A diagnosis of type 2 diabetes can be confusing, upsetting and a bit overwhelming. You probably have lots of questions: How did I get it? What does it mean? What do I do now?
This Diabetes Toolkit is your starting point and go-to resource. If you prefer to have this complete guide in print a ready booklet you can purchase it here. This is very handy if you want to refer to it often.
Just diagnosed? Start here!
What is it type 2 diabetes?
Type 2 diabetes is the most common form of diabetes. It starts with a problem called insulin resistance. This is where the body doesn’t respond properly to a hormone called insulin that helps keep your blood sugar level balanced. With type 2 diabetes the body either doesn’t produce enough insulin or the cells don’t detect it. Inability to use insulin properly means glucose (the simplest form of sugar) doesn’t get absorbed into cells where it is needed for energy, but stays in the blood. So, blood sugar levels rise, eventually developing into pre-diabetes, and then into type 2 diabetes.
For most people this is a gradual progression over many years but, unfortunately, it is often not diagnosed until the later stages when blood sugar levels have already been elevated for some time.
Who gets type 2 diabetes?
Typically type 2 diabetes develops after the ages of 30 to 40 years. Carrying extra weight, particularly around the middle, is a significant risk factor for type 2 diabetes, but genetics also play a big part. This means some people who are carrying extra weight won’t develop diabetes, while others, who are thin, might. Having high blood pressure is a risk factor and belonging to Maori, Pacifika, Middle Eastern or Asian ethnicities increases your likelihood. It’s the interaction between our genes and our lifestyle that influences the development of type 2 diabetes. Those who are genetically at risk don’t fare well with our Western lifestyle.
Why is type 2 diabetes a problem?
The main problem with diabetes is the damage to blood vessels that occurs when your blood sugar levels remain high for long periods of time. This can lead to heart disease, kidney disease, eye damage and circulation problems.
With lifestyle changes and the addition of medication, when needed, the risk of developing these complications can be avoided or significantly reduced. Early diagnosis and maintaining good control of blood sugar levels, cholesterol and blood pressure is the key.
Can you have ‘mild’ diabetes?
Some people with type 2 diabetes, who are not taking medication, think of their diabetes as ‘mild’ or less serious but, unfortunately, this is not really the case. The reality is, if blood sugar levels aren’t kept on track and the body is buffeted by persistently high levels, then complications develop.
We also know type 2 diabetes is a progressive illness so, over time, people usually progress to needing tablets and then insulin.
Taking diabetes seriously from the start, including putting the right lifestyle changes in place and adding medication, when needed, will help to slow the progression and reduce the chances of developing complications.
Did you know?
For every person diagnosed, it’s estimated there’s another unaware they have diabetes.
For people with pre-diabetes, Changes to diet and exercise can reduce their risk of developing diabetes by 60 per cent.
Diabetes basics: What you need to know
What is insulin?
Located behind the stomach, the pancreas is an organ which has two different functions: it produces pancreatic juice used in digestion in the small intestine and it produces a number of hormones, one of which is insulin.
One of insulin’s roles is to reduce blood glucose. After a meal containing carbohydrate, insulin is released into the blood to help transport glucose from the bloodstream into other cells where it can be used or stored as energy. Between meals the liver produces glucose with the aim of keeping blood glucose at a desirable level. Insulin is used to signal the liver to stop production when the level is high enough. If the body is unable to produce enough insulin, or it becomes resistant to the insulin produced, blood glucose levels can get out of control.
What is the difference between type 1 and type 2 diabetes?
These are two very different types of diabetes.
Type 1 accounts for less than 10 per cent of diabetes and is where insulin-producing cells in the pancreas are destroyed, so that the pancreas does not produce any (or only very little) insulin. It is commonly diagnosed in children but can occur at any age and people with type 1 diabetes will need insulin injections for life.
Type 2 is much more common and accounts for nearly 90 per cent of all diabetes. We are presently experiencing a huge increase in cases. In type 2 diabetes insulin production becomes inadequate or body cells become resistant to insulin, or both. Contributing factors include being overweight, having a family history of type 2 diabetes, having a sedentary lifestyle and increasing age. It is treated initially with healthy eating and exercise. Medications may be needed if blood glucose levels cannot be kept within the normal range.
Can you reverse type 2 diabetes?
Type 2 diabetes cannot be reversed but the right diet, exercise and weight-loss can make blood glucose control easier. In fact, in over 50 per cent of people, blood glucose levels can be normalised by:
• following a kilojoule-controlled diet
• increasing physical activity
• losing some weight.
What about pre-diabetes?
Pre-diabetes is a condition where cells in the body are becoming insulin resistant and blood glucose levels are higher than they should be, but are not high enough to be classified as diabetes. For those diagnosed with pre-diabetes, taking steps to improve insulin resistance, such as eating a healthy and balanced diet, losing weight and participating in regular physical activity, may be enough to avoid ever being diagnosed with type 2 diabetes.
I have recently been diagnosed – will it get worse and will I have to inject myself with insulin?
Type 2 diabetes is a progressive disease. As you get older there is a probability you will eventually have to take medication to control your blood glucose and you may eventually require insulin injections.
The good news is that keeping well, good glucose control and a healthy lifestyle have proven to be effective in delaying this process.
What’s the link with being overweight?
There are many risk factors for diabetes; being overweight is just one of them. If you are overweight, losing weight will ensure that your diabetes is better managed and will have many other beneficial effects on your health such as reducing your risk of heart disease.
What will happen if I don’t start controlling my diabetes?
Unfortunately, one of the major problems with diabetes is that after a period of time, if blood glucose levels are not well controlled, it causes damage to the body’s blood vessels. In particular, the large blood vessels of the heart, brain and legs and the very tiny blood vessels and capillaries that supply the eyes, kidneys and nerves.
