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Abstract
Type 2 diabetes mellitus is one of the most prevalent chronic diseases internationally. Some of the causes of T2DM include preventable factors like smoking, lack of physical exercise, and dietary habits. The objective of this paper is to determine the effects of nutrition on the development of T2DM. Data from prospective observational research shows that dietary patterns facilitate the management and prevention of T2DM. The quality of carbohydrates and dietary fats that people eat is more important than the amount of these macronutrients. The intake of saturated fats, red meat, white rice, and fried foods exposes people to the danger of contracting T2DM. The lack of nutritional experience in society is identified as one of the factors that contribute to high cases of T2DM. Nutritional patterns like the consumption of the Mediterranean diet help to improve a diabetic patient’s glycemic control. Physical exercise regulates the amount of glucose in the body. Pharmacological interventions like the administration of metformin boost a patient’s glycemic control. There is a need to sensitize the public on the importance of proper nutritional habits to reduce the cases of T2DM.
Introduction
Type 2 diabetes mellitus (T2DM) or what was previously referred to as adult-onset diabetes is the most prevalent type of diabetes among adults. The condition arises due to the inability of the body to utilize insulin accordingly (Thompson and Manore 12). At the onset, T2DM leads to the accumulation of glucose in the bloodstream, resulting in the deprivation of energy in the cells (Sami et al. 66). The condition can lead to lasting complications, if not managed at an early stage. The long-term impacts of T2DM include myocardial infarction, atherosclerosis, and stroke. According to Sami et al., among the causes of T2DM include physical inactivity and obesity (68). The lack of diabetes knowledge and control is a significant problem in societies internationally. A study conducted by Chrvala et al. found that many people do not realize that they have T2DM until when the condition becomes severe (933). Chala et al. cite a lack of awareness as one of the factors that hinder self-care among diabetes patients (934). Despite scientific studies citing a lack of physical exercise and obesity as the two major causes of T2DM, there is compelling evidence that nutrition has a significant role in the rise or control of the condition.
The number of people suffering from T2DM is expected to rise in the future. Scientists anticipate that at least 439 million people will suffer from the condition by 2030 (Sami et al. 69). Consequently, there is a need to sensitize the public on the measures that it can take to contain the situation. The objective of this paper is to highlight the contribution of nutrition to the development of T2DM. The paper will be of great help to individuals suffering from the condition. It will also be of significant value to nutritionists and health care providers who look after T2DM patients. It will assist these people in identifying the best diet for the patients. The paper will also ensure that the general public avoids dietary habits that might expose it to the dangers of contracting T2DM.
General Information
Link Between Nutrition and T2DM
The role of diet in the risk of T2DM was first documented by the Indians before the First World War. They realized that the condition was prevalent among the rich people who could afford flour, oil, and sugar (Sami et al. 68). Sami et al. state that the Indians noted that the rate of T2DM went down during the First and Second World Wars, an incident they attributed to famine and food scarcity (68). For instance, in Berlin, Germany, the number of deaths attributed to diabetes reduced from 23.1 to 10.9 in every 100,000 people (Sami et al. 70). Stevens et al. argue that North American and Japan, which did not experience food shortage, recorded no changes in the number of deaths that were associated with T2DM (321). A few studies have established a strong link between T2DM and high ingestion of fats and carbohydrates (Sami et al. 70). Conversely, most studies demonstrate a strong connection between the development of T2DM and the high consumption of sugar. Research by Stevens et al. sought to establish the correlation between T2DM and nutrition (322). The study sampled over 500 school-going kids from diverse ethnic backgrounds (Stevens et al. 324). The research found that increased intake of carbonated drinks contributed to the rise in the number of children suffering from obesity, which eventually exposed the kids to the dangers of contracting diabetes.
