Solutions - FSEAP

           August 2013      
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Diabetes
The Canadian Diabetes Association estimates that approximately 2.4 million Canadian have diabetes, or approximately 1 in 17 Canadians. It is also believed that many more people have the disease and do not know it yet; they have impaired insulin sensitivity or insulin resistance. The incidence of diabetes has been increasing steadily since 1990. There are over 200,000 new cases reported each year. Adults with diabetes are two to three times more likely to die than the general population.  With the aging of Canada's population, the total direct health care costs associated with diabetes is expected to increase to over $8 billion annually by 2016.

How can this disturbing trend be stopped? A better understanding of the disease and how it occurs is the best way to undertake preventative measures.
Sugar Metabolism
The digestion of food causes blood sugar or glucose levels to rise. Blood sugar levels need to stay within a very narrow range. This is primarily in order to have a constant supply of glucose to fuel the brain, as it is the brain's primary fuel source. As blood sugar levels rise, the pancreas secretes the hormone insulin. Insulin increases the rate of glucose absorption by the cells throughout body, which in turn reduces the level of glucose in the blood. If blood glucose levels fall too low the pancreas releases the hormone glucagon, which stimulates the release of glycogen from body tissues. (Glycogen is stored glucose).
It gets more complicated. If you are in a fight or flight mode (frightened, angry or stressed) your blood glucose levels can fall very quickly. This can cause the release of two more hormones, adrenaline and cortisol, from the adrenal glands. These hormones provide the extra energy you need to get through your crisis by rapidly breaking down stored glucose. Problems arise if someone is in a chronic state of fight or flight as it stresses the body's natural mechanisms for glucose control. The adrenal glands can become exhausted.
It is clear that our diet and lifestyle have a significant effect on our sugar metabolism.
What is Diabetes?
Diabetes occurs when there is a chronic elevation of blood glucose levels. It can occur when the pancreas does not secrete enough insulin, or it can occur when the cells become insulin resistant (not responding to the insulin), not allowing the uptake of excess blood glucose into the cells.
Types of Diabetes
There are two major types of Diabetes: Type I and Type II. Type I diabetes is insulin-dependent and is seen most often in children and adolescents. It accounts for about 10% of all Diabetes. In Type I Diabetes the beta cells in the pancreas are destroyed and are no longer able to produce insulin. It is an autoimmune disorder where the body's immune system produces antibodies that attack the beta cells in the pancreas. People with Type I diabetes require regular injections of insulin for the rest of their lives in order to control blood sugar levels. These people require careful monitoring of their blood sugar. Scientists do not know exactly what causes Type I Diabetes, but they believe that both genetic factors and exposure to viruses are involved.
Type II diabetes usually develops later in life as a result of the cells losing their insulin sensitivity. Approximately 90% of diabetics are Type II. In this case the pancreas does produce insulin, although possibly not enough. The cells become insensitive to the insulin that is secreted, therefore preventing the uptake of glucose from the blood. Approximately 90% of Type II diabetics are obese. Most Type II Diabetes can be controlled through diet and lifestyle changes. Type II Diabetes is now becoming more common in young people.
Signs and Symptoms of Diabetes
Early detection of diabetes means that one can take steps to get control of their blood sugar levels, as well as prevent or delay any complications.
Anyone who has any of the following signs and symptoms should visit their doctor who will determine if diagnostic tests for diabetes are warranted.
Symptoms can include: 
  • unusual thirst
  • frequent urination 
  • weight change (gain or loss) 
  • extreme fatigue or lack of energy
  • blurred vision 
  • frequent of recurring infections
  • cuts and bruises that are slow to heal and
  • tingling or numbness in the hands or feet
In some cases, a person can have diabetes but not display any signs and symptoms. Regular check-ups with your doctor are necessary to prevent and/or manage diabetes. 
Risk Factors
Several factors contribute to a person's risk of developing Type II diabetes, including:
  • being overweight or obese
  • advanced age
  • physical inactivity
  • high blood pressure high cholesterol
  • a family history of diabetes
  • belonging to high-risk ethnic populations (e.g. Aboriginal, African, Hispanic, Asian)
  • a history of gestational diabetes
  • and polycystic ovarian syndrome  
Complications of Diabetes

Chronic elevated blood sugar levels damage the blood vessels. This in turn can lead to heart disease, diabetic retinopathy (eye damage leading to blindness), diabetic neuropathy (nerve damage in limbs and internal organs), diabetic nephropathy (kidney disease) and diabetic foot ulcers.

Prevention
Physical activity: It is important to exercise every day. Walking is a great exercise that is easy to do, inexpensive and can be done anywhere. Work up to walking 30 minutes a day 5 days a week. You should include at least 2 sessions of resistance exercise each week. You do not need to join a gym. You can do pushups and lift light weights at home. If you are not familiar with weight lifting exercise, you should seek out the advice of a personal trainer.
Diet changes: You need to modify your diet to ensure that you are getting sufficient protein and fibre. You also want to make sure that you are not over consuming simple carbohydrates (sugars and white bread/rice/pasta) in the place of complex carbohydrates (e.g. whole grains). It is important to limit the unhealthy fats in your diet but still take in sufficient healthy fats. It is advisable to seek the advice of a Registered Nutritionist to help you balance your diet. 
Reach and maintain your ideal body weight
Stop smoking if you smoke
Reduce your consumption of alcoholic beverages, they are a source of sugars in the diet and contribute to blood pressure issues. 
Consider nutritional supplements, which can be recommended by your health care professional to help you maintain blood sugar levels. 
Manage your stress. Since stress can lead to high blood pressure and exhaust adrenal glands that control the body's natural glucose regulators, it makes sense to find strategies to better cope with sources of stress. If you are not sure how to manage stress, contact your Employee Assistance Program, where you can speak with a counsellor who can help. 
FSEAP offers confidential professional assistance on a wide variety of personal and work-related issues. For more information on your EAP, call 1.800.668.9920 or visit your MyEAP Web site at www.myfseap.com.
 
*Clicking on this link will open a new window and take you to a Web site that is not affiliated with myfseap.com or Family Services Employee Assistance Programs. Links to other sites of interest are provided here as a service to you, however, we can make no claim as to the accuracy or validity of any information contained on these sites. As always, speak with a counsellor or physician for advice that is specific to you and your situation.
This newsletter is to provide timely information to readers; contents are not intended as advice to individual problems. Please contact your EAP professional for assistance. Editorial material is to be used at your discretion and does not necessarily imply endorsement by Family Services Employee Assistance Programs.
All articles © Family Services Employee Assistance Programs (FSEAP), except where noted otherwise. Please note that the posting of the Solutions newsletters or any articles in whole or part on any public Web site is prohibited. Customers and clients of FSEAP can access an online archive of current and back issues: log on to www.myfseap.com using your assigned Group Name and Password and select Solutions Newsletter from the MyHealth menu. To request permission to reprint specific Solutions articles, contact FSEAP at info@fseap.com.

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