Diabetes is a common chronic disease affecting over 800 million people worldwide. In Canada, approximately 95% of cases are Type 2 Diabetes (T2D). If left unmanaged, high blood sugar damages our vessels over time, leading to heart attacks, strokes, and kidney failure. What is most concerning to me as a physician is how “silent” T2D can be, often brewing for years before a diagnosis.
(Short on time? Click here for The Bottom Line)
There are different kinds of Diabetes:
- Type 1 Diabetes: an autoimmune condition where the body cannot produce insulin.
- Type 2 Diabetes (T2D): a chronic disease where the body becomes resistant to insulin and cannot use insulin effectively. This is the most common type and is closely linked to our lifestyle.
- Pre-Diabetes: an important warning sign where blood sugars are high, but not at the diagnostic level for T2D. Unfortunately becoming increasingly prevalent.
Insulin and glucose are the main components involved in these conditions, which we learned when we read about Insulin Resistance.
T2D progresses silently. We often go years without symptoms. You might be “suddenly” diagnosed between age 40-65, but the metabolic changes started decades prior. Symptoms to watch for:
- Excessive thirst
- Frequent peeing
- Blurry vision
- Chronic fatigue
- Unintentional weight loss
We monitor T2D using a lab test called Hemoglobin A1c, which measures your average blood sugar over the past 90 days.
| <5.7% | Normal |
| 5.7-6.4% | Pre-Diabetes |
| >6.5% | T2D |
Although genetics, age and ethnicity are risk factors we cannot change, there are many lifestyle factors we can change, and these are more impactful than you might realize.
Your Action Plan:
- Balanced Nutrition: prioritize high-fibre vegetables, beans, lentils, and lean proteins. Reduce sugary drinks and ultra-processed foods.
- Daily Movement: aim for 30 minutes of aerobic activity, 5 days a week, along with resistance training.
- Team Players: medications such as Metformin or GLP-1’s can support glucose control and protect your heart and kidneys.
- Weight Management: even a 5-10% body weight loss can significantly reduce your T2D risk.
Reducing stress, getting good sleep, and eliminating substance use will all help too. Managing T2D is about progress, not perfection. Your lifestyle, choices, and behaviours are powerful levers to treat, prevent, and even reverse (clinical remission) T2D!
The Bottom Line
Type 2 Diabetes is a serious metabolic condition, but it is not a life sentence. Lean on Lifestyle Medicine, especially regular physical activity and fibre-focused eating, as well as medications when required, to best manage your blood sugar, protect your cardiovascular health, and live a flourishing, healthy life.