HEALTH MYTHS BUSTED SORTING FACT FROM FICTION FAW \ CINE Tob0 1.0.0 ee o 7 @ EMBRACE THE BENEFITS OF EXERCISEWelcome prediabetes or diabetes itself(or you have a relative who has) then you need See er eee aie rr) healthy. First and foremost, this should come eC ene oe aad Cen Eee ta Dee eee Ee eee ete ee right for you before starting it. This Pe ae Me Te ‘medical support with a range of tasty, eee enter professionals, as well as ideas for fun Sere tae levels, and advice on living healthily and Deeg a eae Ce eee een Cee ee eA where hidden sugars lurk in everyday foods. eee ne eer exercise, and discover tips for making eet teas Cee ee Saeed Nec re Ee doctor and diabetes healthcare team, who eterna fer see eae I= ee ey4 L FUTURE 4 rContents Diabetes 10 2 16 2 Diabetes: The facts Key factsand figures about the condition What's yourtype? The types of diabetes and how they work explained Life ater your diagnosis What to expectaftera medical diagnosis of diabetes 13 surprising myths busted We help you to sort fact from fiction in this guide Type 1 casestudy How one Type | patient took control of herlifestyle ‘Support your loved ones What you can do to help a family member Prediabetic Ifyou're at higher risk, here's what to do next Insulin resistance: The facts Key advice from a diabetes nurse Your healthy eating checklist Improve your diet today Escape the sugar trap Helpful tricks for cutting down on sugar Shockingly sweet Discover the surprising sources of secret sugar ‘Are you eating enough fibre? How to improve your intake Natural helpers. Foods to give youa litle health help. 6 The Diabetes lan Diet 4 6 Could adiet cure you? Can diet alone send Type 2 into remission? We take. look atthe research The Fast 800 Low calorie eating plan High in taste. Delicious low-carb recipes from the Low Carb Program ‘Success in numbers Advice and a meal plan from Slimming World Taking control of comforteating How to manage when you get food cravings. Get on top of anxiety The root of comfort eating 4 6 7% Walk yourself itt Improve fitness with walking De-stress and shape up The benefits of yoga Beginner's guide to running Go from sofa to parkrun with these top tips Getstrong, get healthy! Try strength training Boost your N.EAT Everyday activities Exercise case study The benefits of getting fitterRecipes 8 Low-ca Delicious low-carb meals from Giancarlo and Katie Caldesi 88 Filling and high-ft Tasty high-fibre recipes to keep you fuller for longer 92 Yes, you can treat yourself Low-sugar baked treats 98 10simple carb swaps Easy swaps for everyday eating Keeping healthy 102 Howto drink safely How to moderate your alcohol intake and reduce its sugars 104 Boost your immunity Keep your immune system working well with these tips 106. Stay heart healthy Plant-based recipes are key 110. Know the risks Complications explained 16 skins.o.s Diabetes-specific tips for proper skincare 118 Get to know your gums Oral health advice especially fordiabetics 120 Inclearsight Essential eye care for diabetes. related conditions 122, Let’stalk about sex Intimacy advice 126 Lookto the future Upcoming research 128 Glossary Essential terms explained 64 ‘Theiabetes Plan 7Diabetes THE FACTS Wondering how many adults are in the same situation? Or pondering how much is spent on diabetes annually? We have all the figures you need...* 4.7 MILLION PEOPLE are living with Fe ee diabetes in the UK. By 2030, it’s m ak es up predicted that HY, Yo 7 403 aanctie adults worldwide | 1 million h people in the UK ave are thought to be diabetes _ | still undiagnosed i : i 10 The Diabetes Pan31.5 INCH (80cm) ‘waist measurement or more raises a woman's risk of type 2 “a 5 f tittle 4()+ The age from which type 2 diabetes is most often diagnosed Keep YOUR HEART healthy + Take steps toreduce your blood pressurewith your doctor's advice. + Eata Mediterranean diet and include ‘a small amount of unsaturated fats. + Reduce bad cholesterol levels and boost good with your doctor's advice. “+ Turnto p32, where you'lfind Your Healthy Eating Checklist. C10 billion The amount the NHS spends on treating diabetes