Dr. Akshay Jain
Endocrinologist & President of the Canadian Chapter of the American Association of Clinical Endocrinologists
Information and self-advocacy can help patients learn their risk factors and take control of their health.
Raymond Deo says that when he was diagnosed with type 2 diabetes, he didn’t know much about the disease and hadn’t noticed any symptoms. Over 90 percent of people with diabetes have type 2, which is when your body can’t make enough insulin or doesn’t properly use the insulin that it does make.
“I had been extra thirsty and was very tired. But I’m a chef and back then, as a line cook, I worked 12 to 14 hours a day. I thought I was just tired from working such long hours. My eating also wasn’t very good. I would just grab the first thing I saw,” says Deo, 42, who lives in Surrey, BC.
After his diagnosis, Deo’s doctor put him on medication and explained the disease, treatment, and possible complications. He enrolled Deo in a two-day course on diabetes that covered topics including nutrition and blood sugar monitoring.
Who’s at high risk?
Anyone can get diabetes but there are a number of factors that can put people at a higher risk, including adults who: are overweight or obese, have a larger waist circumference, have had gestational diabetes, have a family history of diabetes, or are a member of a South Asian, East Asian, Indigenous, or Black community, due to a combination of genetics and inequitable access to health care.
People in these groups are also at a heightened risk for heart attacks and strokes, and diabetes increases it even further. “We’ve seen in epidemiological studies that South Asians tend to develop diabetes 10 years earlier than Caucasians,” says Dr. Akshay Jain, an endocrinologist in Surrey, BC. “If they develop diabetes at an earlier stage, they live with diabetes for longer, increasing the risk of heart attacks and strokes even more.”
Ask questions and get informed
Even if they’ve never had previous heart issues, people living with diabetes, especially type 2, are encouraged to understand their risk factors and then to open up a conversation with their health care provider. Together, they can take preventative steps to help reduce diabetes-related complications, such as strokes, says Dr. Jain. “We need the communication to open up both ways and for health care professionals to be aware that certain ethnicities are at high risk for developing these conditions,” he says. “Doctors and nurses need to actively screen individuals in these high-risk populations.”
We need the communication to open up both ways and for health care professionals to be aware that certain ethnicities are at high risk for developing these conditions. Doctors and nurses need to actively screen individuals in these high-risk populations.Dr. Akshay Jain
Be proactive about diabetes
New medications can also help. Dr. Jain says diabetes management is not just blood sugar management, but also involves reducing the risk of heart attacks and strokes and lowering blood pressure and cholesterol levels. “Optimal management of diabetes is preventative management. And that’s where, for the longest time, we were lagging behind,” he says. “We’re great at treating heart attacks and strokes, but treatments to help prevent these conditions are more limited.”
Previously, medications that help control blood sugar could cause low blood sugar, and weight gain, and increase the risk of cardiovascular disease. New medications don’t cause low blood sugar and even promote weight loss. “Most importantly, independent of the blood sugar reduction, these medications help reduce heart attacks, strokes, and even death,” says Dr. Jain.
As for Deo, he’s controlling his blood pressure and cholesterol with medication and has gotten more serious about a healthy diet. He recently lost 30 pounds and his blood sugar levels have improved.
While Deo’s doctor made sure he learned about the disease, many ethnic groups don’t receive adequate information and health care. He wants other people who have diabetes to feel empowered and to take ownership of their health. “Education is very helpful,” says Deo. “You have to really clamp down and take it seriously. You have to pay attention and do what you can to help yourself, for now and for your future.”
Know Your Numbers
Because type 2 diabetes is associated with high cholesterol and high blood pressure, which are both factors for cardiovascular disease, you should know your numbers and take preventative measures.
At every medical visit, you should find out your:
The glycated hemoglobin test (A1C) evaluates the average amount of glucose in your blood over the last 2–3 months.
With high blood pressure, the long-term force of blood against the artery walls can increase your risk of cardiovascular and kidney complications.
Cholesterol is a fat found in the blood. Low-density cholesterol (LDL) can form plaque in your arteries, increasing your risk of cardiovascular events.
You should also focus on preventative options like:
Limit your intake of high-sugar and high-fat foods like processed foods.
Get your heart rate up through moderate- to vigorous-intensity exercise for at least 150 minutes a week over 3–5 sessions.
If you’re overweight, aim to lose at least 5% of your body fat through a healthy diet and regular exercise.
Of people with type 2 diabetes:
die of cardiovascular disease
of people over 65 die due to stroke
Know Your Risk
Understanding your risk for type 2 diabetes can help spark a conversation between you and your health care provider.
A number of factors can put you at higher risk if you’re over 18 years old, such as:
🔲 Being overweight or obese
🔲 Having a larger waist circumference
🔲 Having a family history of diabetes
🔲 Are a member of a South Asian, East Asian, Indigenous, or Black community
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