World Diabetes Day was launched in 1991 in the face of the growing number of diabetics around the world. The date of November 14 commemorates the birthday of Frederick G. Banting, who discovered with Charles Herbert Best in 1921 the vital hormone insulin, as the communique of cantonal hospital Uri says.
On this day, diabetes, its causes and its impact on the lives of those affected should be brought to the attention of the world. "Above all, it should be clear that diabetes is not the problem of a few, but that more and more people around the world have to live with the disease," writes the Swiss Society of Diabetes (SDG).
Is early detection of diabetes possible?
Esther Hunkeler: In type 2 diabetes, formerly called adult diabetes, definitely. If someone belongs to a risk group, it makes sense that the blood sugar level is checked regularly by the GP. Thus, elevated blood sugar levels can be detected early and initial measures, for example in the context of lifestyle change with the help of nutritional counseling, can be started. There is no early detection for type 1 diabetes, which occurs mostly in childhood and adolescence, and can usually develop at any stage of life. The reason for this is that the pancreas suddenly stops producing insulin and this is unpredictable.
risk group? So how does one know if you are at risk for diabetes?
Esther Hunkeler: A person has an increased risk of developing diabetes if, for example, they are overweight, they suffer from high blood pressure and high cholesterol levels. These factors are aggravated when you have close relatives who already have diabetes – for example, father, mother or brother. However, people who have normal body weight but are biased towards the family may also develop diabetes. In addition, studies have shown that regular physical activity can be an effective way to prevent diabetes.
The cold is also the sweet season. What does this mean for diabetics?
Esther Hunkeler: Eating and drinking have a direct influence on blood sugar level. In diabetes counseling, I often get questions about nutrition, which are discussed in nutrition counseling. In diabetes counseling, I explain to the patient the clinical picture. They also learn to measure blood sugar correctly. In addition, patients should learn to understand their individual therapy for diabetes, whether it is the mode of action of a drug or an insulin regimen. If someone has to inject insulin, he or she will also be trained by me. The goal of diabetes counseling is that the patient is able to manage diabetes well with the help of the doctor.
Patrik Jauch: Sweet things need not be completely eliminated from the diet, even with diabetes. It usually makes sense to schedule sweets and desserts immediately after a main meal rather than in the middle.
Is consuming too many sweets the cause of diabetes?
Patrik Jauch: People usually say that, but they're not right. The main factor is overweight or, in particular, excessive belly fat. This has the biggest impact. And then you have to say that not only white sugar has an influence, but the total amount of carbohydrates, it also affects fructose, starch supplements, malt sugar or milk sugar. Excessive intake may, in addition to influencing weight and abdominal fat, also have an independent influence on when a type 2 diabetes "breaks out." A supply with measure – including candy – but also belongs to a balanced diet.
Usually for nutrition. How does the risk of disease really depend on the diet?
Patrik Jauch: A well-balanced diet is essential to maintaining good health. It's not just about eating greens, but about general balance. Today, it is known that several diseases, such as diabetes, cardiovascular diseases and many others, can be avoided for a long time – but not 100%. Nutrition or malnutrition is also just a risk factor, such as heredity, environment, smoking, etc.
Is diabetes a disease of prosperity?
Esther Hunkeler: Yes, part of that is certainly due to the prosperity of our society. A large part of the population is seeking a sedentary job. In addition, food is always and everywhere available, especially high energy and high calorie foods. These two factors promote overweight, which in turn is a risk factor for the onset of diabetes.
In the morning, after getting up, a cup of coffee, an espresso. What do you say as a nutritionist?
Patrik Jauch: Breakfast is important. People who eat breakfast have a lower risk of suffering from diabetes, obesity or its consequences, even according to recent studies. That's why I would not cancel the coffee. Especially with coffee, it is thought to have positive effects on the cardiovascular system as well. However, I would consider in nutritional advice what you would most likely imagine eating at breakfast. At most, I would set a concrete goal until the next meeting.
Nourish healthy, avoid diabetes. Can you say that?
Patrik Jauch: Avoiding is perhaps the wrong word, but delaying it. So you get, if you eat healthy, the so-called type 2 diabetes, called sugar-age, only with 90 instead of 60 years, if you bring a strong family disposition. However, type 1 diabetes has nothing to do with lifestyle. This can be affected at an early age, as well as in old age, even if the lifestyle is healthy.
Should diabetics play more sports?
Esther Hunkeler: Yes, absolutely. Regular physical activity is an important part of the treatment concept because exercise can reduce blood sugar even without insulin. Movement within 150 minutes per week has a positive impact on sugar metabolism. It does not matter if there are 60 minutes of swimming twice a week plus 30 minutes of cycling in the home trainer at home or 30 minutes of quick jogging after dinner four times a week. And of course, it does not matter if someone moves more than 150 minutes a week.
Are there special dietary recommendations for diabetes?
Patrik Jauch: The basis today is the recommendations of a normal balanced diet. The "right" diet, however, is the one that caters to the respective therapy. If they just need to pay attention to lifestyle, take pills or inject insulin, it is fundamentally different from the recommendations. It is important to know the possibilities and then decide how much you can or want to do. One wants to get the most out of a change of lifestyle, the other wants to implement especially the most important pillars of everyday life, which is also good. That's why we recommend individual consultation rather than very general information.
Can a person go to your hospital if they have any questions about their diet and health?
Patrik Jauch: Yes, in the case of diseases such as diabetes, each person is entitled to six to twelve nutritional consultations and nine diabetes consultations per year. These are taken over by basic health insurance insurance if you have a medical prescription. It is therefore worth discussing with the family doctor a possible allocation. (Pd / ml)