each year EVERY 3 MINUTES someone is diagnosed with type 2 diabetes*** ve Ifyou lose LOY of your body weight with no explanation, consult your GP ‘THE FACTS. Tam ere + Passing more urine more frequently, especially at night. + Dry mouth or excessive thirst. + Losing weight with no effort or fornoapparentreason. + Feeling extra tired. (But this and ‘sudden or unexplained weight loss 7 common symptoms of type 2 d diabetes ‘can both be important symptoms of other diseases) * Vaginal itching and/or discharge, fr thrush anywhere on your body. + Cuts and wounds that take longer than usual toheal. “Visual disturbances. The Diabetes Plan 11y ‘S SA, ze IL ereicras S a seiele lauCUL le,TYPES verthe past 20 years, thenumber of people diagnosed with liabetesin the UK ! hhas more than ae doubled, taking es from 1.4 milionto almost 3.8. ifyouare ciabet, you're ether not producing insinor the inaun youre producinais nue or isntbeng used efectvey Thisleadsto anoverload of glucoseinthe blood, which cant get into the body'sclls tobe Used for fue Too much glucose inthe bid fr a sustained period can eventually led toserous complications suchas kidney faire, stoke, sightloss and even amputation, which shyt alto M OST remission, given the LEADA “Zn. NORMAL is that much moreis LIFE cee a eh The Diabetes Plan 13.eat plays : a huge part in the control Pedple with type 1 diabetes don't ~ produce any of their own insulin, so they need totakeit daly, either by Injection or insulin pump, and monitor their lood-glucose several times day. Type 1 accounts for about eight per cent of ll diabetes diagnoses. Thisisalifelong condition which has nothing to dowith dietor lifestyle. I's an autoimmune disease, wherethe body attacks and destroys insulin-producing cells. Experts are still unsure why people are born with although family history isknown tobe factor. ‘The majority ofpeople with type 1 slabetes are diagnased in childhood and early adulthood ~ typically at 10-14 years cold ~ butit ean develop at any age. ‘The symptoms tend to come on quickly indays or weeks, butare broadly the same asfortype2. Diabetes UK's'4Ts’campaign was specifically targeted at parents so they could bealertto the signsin ther children, butt’sahandy reference for anyone of any age. The Ts are + Tollet Needing to wee often; wetting accidents in a previously dry child heavier ‘nappies in babies. + Thirsty Unable to quench thirst. + Tired Feeling more tired than usual 4 Thinner Unexplained weight loss. 14 The Diabetes Pan of type 2 diabetes | ‘J Cree ieee ay iors beteslastyear Tiere ic een as they failed to identify Coens Type 2 Obetes Intype 2diabetes, the insulin your pancreas makes can’t ‘work properly, or your pancreascan‘t ‘make enough. This type most ‘commonly developstater in ite, ‘typically after the age of 40. Family history, ethnicity and lifestyle canal beinstrumental in developing the ‘condition. There are currently more ‘than 3 million people in the UK with type 2 diabetes, andit’sthought there are 1.1 million more who romain undiagnosed. Intype2, symptoms may develop gradually. ‘Symptoms often creep upon peopl: says Drlan Lake, GPand founding ‘member ofthe Pubic Health Collaboration. "You might be more tired than normal; have central obesity - where excess fat accumulates around your middle; be tourinate; possibly have increased thirstand need tosleep moreafterabig mea. ‘Alotof people also mention brain fog many ofthese are things that we often putdown toageing’ The-good newsis that type2 diabetesisa reversible condition for ‘alot of people, says Dr Campbell Murdoch, GP and Diabetes Digital Media's (ODM) Chief Medical Officer “The challenge now isto empower as ‘many peoples possible: fyounotice any or allofthe symptoms, ‘contact your GP fr advice. if you are ‘diagnosed, i's very important that you ‘acton advice about diet and exercise and that you take prescribed medications. ‘can take time to get the dosage right, 0 bear with your medical team, g BType 3c Witt types 1 and 2, the pancreas either doesn’t produce enough insulin, doesn’t produce enough ‘to.control blood-glucose