Research involving diabetic patients with varying levels of glycemic control was conducted. The study found no “differences in the mean daily plasma glucose levels or diurnal glucose profiles” (Feinman et al. 4). As with carbohydrates, there were discrepancies in the correlation between T2DM and dietary fats (Feinman et al. 4). The majority of prospective investigations have identified links between fat ingestion and the consequent danger of developing T2DM. In a research carried out at San Louis Valley, a total of 1000 participants who did not exhibit signs of suffering from T2DM were studied for four years (Feinman et al. 4). In this research, the investigators discovered a connection between fat consumption, reduced glucose tolerance, and T2DM (Feinman et al. 4). Another study investigated the association of the various nutrition constituents amid two categories of women. The study sought to determine the link between fiber plus sucrose, fat intake, and the danger of T2DM (Feinman et al. 5). After adjustments, the study found no correlation between sucrose, consumption of fat, fiber, or carbohydrates, and the danger of developing T2DM in the two groups.
Recent studies cite a connection between diabetes and obesity and the consumption of soft drinks. DiNicolantonio et al. allege that most soft drinks are manufactured with high degrees of fructose corn syrup that affects a person’s body mass index (BMI) and blood glucose level, exposing them to the danger of developing T2DM (374). DiNicolantonio et al. maintain that soft drinks “contain glycated chemicals that markedly augment insulin resistance” (379). For years, physicians have argued that poor dietary habits predispose people to the risk of becoming obese. As DiNicolantonio et al. contend, the nutritional value and volume of food intake impact the development of T2DM (780). The increased consumption of fried foods, sweets, and red meat results in high cases of insulin intolerance and T2DM. On the contrary, the studies found no connection between the development of T2DM and the consumption of vegetables (DiNicolantonio et al. 379). A study carried out among Japanese women found that high consumption of white rice heightened the risk of them developing T2DM (Stevens et al. 328). The study highlighted the importance of sensitizing the public on the right diet and the need to change lifestyle.
There exists conflicting information about the connection between the development of T2DM and the consumption of fruits and vegetables. Wu et al. found that increased eating of vegetables and fruits was not related to a significant decline in the risk of developing T2DM (141). The latest systematic study by Wang et al. also examined the connection between T2DM and increased intake of fruits and vegetables (58). It was found that improved eating of green leafy vegetables and fruits contributed to a 14% decline in the danger of suffering from T2DM (Wang et al. 61). The eating of whole grain was found to exacerbate the risk of developing the condition. A study to determine the connection between consumption of coffee and the development of T2DM found that coffee intake lowered a person’s risk of developing the illness (Chrysant 153). In spite of the information about a single food or nutrient analysis proving to be invaluable, it is hard to study the impacts of distinct dietary constituents independently since diet is an intricate entity. Thus, Wu et al. suggest the conduction of dietary pattern analysis to capture a picture of the whole diet and obtain comprehensive data about the nutritional causes of T2DM (143).
Nutritional Knowledge
As aforementioned, the lack of awareness about the causes and management of T2DM contributes to high cases of the condition worldwide. Yue et al. allude to nutritional awareness as an essential factor that impacts dietary habits among individuals (3). In research conducted by Yue et al., it was found that information about diabetic diet options influences a patient’s nutritional routines (7). The American Diabetes Association cites self-dietary supervision as an essential step towards equipping diabetic patients with skills regarding nutritional aspects, management, treatment, and complications that are associated with T2DM (Yue et al. 9). The study carried out in China found that individuals who were at a high risk of developing T2DM lacked the necessary dietetic information about their health condition (Yue et al. 11). Yue et al. found that more men than women consumed red meat without considering the dangers of such a dietary pattern (13). Moreover, it was discovered that most males and females consumed high amounts of white rice.
The lack of knowledge about the factors that contribute to the increased rate of T2DM is not a Chinese problem only. Studies conducted in the Gulf countries found that the population in these nations has limited nutritional knowledge of T2DM (Mohamed et al. 360). Mohamed et al. aver, “In recent times in Saudi Arabia, food choices, size of portions and sedentary lifestyle have increased dramatically that resulted in high risk of obesity” (363). Mohamed et al. discovered that the number of fast-food restaurants in Saudi Arabia and other Middle East nations continued to increase (365). High intake of junk food and lack of exercise among the Saudis contributed to most of them becoming overweight and facing the danger of contracting T2DM (Mohamed et al. 367). Moreover, most people from the Arab nations liked soft drinks with high-sugar contents (Mohamed et al. 367). Contrary to the past assumption that T2DM is a disease of the rich, it has been established that the condition is common among the poor, especially those who are not educated. The latter group lacks knowledge about proper dietary habits.
