November is World Diabetes Month. During this month the spotlight is on creating awareness of diabetes, its causes, how to prevent it, and the latest research. Diabetes falls under the banner of non-communicable diseases (NCD), which means that it cannot be passed from person to person, but is a result of a combination of genetic, physiological, environmental, and behavioural factors. In many cases, this disease can be prevented and, in some cases, even cured with a lifestyle change. Several clinical studies have proven that the reduction of carbohydrates, a key factor in the keto lifestyle, can lead to a variety of benefits for type 2 diabetes. But before we get into more details, let’s first share some more information about diabetes.
World Diabetes Day is the world’s largest diabetes awareness campaign, reaching a global audience of more than 1 billion people in more than 160 countries. The day is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.
What is diabetes?
Diabetes is a health disorder that occurs when the pancreas is unable to produce or use insulin well, resulting in a high blood sugar level. According to the International Diabetes Federation, when the body fails to make insulin at all, this results in Type 1 diabetes.
With Type 2 diabetes, the body does not produce or use insulin effectively. Both types come with side effects that are detrimental to a person’s life. The World Health Organisation has stated that on the African continent, South Africa has the second largest population of people with diabetes.
5 Facts you should know about diabetes in SA
- Diabetes is a leading cause of death in South Africa. With non-communicable diseases (NCDs) like diabetes on the rise globally, South Africa is no exception. In 2016, diabetes and other NCDs caused 16% of the total deaths in the country.
- South Africa has the highest incidence of diabetes in Africa, with 1 out of 9 adults currently living with this health disorder.
- Figures released by the International Diabetes Federation show that more than 4 million adults in the country are affected by this condition.
- Almost half of the people living with diabetes in South Africa are undiagnosed.
- One in three adults in South Africa is at high risk of developing type 2 diabetes.
What are the diabetes statistics worldwide?
12 November 2021 - Ahead of World Diabetes Day, the International Diabetes Federation (IDF) has released new figures showing:
- 537 million adults (20-79 years) are living with diabetes - 1 in 10. This number is predicted to rise to 643 million by 2030 and 783 million by 2045.
- Over 3 in 4 adults with diabetes live in low- and middle-income countries.
- Diabetes is responsible for7 million deaths in 2021 - 1 every 5 seconds.
- 541million adults have Impaired Glucose Tolerance (IGT), which places them at high risk of type 2 diabetes.
What are the side effects of living with diabetes?
The Mayo Clinic states that diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.
Some of the symptoms of type 1 diabetes and type 2 diabetes are:
- Feeling more thirsty than usual.
- Urinating often.
- Losing weight without trying.
- Presence of ketones in the urine. Ketones are a by-product of the breakdown of muscle and fat that happens when there's not enough available insulin.
- Feeling tired and weak.
- Feeling irritable or having other mood changes.
- Having blurry vision.
- Having slow-healing sores.
- Getting a lot of infections, such as gum, skin, and vaginal infections.
Type 1 diabetes can start at any age. But it often starts during childhood or teen years. Type 2 diabetes, the more common type, can develop at any age. Type 2 diabetes is more common in people older than 40.
When should I see a doctor?
- If you think you or your child may have diabetes.
- If you've already been diagnosed with diabetes.
The history of treating diabetes with lifestyle change
During 1879 and 1964, Dr Frederic Allen, a physician based in New Jersey, was the first person to realise that diabetes was a global disorder of metabolism. He developed the best therapy for diabetes before insulin. He prescribed a restricted (400) calorie, ketogenic diet consisting of mainly fat and protein, with the minimum amount of carbohydrates needed.
From 1914 to 1918 he treated 100 diabetic patients at the Rockefeller Hospital in New York with the ketogenic diet. Many other physicians followed suit, including Elliott Proctor Joslin, the first U.S. doctor to specialize in diabetes and the founder of today’s Joslin Diabetes Centre.
The Keto lifestyle and diabetes today
While Dr Allen’s diet was essentially ketogenic, today’s keto diet is not a starvation diet. Strictly spoken, the keto diet prescribes a sustainable daily caloric intake, based on an individual’s weight, age, and other factors, broken into macronutrients of 75 percent fat, 20 percent protein, and 5 percent carbohydrates. However, even for people who don’t want to count calories, the keto diet has proven to be influential in the management and reversal of type 2 diabetes, and the reduction in medications for type 1 diabetes.
According to Keto-Mojo.com, a variety of clinical studies have proven that the reduction of carbohydrates, a key factor in the ketogenic diet, can lead to a variety of benefits for type 2 diabetics, including:
- Blood-sugar regulation
- Lower blood-glucose levels
- Improved glucose tolerance
- Lower blood pressure
- Improved insulin sensitivity
- A drop in insulin
- Improvements in high-density lipoprotein (HDL), or “good” cholesterol, without adding to low-density lipoprotein (LDL), or “bad” cholesterol
- Improved cholesterol levels over the long term due to increased numbers of HDL (high-density lipoprotein) particles
- Decreased triglycerides and LDL (low-density lipoprotein) particles
- Weight loss
- Reduced dependency on medication*
*It’s important for patients and doctors to discuss any dietary changes while on medication. Consuming too few carbohydrates can be dangerous when taking certain medications for diabetes.
There are many keto diet plans to consider
Endocrineweb.com explains that aside from the standard keto diet, there are a few other variations of the keto diet, including:
- The cyclical ketogenic diet, which allows for eating 100-150 grams of clean carbs one to two days per week.
- The targeted ketogenic diet, which follows the same rules but asks you to time when you eat carbs, such as before or after a workout.
- The very low carb diet (VLCD) approach, which allows people to eat high fat, moderate protein, and very low carbs. Compared to the standard keto diet, this is more generous. It allows for 100-150 grams of carbs daily, versus the standard keto’s 50 grams daily or the cyclical keto’s approach and may not get you into ketosis.
Benefits of the Keto lifestyle for people living with diabetes
Endocrineweb.com lists some of the benefits associated with keto for diabetes:
- Quick weight loss
- Lower A1C levels
- Improved glycaemic (or blood sugar) control
- Lower triglycerides
- Insulin resistance improvement
- May reduce the need for insulin
- Increases heart-healthy HDL (or “good”) cholesterol levels
- Improves cognitive function
According to Dr Dimitar Marinov, who holds a Ph.D. in nutrition and dietetics and is an assistant professor at the Department of Hygiene and Epidemiology, the keto diet — as well as very low-carb diets — does show consistent benefits for people with diabetes and prediabetes by vastly improving blood sugar levels and reducing the need for insulin. They also help the weight come off faster than other diets.