levels or produces insulin that doesn’t work properly - but food digestion is normal However with the newer, rarer type 3c, which is sometimes caused by inflammation, digestion isalso affected. Symptoms include vague abdominal pain, loose, fatty stools and vitamin tn walk around during the break. WALKAROUND hen you'e ene phone A = SETANALARM ON YOUR Lose weight COMPUTER OR PHONE so that \We'renotsaying sheda stone in aweek ‘every 30 minutes you're reminded «studies show that a 5-7 per centloss can tostand up and walk around, delay diabetes by nearly 60 percent. ‘TOPTIPS. + Toke tstow and steady. Aim for 1-2ibs ‘week, Crash diets make you more likely to regain the weight. + Watch your portion sizes. Weigh your food, use smallerplates and eat more slowly, + Don’t get hungry. Healthy, low-calorie snacks keep hunger at bay and make you lesslikely to binge at mealtimes. “+ Eatagood breakfast to stop yourself filing upon high-calore snacks eeeINSULIN RESISTANCE: THE FACTS In an extract from her new book on the subject, registered nurse Hanna Purdy shares her expert tips for avoiding type 2 diabetes... ee A pier Erie ea cormequeee of engin El pcb sil: leo am LA Saintes yhathshacbcen”presredabtesiae consistent theca er manyyeas evn dais peiteaineera)canerenuaty, = Boren dupresa ate Cauedorogesroundtiebody.” _spvbacaathe cron enh Its often symptomless, but signs ‘no definitive symptoms. ‘can include weight gain, frequent Not tobe confused with prediabetes, hunger pangs and tiredness. Inher which sa condition arising from having book Could tbe insulin Resistance? consistently slightly abnormally raised (€14.99, Hammersmith Health levels ofglucosein the blood, Books), Hanna Purdy talks us : ‘through what happens tothe body during this process. WHATIS INSULIN RESISTANCE? ‘Your doctor may have had reason to test you for type 2 diabetes and found ‘that, although you den'thaveit, you are insulin resistant, which isa precursor. ‘The constant presence of insulinin itself causes resistance. t's believed that insulin resistance sa protective ‘mechanism - that the organsare protecting themselvesagainst EeeWHAT CAUSES IT? “There are many contributory factors including poor aie, smoking, lack of ‘exercte, anda stressullfe-buta diet high in sugar and starchy carbohydrates iskey,asis eating too much and too ‘often, meaning insulinisalvaysin ‘demand, We need to let the counteracting hormone, glucagon, which uses stored fat, havea chance todo isbit. DIETThemain ole ofinsulinisto regulate the level of glucosein the blood. After acarb-aden meal - especially one Containing refined sugars and processed foods the level increases, and the cells inthe pancreas releaseinsulin into the bloodstream. Insulin circulates, instructing cells to pick up glucose from the blood to ‘notmalise the level. When the body has ‘more sugar than t needs, insulin helps store the excessin the liver and ‘lease it when needed - consistently high, Insulin resistance STRESS Every aspect of our healthis impacted by an overload of stress, which can cause or make existing conditions much worse lor prevent us recovering even when al other lifestyle factors are inbalance. High stress levels are known to-exacerbate insulin esistance. LACK OF EXERCISE Exercise is known to havea positive impact on insulin resistance. According tomany studies, even short periods of regular exercise, suchas walking, help. Finding te right pursuit for you wi enable you to stick toa regular programme. Exercisereleases ‘endorphins, chemicals that make you feel ‘9004, sols beneficial for body and mind, INFLAMMATION Chronic inflammation is bath a cause and efecto insulin esistance. inflamed cells donotrespond to insulin, and inguin resistance itself activates inflamma factors, causing probiemsin ‘normal metabol INSULIN RESISTANCE, inflammationisa situation where the ‘body’snormal immune responses to ‘2cute injury or infection remain switched ‘onand do not resolve, leaving the body in ‘prolonged state of immunological alert. Research has shownadiet high in refined carbs, especially sugar, is highly inflammatory, and