If we don't have it ourselves, most of us know someone with diabetes.
With that in mind, we caught up with Joy Zhang, a registered dietitian and diabetes educator with Hector's Your Independent Grocer in the Garibaldi Highlands, for some information and tips on this disease.
What follows is an edited version of that conversation.
How prevalent is diabetes in Canada?
As of March this year in Canada, there are more than 5.7 million Canadians living with diagnosed diabetes (Type 1 or Type 2 diabetes). However, there are 11.7 million Canadians living with diabetes or prediabetes. So it's actually pretty prevalent.
Is Type 2 mostly due to diet?
A lot of factors that increase the risk of diabetes are out of people's control. It could run in your family — you have an immediate family member, a parent or a sibling who has diabetes, which increases your risk of getting diabetes. Age is a contributing factor. If you're over 40 years old, it increases the chance of developing Type 2. It could be ethnicity. Basically, if you're not white, you have a higher risk of developing diabetes. People of African, Arab, Asian, Hispanic, Indigenous or South Asian descent have a higher risk than white people of getting Type 2 diabetes.
If you've had a history of gestational diabetes — if you had diabetes temporarily when you had a baby — that also increases your chance of getting Type 2 diabetes later on in your life.
Some mental health disorders increase your chances of Type 2 diabetes.
Being overweight means there's a higher chance of getting Type 2 diabetes.
If we're speaking of Type 2 diabetes, can you speak to some foods we can eat or avoid eating to prevent it?
If we're speaking about Type 2 diabetes, nutrition definitely plays a big role in managing that. Number one is always to keep carbs on top of mind. One myth we hear a lot about nutrition and diabetes is that all carbohydrates are off-limits. However, there are actually a variety of slow-digesting carbs out there. For example, sweet potatoes, oats and quinoa. They're tasty, and they're actually really beneficial in terms of managing blood sugar. So complex carbohydrates are especially good for people living with diabetes because they take a body longer to break down its sugars, and help the body release glucose at a more consistent rate throughout the day.
I see a lot of people who have already tried the ketogenic diet or at least a low-carbohydrate diet to manage their blood sugar. In the short term, yes, it would work because it's just like not giving your car gas. But over the long term, it could actually do more damage to your pancreas, and it could actually increase the risk of diabetic ketoacidosis — a life-threatening situation when your body doesn't have enough insulin to allow blood sugar into your cells for use as energy.
Number two is choosing low glycemic index food. Diabetes Canada recommends that people who live with diabetes, especially Type 2 diabetes, incorporate more low glycemic index foods. This is especially beneficial because it could decrease the risk of Type 2 diabetes, and also helps people who are already living with it to decrease any complications. It also helps to make them feel full for longer.
We have covered carbohydrates, so I would also say, for example, pears and Greek yogurt would be a good combination as a low-glycemic snack.
Are there foods you should just completely avoid if you are diabetic?
I would never say there's anything that you should avoid or cut out completely. It is just a matter of what to eat, how to eat, and the timing.
Can you go into the timing a bit?
It is recommended to have something to eat — a meal or a snack — every four to six hours. Keep in mind your activity level throughout the day. If you're out and about, you probably would want to eat a little bit more and more frequently as needed.
We have likely all seen a person who is diabetic who suddenly needs a glass of orange juice or candy or something. What is going on there?
You're probably observing somebody having a hypoglycemic episode, which is a low blood sugar (glucose) episode. This is a perfect example of how there is no food you absolutely can never have. In this case, a juice box or quick sugar would save your life when your sugar is too low.
What is happening is the person's blood sugar is going lower than ideal. And that's when you experience those symptoms of low blood sugar — getting shaky, feeling weak, and some people could have blurred vision. It's quite dangerous, and we need to take action quickly.
We need to bring the blood sugar back to normal levels.
The holidays are coming up. What should cooks keep in mind for our diabetic relatives?
In terms of holiday eating, we always make sure that we provide a variety of food choices.
It is quite easy for us to just go for the sugary options — have more pleasure foods around during holidays, which is totally fine. But also always have available some vegetables and fruit, fibre choices, and protein choices.
Right now, groceries are so expensive. How can folks cost-effectively shop in a way that helps avoid diabetes or manage it?
I always tell my clients to look at what's on sale this week. And a general rule of thumb is that vegetables have a low glycemic index and are really high in fibre.
Look at half of a cart being fruits and veggies. Go for higher fibre and protein options — read the labels.
Opting for a more plant-based diet — increasing beans, lentils, or legumes — saves money and increases fibre, which helps manage your blood sugar.
Anything else you want folks to know about diabetes that I didn't ask you?
Diabetes is a very individual disease; no one's journey with diabetes is the same. One thing that is in common is that with healthy eating, you could make the condition more manageable.
I really want people to understand that there are easy things you can do to use nutrition to your advantage when you manage diabetes.
And if you ever need any more information or want more individualized assessments or recommendations, as registered dieticians at the grocery store, we offer free 15-minute consultations. Find a dietitian at www.dietitians.ca.