Diabetes is a chronic, metabolic disease characterised by elevated blood glucose (blood sugar) concentrations and, broadly, there are two different types of diabetes, type 1 and type 2. In type 1 diabetes, formerly known as juvenile diabetes or insulin-dependent diabetes, the pancreas produces little or no insulin. Type 2 occurs when the body becomes resistant to insulin or does not produce enough of it.

In recent decades, the prevalence of type 2 diabetes has increased dramatically. For people living with this disease, access to affordable treatment, including insulin, is essential, but a healthy diet is also important to control surges and dips in blood sugar. Untreated diabetes increases the risk of cardiovascular disease (such as stroke or heart attack) as well as blindness, kidney failure, and nerve damage. It is not known whether those living with diabetes are at greater risk of coronavirus infection, but it is known that those with diabetic comorbidities are usually more vulnerable to being unwell.

In the past, progression of type 2 diabetes was regarded as inevitable, but there is evidence that significant weight-loss through clinically supervised dietary interventions can halt or reverse this condition in some individuals. It is, therefore, essential that anyone living with diabetes follows a healthy diet and keeps an active lifestyle. Weight loss of 10% can improve significantly glucose control and triglycerides concentrations, as well as reducing blood pressure.

Nutrition has an important role in both the prevention and management of diabetes. It is essential that those diagnosed with diabetes work with healthcare professionals to manage their condition. Everyone should be treated as an individual, as diet needs to be aligned with lifestyle and medication, especially insulin. People with diabetes should eat regularly and control carbohydrate intake, whilst making sure they consume enough dietary fiber (> 25g/ day), limit intake of simple sugars (including added sugars) and prioritise consumption of products with a low glycaemic load. Alcohol is not generally recommended, as it can lead to hypoglycemia (low blood sugar).

Food for thought:

• 422 million people worldwide live with diabetes, which is 1 individual in 11.
• Diabetes was associated with 4.2 million premature deaths (under 75 years of age) in 2019; 1.6 million deaths can be attributed directly to diabetes, making it one of the leading causes of death, together with cancer and cardiovascular disease.
• 1 in 5 people living with diabetes (136 million) is aged 65 years or older
• Two-thirds of people with diabetes live in urban areas.
• More than three out of four people with diabetes live in low- and middle-income countries.
• Diabetes and comorbidities were responsible for at least €760 billion spent on health in 2019, which is ca. 10% of the total healthcare expenditure globally.
• Type 2 diabetes is largely preventable by maintaining normal body weight, exercising regularly and eating a healthy diet. Smoking can be a potential risk factor for diabetes, which is why quitting can be considered a preventative measure.
• Healthy eating habits and physical activity have positive impacts on management of diabetes.