other lifestyle choices, suchas the over-consumption of alcohol ‘and refined and damaged ols, eating too often, chronic stress, lack of exercise, and smoking, make the situation worse The resistance that follows prolonged consistently high evels of insulin in the bloodstream can develop into diabetes. Insulin continues tobe released, but becomes ess andless effective. Unless treated, this is when ‘diabetes can occur, Lifestyle changes can help even out blood-glucose levels. Cu sugar starch and alcohol out, imit yourselftothree healthy rmealsaday and up exercise levelstouse ‘excess blood glucose. No snacks: you ‘need tolet your body rest between meals and thee tee Here + + we sane i COULD IT BE <= INSULIN RESISTANCE? ISS Hanna Purdy'sbook s available to buy from ‘© wwwshammersmithbooks.co.uk/product/ could-it-be-insulin-resistance/CHECKLIST So you've been told to eat a healthy, balanced diet. But what does that actually mean? Here’s our guide to the basics... 82 The iabetesPlan‘any of us think we eat asonably healthily when, fact, thereare often huge gaps in our daily diets. tf you've been diagnosed with, orare at tlskof, diabetes thenit’sallthe more Importantto ensure you're eating the right balance of foods. We're here to make ife easier for you and remove any confusion about what's {good to eat and what’s not. So we've developed this guide to your healthiest cating ever, with all the targets, suchas five-a-day, low saturated fatand high inone checklist. You'lbe getting the balance right every time. Keep the checkliston the next two pages to hand throughout the week to be sure you're getting al the good stuf and the right amount of the not-so-good. These recommendations are based on ‘general daily guidelines, butit ay be that ‘your personal situation means there are certain foads you need to eat mare or less of if you're inany doubt, ask your ciabetes care team for advice. Medical professionals recommend wetakea daily 10 microgram (meg) vitamin D supplement. oP, & ‘Top 10 tips for diabetics suggests you start with the following top 10 suggestions: Choose wholegrain carbs Eatless salt Eat more fruitandveg ~especially veg Eat less red and processed meat ‘Choose unsaturated fats Cutdownon sugar Choose healthy snacks Don'tbuy foods labelled ‘diabetic’ Drink alcohol responsibly ‘Ty toget your vitamins and minerals from food Now turn the page to learn more about the different food groups. The Disbetes Plan 337 YOUR HEALTHY EATING CHECKLIST 5 Fresh frozen, canned and ried. One small glass of juice (but only one serving adaycan be juice). All dairy foods and calcium-enriched, non-dairy alternatives (check labels. oly fish (mackerel trout, sartines, herrings, kippers, salmon, plchards, spats, Fruitandveg |__ Calcium Fish Plant foods How often. How often How often How often Ea Sean | eee Seta set ven pare se a oso ete eecerater eGo Mesias at niet eer fete ee ae ro eee to700m0 pce What counts What counts What counts What counts Fruits, vegetables, pulses, grains, nuts and seeds and plant-based dairy fresh, frozen or canned, enriched non-dairy + 1259 canned fish, fortheamountofsugar and | anchovies) shark martin, akernativs. Lowcarbfruitsincude | lookfor 59 oss per 1009) swordfish andcrab bers, watermelon, plums | Mikpudings, custard, | (especially the brown mea) ‘and peaches. Veg usedin smallfish with bones *ifyoue pregnant or ‘ooking aso count. (ea. sardines) saimon, | planning a pregnancy, eat no onions, musroomsand | aglassofmiknaturalyogurt, | morethan 2 portions of lly tomatoesina pastasauce). | cottage cheese, a lass feha week and avoid Potatoes don't count ofa swordfish, marinand shark ‘Typical serving ‘Typical serving Typical serving ‘Typical serving + 80g(Sheapeditosp) | + 200mimikorcalekim “140g fess “+Airmtofillyour plate with ‘wo: thirds plant foods, + Supplies your requirement of protective antioxidants needed to lower the risk of high blood + Good for bonesand teeth “+ Keeps muscles healthy “+ Unsaturated fats help to + Omegs-3 isan essential, group offats to keep heart isease at bay and pulses, alternative, ‘one-third animal