In spite of there being a lot of studies that illuminate the connection between nutrition and the development of T2DM, there is a need for additional research to investigate synergistic impacts of distinct constituents of different dietary patterns. Furthermore, comprehensive, large prospective investigations are required to explore the contribution of varied nutritional behaviors and food choices to the rise and management of T2DM among different populations. Such studies will be helpful in minimizing the rate of diabetes globally.
Application
Diabetes remains one of the most common chronic illnesses in the United States and across the globe. A study conducted in 2012 found that between 12 and 14% of Americans had detected or undetected type 1 or type 2 diabetes. Even though doctors have managed to reduce the complications attributed to T2DM, the illness is still a significant cause of disability. Moreover, T2DM contributes to the rise in expenses in the health care system. Thus, the study on the impacts of nutrition on the development of T2DM is of immense value to multiple stakeholders. They include health caregivers, nutritionists, patients, families, and policymakers among others. Patients have a duty to take control of their daily management of T2DM. They require monitoring the level of blood sugar, observing the recommended treatment procedures, engaging in physical exercise, and sticking to the right diet. The lack of experience in self-care makes it hard for diabetic patients to assume control of their wellbeing. This topic will be of interest to individuals with T2DM because it will enlighten them on the dietary routines that they should adopt to relieve themselves from the health problem. Moreover, it will encourage them to engage in healthy behaviors, which might protect them from developing long-term complications like stroke and myocardial infarction that are related to T2DM.
The number of kids who are obese continues to rise across the globe. This problem is attributed to poor feeding habits and a lack of physical exercise. This study will be of great importance to families, particularly those with young children. Doctors recommend the adoption of healthy dietary behaviors to protect children from becoming obese. Therefore, this topic will serve as an eye-opener to many families. It will educate them on the nutritional behaviors that expose their children to the risk of developing T2DM. In return, families will strive to change their feeding habits and lifestyles to protect children from the illness. The study will also be invaluable to policymakers. It will help them in formulating guidelines on the appropriate dietary patterns. Moreover, they will use the paper to develop self-management programs aimed at helping individuals with T2DM.
New cases of patients suffering from T2DM continue to emerge every day. Hence, there is no other better time to address the impacts of nutrition on the development of T2DM than now. The number of fast-food restaurants has increased significantly. Additionally, many schools allow canteens to sell junk foods. Consequently, kids are at great risk of becoming diabetic. It is time for stakeholders in the health care sector to come together to address the issue of dietary patterns and their contribution to the increase in the cases of T2DM not only among adults but also among children. It will help to improve nutritional patterns in most households, therefore protecting members from contracting diabetes. The study shows that most people lack knowledge about the dangers of unhealthy eating habits. It underscores the reason many men enjoy eating red meat and taking alcohol. Additionally, fruits and vegetables are not regarded as essential food items in many families. Thus, there is a need to address the role of nutrition in the development of T2DM. It will lead to families changing the perception that they have towards the products that they regard as staple foods.
The increased rate of cases of T2DM has raised an alarm, prompting stakeholders to initiate campaigns aimed at containing the health condition. In the United States, schools are discouraging the sale of junk foods and soft drinks in their canteens. Moreover, there are calls for the reduction of the number of vending machines that are located near schools. Statistics show that over 30.3 million Americans suffer from diabetes (Sami et al. 65). They also indicate that at least 84.1 million American adults are at risk of contracting the health condition. A study carried out in 2015 showed that over 400 million people had diabetes worldwide. These figures are scary and call for immediate response to address the situation. This topic will be of significant help in the campaigns aimed at changing the feeding programs in American schools. It will help in identifying healthy food items for children. Based on the statistics above, it is evident that this topic is very important. There is a need to create awareness of the dangers of T2DM and how to avoid the disease. This topic serves that purpose by identifying the dietary behaviors that put people at risk of contracting T2DM. It also enlightens them on the right nutritional habits.