These lead to the classic complications of diabetes including poor blood circulation and numbness of feet, high risk of heart disease and kidney failure, all needing to be carefully managed.
What is hypoglycaemia?
This is when blood glucose falls below the normal level. It can occur when people are on medication or insulin to reduce blood glucose. There are several warning signs such as feeling dizzy, faint or sweating.
Treatment is by taking some form of fast acting sugar, eg, glucose tablets, which raise the blood glucose levels rapidly. This is followed by a sandwich or meal to ensure the level doesn’t drop. It is important to take note of the cause of each episode, so you can avoid it happening again.
Diabetes basics: What to do
Diabetes is a serious disease, and it’s important to take it seriously. People with type 2 diabetes are two to four times more likely to develop cardiovascular disease than people who don’t have the disease; and they are more than twice as likely to have a heart attack or stroke.
But it’s not all doom and gloom. Controlling blood glucose levels and maintaining a healthy lifestyle can significantly reduce the complications associated with type 2 diabetes. Research shows you don’t have to be a saint to make a difference to your health, either.
Have regular tests
It’s important to keep up with your doctor’s appointments and make sure you have the tests your doctor recommends. These tests are to monitor diabetes control and detect any complications. Read more.
What can I eat with type 2 diabetes?
One of the first questions that comes with a diagnosis of type 2 diabetes is: “What can I (or my family member) eat now?”
The answer doesn’t have to be complicated. Here are some tips to get you started. Read more.
What a healthy plate looks like
Before dishing up your meal, mentally divide your plate into four quarters. One quarter should contain protein foods, another quarter should contain low to medium-GI carbohydrate foods and the rest of your plate (the final half) should be filled with vegetables and/or salad. This will help you get the right balance to your meal and help with portions sizes. Remember, smaller plates make for smaller portion sizes.
More type-2 diabetes-friendly cooking tips
Most people think of reducing sugar when they are cooking for someone with diabetes. While this is something you need to consider, there are a few other things to keep in mind, too. Read more.
At HFG we have hundreds of diabetes-friendly recipes, and we are adding more all the time. Start with these ten, and come back here often for new inspiration.
Swedish meatballs with vege mash and slaw
Warm broccoli and miso-roasted buttercup salad with peanut dressing
Baked almond-crusted fish and kumara chips
Spicy chicken tacos with slaw and avocado dressing
Mediterranean mince and eggplant bake
Chicken, leek and mushroom pie
A type 2 diabetes-friendly pantry
There’s no doubt that what you have at home has a huge impact on your food choices. If your pantry contains items that may compromise your health, a few easy changes can make a big difference. Start with your pantry and fridge. Read more.
Shopping smart for type 2 diabetes
Shopping for your new diabetes-friendly life means being thoughtful about how and what you choose. We take you on a healthy supermarket tour. Read more.
Get moving: Exercise for type 2 diabetes
Frequent exercise is one of the best ways to lower blood glucose levels. Exercise also improves your insulin sensitivity by enhancing the way your skeletal muscles absorb glucose. Aim to get active for at least two-and-a-half hours each week. More is good. Read more.
Lose weight (even a little can make a big difference)
Fortunately, you don’t need to lose a huge amount to improve your health – just five to nine kilos will help. Losing weight is probably the best thing you can do to manage your type 2 diabetes. Excess weight increases the body’s resistance to insulin, making it harder to control blood glucose levels. Losing weight can increase the body’s sensitivity to insulin, and reduce your likelihood of developing heart disease and certain types of cancer. It has also been shown that moderate weight-loss can reduce both high blood pressure and glucose levels, as well as improve blood cholesterol levels, which just goes to show how important a small reduction in weight can be.
Manage your stress
A diabetes diagnosis can be a stressful time. But looking after your mental health and managing your stress levels can go a long way towards helping you keep your diabetes under control. For stress-busting tips head here.
For more on managing your stress and mental health start here.
Being diagnosed with type 2 diabetes doesn’t have to mean the end of the world. Here are some inspiring stories that show how others like you have tackled it.
How I danced away type 2 diabetes
A diabetes diagnosis gave Yvonne Appleby a surprising new lease on life. Read more.
My journey to health
Ann is a 62-year-old, recently retired grandmother of two who was diagnosed with type 2 diabetes eight years ago but “hasn’t taken it seriously” until recently, when she was prescribed insulin to control her blood sugar levels. Read more.
How I reclaimed my health!
Margaret’s story. Read more.
Diabetes: Commonly-asked questions
Nutritionist Claire Turnbull answers the questions people newly-diagnosed with diabetes most often ask. Read more.
Is diabetes hereditary? My mother and grandmother have it so does this mean I will get it?
With type 1 diabetes, the susceptibility is inherited but not the disease itself.
Type 2 diabetes has a significant genetic predisposition so it does tend to run in families. If there is a family history you should reduce your risk factors such as being overweight or lacking exercise. Have your doctor check your glucose levels on a regular basis.
Can I still drink alcohol now that I have diabetes?
Yes, but in moderation. It will have less impact on your blood glucose levels if you drink small amounts of alcohol regularly, than having it all at once.
It is also important to eat carbohydrate food when drinking alcohol to avoid a hypoglycaemic reaction.
My husband has just been diagnosed. Do I have to cook different meals for him?
The types of meals that are appropriate for your husband are healthy meals for everyone in the family. By adjusting the family meal to accommodate your husband’s needs, you will be encouraging your children to develop healthy eating from an early age and it will become a way of life.
Tools to help
Meal planner and shopping list