food. + 150ml ruitjuice only “+ 30g cheese. ‘counts once per day) + 120 yogurt. + Heaped thsp dried fruit, Benefits Benefits Benefits Benefits ‘¢Helps you meet your requirements for fre, vitamins and minerals. mixture ofvitaminsand minerals, Eatas many ‘colours as youcan, ‘wholemeal toast + Wholegrain cereal with milk meets two targets + Ifyou‘renot keen on eating fish, investin a dally omega-3 cilsupplement, protect your hear. + Fishalsprotetthe blood | +Reducesriskot Type pressure, obesity, heat vesselsfomlseaseandmay | diabetes bya quarter clseace, stroke helpmaintain memory and. | Lowers your isofheart and some cancers. prevent depression, disease and sveralcancers Tips Tips Tips Tips + Thecolourottuitand | + Drizdleolivecitonsalad. | + Tinnedsalmon, sardines, + Have 1-2 meat ee vegetablesingicatestheir | + Spread peanut butteron | and mackerel all count. days week + Snack on fruitand nuts + Swap butter for vegetable based spread, 34 The Diabetes PlanHEALTHY EATING at a Whole grains Fats How often How often How often How often. Keep your intake of free Atleast three servings: Less than 6g every day Keep to 70g per day, 509. suantohstivepercent | tolling sépadzy ‘ivtich sted be eee era feats] What counts What counts What counts What counts Fmenparlethecper || Cwedswitiwhaegant | foouranraiybighinett | Uneauatedtetsincte ier afi dia Becaks || nthe bende, || Pccksmoles moe ieee ewer thosenaturally occuring in ‘ruitjuices, syrups and honey. wholegrain pasta, wholemeal bread, barley oats, popcorn, rye, wldrice, ‘buckwheat, quinoa bacon, anchovies, fish, prawnsand cheese. Take care with Marmite, Boil some breads and breakfast cereals, ready meals, sandwiches avocados, nuts, olive ols, vegetablecils, salmon, mackerel, cashew nutsand sesame seeds, Saturated fats include buttercream, cheeses, and sauces. meatand processed foods ke pastries, biscuits andeakes ‘Typical serving Typical serving Typical serving ‘Typical serving + Recent government + tbsp uncookedoats. | + Lowsatfoodhastess than | + Cookwithsunfower, ouideines asstatedbythe | + Stbspwholegran cereal 0:39 saltper 1003 INHSsay that adults should consume no mare than 309 of, free sugars per day, + I slice brown bread, + Yepitta + 2oateates + 2tbsp cooked brown rice, + Forready meas, aim for less than 1.259 salt per pack, + For soups, sauces etc ess ‘than 0.759 sat per serving, soyaorcoroll + Make dressings and use spreads made from oliveor rapeseed oil “+ Eatolly fish each week. Benefits + Reducing sugar intake has been identified asone ofthe main waysto tackle obesity, whichisa risk factor for Benefits + Lowerstte risk of heart disease, diabetes and Dowel cancer + Canhelp with weight Benefits + Cutting down on salt will lower bload pressure and the riskotheart disease stroke Benefits + Total fatintake isabout keeping your weight down, which lowers the risk of andkidney disease labetes and joint problems ‘ype2ciabetes. contrel by keeping you “+ Balanced ftntake can ++ High sugarintaetsalso | feeling filer for longer lower theriskof heart associated with tooth decay. disease and igh cholesterol. Tips Tips Tips Tips + Findtheriddensugar | + Focusonstapestiverice, | + Trytohavenomorethanone | + Iftis liquid atroom inyour diet. pasta breads, cereals | natualysaltyfoodeach day. | temperature, it nearly + choose cereals with and crackers ‘ Dontaddsattofood unt | always unsaturated no added sugar. + snack on wholemeal scones you'vetastedit + Gil poach orsteam + Limiteontectonery. | popcorn, Ryvtaoroatcakes. | +Use garicorherbs instead instead of ying The Disbetes lan 35An overload of sugars not only found ‘nthe obvious cakes and treats ~italso irksin ess immediately obvious places: ta sauces, tomato ketchupand other ple sauces, canned vegaand even 2 a study by Which? magazine, some ready meals can contain asmuch sugar asicecream. Nowa growing band of doctorsand etitians believe that excess sugar is otonly making us overweight, but ‘may be contributing to mood issues, ‘excess skin wrinkling, an increased risk ‘of heart disease and excessive weight ‘gain that can lead tothe development