitigation at an earlier stage in the disease progression. Basically, medical teams want us to be alerted at an earlier stage and start making lifestyle changes that will steer us away from type 2 diabetes and the nasty complications that follow. In addition, this new model has spawned further studies designed to give all of us evidence-based information about what eating and lifestyle changes work.
I just ran into a study accepted for publication in The Journal of Clinical Endocrinology & Metabolism. It was published online ahead of the print publication just two days ago, on June 2. This study followed 7,675 Australians participating in the Baker Heart and Diabetes Institute’s “AusDiab” Study. Quoting an article on the Medical Dialogues website, “researchers at Edith Cowan University (ECU) have found in a new study that eating at least two serves of fruit daily has been linked with 36 percent lower odds of developing type 2 diabetes.” The study’s lead author, Dr. Nicola Bondonno from ECU’s Institute for Nutrition Research, said the findings offer fresh evidence for the health benefits of fruit. “We found an association between fruit intake and markers of insulin sensitivity, suggesting that people who consumed more fruit had to produce less insulin to lower their blood glucose levels.”
That is cool info, but what caught my eye was that they differentiated between whole fruit and fruit juice.
“Dr. Bondonno said they did not observe the same beneficial relationship for fruit juice. ‘Higher insulin sensitivity and a lower risk of diabetes was only observed for people who consumed whole fruit, not fruit juice,’ she said. ‘This is likely because juice tends to be much higher in sugar and lower in fibre.’ (They are Aussies and use the British spelling of fiber – we like them anyway!)
Dr. Bondonno continues, “As well as being high in vitamins and minerals, fruits are a great source of phytochemicals which may increase insulin sensitivity. and fibre which helps regulate the release of sugar into the blood and also helps people feel fuller for longer,” she said. “Furthermore, most fruits typically have a low glycemic index, which means the fruit’s sugar is digested and absorbed into the body more slowly.” I just want to note here that increasing insulin sensitivity is a good thing; it means that you require less insulin to do the same job. One of the worries about consuming larger and larger quantities of refined sugar is that your pancreas gets overworked, making large amounts of insulin. The phytochemicals in whole fruit may increase insulin sensitivity and thereby reduce the workload on the pancreas. The glycemic index is a standardized measure of how quickly different foods affect blood sugar.
One topic that comes up many times during dietetic consultations with people is the importance of eating whole foods. Whole foods are completely unprocessed foods that you find in the grocery store’s produce section or with the beans as unprocessed beans, legumes, or pulses (lentils and peas). I mention time and time again that whole foods have that all-important element of fiber! Fiber slows both digestion and carbohydrate absorption, which reduces the sugar rush you get when you do something like drinking a full-sugar soda. As I mentioned in the May 7 Healthy Eating Tip entitled “Choose One Thing to Start With; Sugary Drinks,” fruit juice is just a small step down from full-sugar pop. What you want to do is eat the whole fruit, not just drink the fruit juice! All whole foods are loaded with nutrients and phytochemicals we don’t even know about yet, and they all have fiber, which is one of the real secrets of health!
This very recent study indicates that eating two pieces of whole fruit every day can lower your risk of getting type 2 diabetes by a whopping 36%. Of course, a HUGE part of that is due to the FIBER present in whole foods!
Have a great week; we’ll discuss the glycemic index again next week.
Here are the references for today’s healthy eating tip:
U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Diabetes Home. Diabetes Basics. https://www.cdc.gov/diabetes/basics/diabetes.html. (Accessed 6/4/2021.)
Nicola P Bondonno, PhD, Raymond J Davey, PhD, Kevin Murray, PhD, et al. Associations between fruit intake and risk of diabetes in the AusDiab cohort. The Journal of Clinical Endocrinology & Metabolism. 2021 June 2. Epub ahead of print. PMID: 34076673. (Accessed 6/4/2021).
Medical Dialogues. 4 Jun 2021. Intake Of Two Fruit Daily May Lower Diabetes Risk By 36% Finds Study. https://medicaldialogues.in/diet-nutrition/news/intake-of-two-serves-of-fruit-may-lower-diabetes-risk-by-36-finds-study-78230. (Accessed 6/4/2021).