Preventing Type 2 diabetes in the Midst of a Pandemic:

Author: Prof. Paul Zimmet AO

There are two main forms of diabetes – Type 1 and Type 2 diabetes. Both are on the rise. Type 2 diabetes is my focus here as it has the highest number of people affected both in Australia and worldwide. To obtain more information on Type 2 diabetes and the other forms, which include gestational diabetes, please look at the Diabetes Australia website. This contains valuable information: https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/

I am also focusing on Type 2 diabetes in the context of the current Covid-19 pandemic to provide information you should be aware of for your health and your family.

The “Rise and Rise” of Type 2 diabetes

Type 2 diabetes numbers have been rising over many years. This is clear from my own research studies in Australia, in the Pacific and Indian Ocean nations and in Asia. In the Pacific Island of Nauru in the mid-1970s, I reported the diabetes frequency of 33%. This compared with rates under 10% in Australia and other countries. Virtually all the diabetes cases in Nauru were Type 2 diabetes. This was  the highest national diabetes prevalence ever found in the world at that time.

The International Diabetes Federation, of which I am an Honorary President, has recently estimated that the number of people with diabetes globally totals 537 million. The majority are people with type 2 diabetes. I believe this figure is an underestimate.

Type 2 diabetes results when key tissues in the body like muscle become resistant to the effects of insulin. Consequently, the production of insulin by the pancreas is reduced and a person is less able to utilize sugar (glucose) for energy purposes. This condition of tissue resistance is named Insulin resistance. Exercise is an excellent “tonic” for reducing insulin resistance for treating Type 2 diabetes and also preventing it!

Until about 20 years ago, Type 2 diabetes was considered a disorder of only adults. It was usually diagnosed after 50 years of age. Today, the diagnosis in younger adults, adolescents and even children has become very common.

Can we prevent Type 2 Diabetes?

I will not keep you waiting, and the answer is Yes! I believe it is most important that you are aware that Type 2 diabetes is potentially preventable. While genetic susceptibility does play a part, the diabetes is often unmasked by our lifestyle behaviors. These include a poor diet, overweight and obesity, and sedentary behavior. Therefore exercise, healthy diet, moderation in alcohol and not smoking give an exceptionally good start.

In this context, it is important to remember that Maccabi LIFE was developed to support members of the Jewish community to achieve sustainable health changes. The vehicle for this is promotion of the benefits of a healthy lifestyle through various initiatives. These include health and wellness events, and education. The Maccabi Life programs operate under “The key lifestyle pillars of Nutrition, Physical Fitness and Mental Health”. The aim is to enrich the physical and mental health of the community. This philosophy fits neatly with strategies to prevent Type 2 diabetes and reduce its complications and associated conditions such as heart disease.

What has the Pandemic taught us?

From the start of the Pandemic, it was recognised that diabetes and obesity (I call them “partners in crime”) are very high-risk conditions for infection by the coronavirus, Covid-19. As a result, it is important to be aware of the current situation as to some of the longer-term risks and how to reduce them if you have type 2 diabetes or are at risk of diabetes, for example, if you have a family history of Type 2 diabetes, have prediabetes or a history of diabetes in a past pregnancy.

Furthermore, numerous reports from around the world testify to the rise in obesity in children and adults. There appears to be a link to the impact of the  lockdowns, less exercise, poorer diet and mental health issues.

Also, along with colleagues at Kings College University in London, I predicted that there would be new cases of diabetes caused by Covid. This has been confirmed. We established the CoviDiab Registry, and it has been documenting this, collecting data on new cases of diabetes, both Type 1 and 2, around the world.

As we are now almost 2 years into the Pandemic, it is particularly important to note a number of new perspectives in the story. There are some lessons we have learnt during this time although there is still much to learn, and unfortunately, we cannot predict when the number of new cases will be declining.

In the meantime, people with diabetes who have been infected by COVID-19, even mildly, are at increased risk for what we call Long Covid. Some call those with Long Covid the “Long Haulers”. So what is it?  It represents the potential future as to what may be the long term after-effects and complications after being infected by Covid-19, even mildly. There can be long term damage to key organs including the heart, brain, lungs and the pancreas. The early symptoms include extreme tiredness, chest, muscle and joint pains, poorer concentration and memory and changes to smell and taste to mention a few.

We are slowly learning more about other longer-term effects of Covid-19 infection. Very recent studies from the USA and Germany have shown that people who have had even mild Covid-19 infection, are at increased future risk of Type 2 Diabetes. This fact needs to be better publicized within all ethnic communities., even at a national level. This finding suggests that people affected need to be aware of this and the symptoms of diabetes. As the condition may be asymptomatic, regular checks, at least annually may be necessary.

These are some of the challenges we all may face, even as the Pandemic itself goes into decline. Our governments need to face this scenario and include it in the ongoing health challenges from the Pandemic. There may still be a long road ahead.

In Maccabi Life, we have the elements to both reduce the risks for Type 2 diabetes as well as enhance its treatment in persons who already have diabetes through its lifestyle pillars of Nutrition, Physical Fitness and Mental Health.

We do know that exercise is one of the best strategies to lower insulin resistance and help the body cells use glucose to generate energy!! So, the Maccabi Life program which aims to improve nutrition and increase exercise is an excellent diabetes preventative.

Very Important LATE NEWS

My final recommendation is to “Stay POSITIVE and Test NEGATIVE” and Stay Fit and Stay Well!

Prof. Paul Zimmet AO