Approaches/Treatments
The body of a person suffering from T2DM has challenges in changing glucose to energy due to the development of insulin resistance. There is no cure for T2DM. Nevertheless, it can be managed through physical exercise, changes in dietary habits, and regulating one’s blood glucose level. Eating a balanced diet helps to manage a person’s body weight and blood sugar levels. On the other hand, engaging in physical exercise facilitates the conversion of insulin into energy and lowers one’s likelihood of suffering from heart disease (Colberg et al. 2069). The primary objective of T2DM management is to ensure that a patient’s blood glucose remains stable (4-6mmol/L). It protects a patient from developing complications that are associated with this health condition.
Nutritional therapists identify rigorous lifestyle interventions as the most effective approaches to managing T2DM. The objective of lifestyle interventions is to assist a person with T2DM to lose or maintain appropriate body weight. The intercession comes with other benefits, which include reduced chances of developing complications like urinary incontinence, depression, and sleep apnea. Various dietary patterns that are made up of diverse food groups help in the management of diabetes. An analysis of five randomized control trials (RCTs) in individuals with T2DM found that the intake of the Mediterranean diet contributed to improved insulin sensitivity and glycemic control (Salas-Salvadó et al. 921).
The study found that diabetic people who used Mediterranean diets did not require antihyperglycemic medications. A combination of Mediterranean diets and nuts or extra-virgin olive oil minimizes the risk of diabetic patients suffering from cardiovascular disease (Salas-Salvadó et al. 921). Research shows that the amount of fat intake does not expose a person to the risk of T2DM (Salas-Salvadó et al. 923). What matters is the type of fat consumed. Nutritionists discourage the use of saturated fats since they can cause complications like cardiovascular disease. A study carried out on women suffering from T2DM found that high intake of saturated fat put them at the danger of developing heart disease (Salas-Salvadó et al. 924). On the other hand, the consumption of long-chain omega-3 and fish protected them from coronary heart disease (Salas-Salvadó et al. 927). The reduced intake of saturated fat helps to improve a diabetic patient’s glycemic control.
At times, physical exercise and dietary patterns may not be adequate to manage T2DM. It is imperative to note that the health condition is progressive. Thus, as the disease advances, a patient’s pancreas becomes incapacitated, resulting in the accumulation of glucose in the body. If the condition is not managed, it reaches a point where patients are encouraged to use drugs to regulate the levels of glucose in their blood. The objective of introducing pharmacologic therapy is to enhance a patient’s glycemic control and protect them from developing long-term complications (Stevens et al. 329). The classes of drugs that are used to treat T2DM include sulfonylureas, biguanides, alpha-glucosidase inhibitors, and meglitinide derivatives among others. The only biguanide drug that is used to treat T2DM is metformin. As Sami et al. allege, “Metformin lowers basal and postprandial plasma glucose levels” (70). It works differently from other groups of oral antidiabetic drugs. Metformin reduces the production of gluconeogenesis and minimizes the assimilation of glucose in the intestines.
Expected Outcomes/Recommendations
Physical exercise is critical to persons with T2DM. Patients are encouraged to engage in numerous activities, which include walking, jogging, cycling, and swimming. Moreover, they can take part in resistance training such as weightlifting. The expected results of engaging in the physical exercise include the reduction in hemoglobin A1c (HbA1c) (should not exceed 5.7%), blood pressure, triglycerides, and insulin resistance (Colberg et al. 2069). Continued involvement in moderate-intensity exercise improves the pulse rate (120/min for young people and 100/min for old persons) of individuals with T2DM. Diabetic patients are expected to participate in physical exercise for at least 10 minutes after meals (Colberg et al. 2071). This should be done at least twice a day and between three to five days a week. T2DM is lifestyle-related, thus, there is a need to engage in physical activities throughout a patient’s life. This paper recommends getting off the bus before reaching one’s destination and walking for the remaining distance. Moreover, people can use Life-corder or pedometers to monitor their daily participation in physical exercise.
The primary purpose of recommending the Mediterranean diet is to enhance a diabetic patient’s glycemic control including hemoglobin HbA1c, glucose level, and insulin resistance. The glucose level for an individual with T2DM should be between 70 and 130mmol/L before a meal and below 180mmol/L after eating (Salas-Salvadó et al. 926). Adherence to the Mediterranean diet is expected to result in improved postprandial glucose levels. Sleiman et al. found that daily consumption of 30grams of tree nuts for three months contributes to the reduction in the level of fasting glucose (3). It is imperative to control the amount of fat intake because it may contribute to one becoming overweight. One should understand that both saturated and unsaturated fats are rich in calories. Thus, their unregulated intake might lead to a person becoming obese. The basis of the Mediterranean diet is extra-virgin olive oil (Sleiman et al. 3). In spite of the oil is healthy, it should not be consumed in large amounts. Doctors recommend daily ingestion of between six and seven teaspoons of olive oil. For individuals who eat nuts, it is imperative to reduce the daily intake of olive oil. Failure to adhere to this may result in one becoming overweight, therefore being at risk of developing complications associated with T2DM.
The administration of metformin to diabetic patients is aimed at reducing the amount of postprandial and basal plasma glucose in the body. One of the expected outcomes of continued use of the drug is the improvement in HbA1c (to below 7%) in patients with T2DM. Moreover, patients who use metformin are expected to show significant weight loss. Adding metformin to insulin helps in weight loss in patients with T2DM. Additionally, the administration of metformin together with insulin for four years reduces the possibility of a diabetic patient suffering from macrovascular disease (Stevens et al. 329). Therefore, this paper recommends the sustained use of the drug after a T2DM patient starts to use insulin. A study conducted by the American College of Physicians (ACP) found that metformin is effective if administered together with additional drugs (Stevens et al. 330). Hence, this paper recommends the use of metformin together with drugs from classes such as thiazolidinediones, sulfonylureas, or dipeptidyl peptidase IV (DPP-4). Stevens et al. found that if used together with metformin to treat diabetic patients, sulfonylureas, thiazolidinediones, or DPP-4 help to lower the HbA1c level to 7% (330). The inclusion of a second drug assists in improving glycemic control.
Conclusion
This paper highlights the significant link between nutrition and the development of T2DM. High intake of saturated fats, sugar, and carbohydrates exposes people to the danger of developing this health condition. Additionally, the consumption of soft drinks with high fructose corn syrup contributes to people becoming obese and eventually suffering from diabetes. The nutritional value and the amount of food consumed influence the development of T2DM. The prolonged consumption of red meat, sweets, and fried foods results in the body developing insulin resistance.
There is no clear information regarding the link between eating fruits and vegetables and the development of T2DM. The review of numerous studies shows that the lack of knowledge about the causes of T2DM contributes to people suffering from the health problem. Indeed, most people have limited knowledge of the nutritional patterns that protect them from becoming diabetic. It underlines the reason people from the Gulf countries are yet to abandon the culture of eating junk foods. Diabetes is one of the most prevalent chronic illnesses around the globe. Thus, stakeholders in the health sector may have an interest in the topic of the impacts of nutrition on the development of T2DM. The topic is invaluable to families, policymakers, health care providers, and schools among other stakeholders. It helps to identify the dietary habits that can protect all people regardless of their age from developing T2DM.
Diabetes is a life-long illness that can be managed through appropriate dietary habits, physical exercise, and pharmacological therapy. Doctors encourage diabetic patients to engage in physical exercises like jogging, walking, and weightlifting among others. It helps to improve a patient’s HbA1c. On the other hand, nutritionists recommend the adoption of the Mediterranean diet, which helps to improve a patient’s glycemic control. Pharmacological intervention entails the use of drugs like metformin. The medicine helps to regulate the level of glucose in the patient’s body. A combination of metformin with other drugs improves glycemic control of a diabetic patient. Because diabetes has no cure, patients should be equipped with skills on how to manage the condition. Doctors should emphasize the strict observance of the prescribed dietary patterns. Patients must be encouraged to work on their nutritional habits as a way to protect them from developing long-term complications that are associated with T2DM. There is a need to introduce diet education in schools to prevent the likelihood of children developing T2DM due to poor feeding habits.
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