“People think...we're going to take all their favourite foods away, but you can still have food that you love.”—Phillippa Phiri, Health Coach, Remedy Healthcare
- Statistics show that up to 58 percent of type 2 diabetes cases can be prevented or delayed—just by making lifestyle changes.
- Exercise is key to managing our blood glucose levels, but also it can help improve sleep, which is an underrated area of type 2 diabetes prevention and management.
- "Plate portioning" helps create a strong foundation for healthy eating: a meal should consist of one-quarter lean protein, one-quarter high-fibre carbohydrates and half vegetables.
- Specialist backup and support—including from your GP, Diabetes Australia, a credentialled diabetes educator, an accredited dietitian or an exercise physiologist—can help you stay on top of your health goals.
If you’re one of the 2 million Australians with pre-diabetes, or you’ve been told you’re at risk of developing type 2 diabetes, we have some good news for you. Statistics show that up to 58 percent of cases can be prevented or delayed—just by making lifestyle changes.
The different types of diabetes
Just over 1.3 million (or one in 20) Australians are living with diabetes, which Carolien Koreneff, Credentialled Diabetes Educator at Diabetes Australia, describes as “a chronic condition that affects the metabolism of carbohydrate foods in particular”. She adds: “Carbohydrate foods get broken down to glucose. Glucose is our main energy source, but if it can't be utilised properly then diabetes will develop.”
There are three main types of diabetes. Type 1 is an autoimmune condition that is not preventable. “In some people, the body's immune system starts attacking the pancreas,” explains Carolien. “Once the pancreas is destroyed, a person is no longer able to produce insulin, which affects glucose metabolism. And so, people with type 1 diabetes rely on insulin injections or insulin infusions.”
Type 2 diabetes, however, can often be prevented or managed through lifestyle changes. “Type 2 diabetes is more an issue of insulin resistance. The body still produces insulin, but the insulin doesn't work properly.”
The third main type is gestational diabetes (GDM), which occurs during pregnancy. “Usually, it means that glucose levels are slightly above target. Those targets are very different from targets we have in type 1 and type 2 diabetes because the foetus is very sensitive to glucose.” Alongside medication, treatment for GDM focuses on lifestyle changes.
The symptoms of diabetes, according to Carolien, include the four Ts: tired, thirsty, thinner and toilet. She says that rising glucose levels result in the need to use the toilet more—and, because of this, people end up thirsty and tired. For those with undiagnosed type 1 diabetes, the condition can also lead to sudden unexplained weight loss.
The risk factors you can and can’t change
When it comes to preventing type 2 diabetes, there are some risk factors you won’t be able to change. Age is one factor, says Carolien, with your risk continuing to increase after 40.
Another is ethnicity and cultural background. People of Aboriginal and Torres Strait Islander, Pacific Island, Indian subcontinent or Asian descent are more likely to develop type 2 diabetes. Having a family history of the condition, previously having gestational diabetes or living with polycystic ovary syndrome (PCOS) are other non-modifiable risk factors.
So, what can we manage? “The risk factors we can influence include high blood pressure, high cholesterol, smoking, inactivity, unhealthy eating habits and excess weight, particularly around the waist.”
Carolien adds: “We can’t always avoid type 2 diabetes, but the healthier the lifestyle, the lower the risk, generally speaking.”
Embrace exercise for a big pay-off
In terms of ways to prevent and manage type 2 diabetes, it’s no surprise that exercise is high on the list—especially when you consider its positive impact on most of the condition's controllable risk factors.
The Australian Government recommends adults do at least 2.5 hours of moderate intensity physical activity a week or, if you’re over 65, 30 minutes on most days. If that sounds like too much, accredited practising dietitian and health coach Phillippa Phiri has this great advice.
“It doesn’t have to be 30 minutes all at once,” says Phillippa, who works with HealthierMe, a health coaching program delivered by Australian Unity's health partner Remedy Healthcare. “It can be broken up throughout the day into manageable chunks, whether it's two 15-minute brisk walks or three 10-minute brisk walks."
Exercise plays an important role in increasing insulin sensitivity and managing blood glucose levels—but the benefits don’t stop there. In addition to helping with excess weight, hypertension and high cholesterol, being physically active can also improve sleep, which Phillippa says “is a really underrated area of type 2 diabetes prevention and management”.
She explains: “When you get less than seven hours of sleep per night or poor-quality disjointed sleep, it can increase insulin resistance. Adequate sleep helps to decrease the amount of stress hormones—cortisol and adrenaline—that make it harder for insulin to do its job properly.”
Think differently about food
It can feel daunting to be told you need to change your eating habits to prevent or manage diabetes. “People think this means we're going to take all their favourite foods away, but you can still have food that you love,” reassures Phillippa.
To start with, she recommends creating a healthy foundation with “plate portioning”. This means ensuring lunch and dinner always consist of one-quarter lean protein, one-quarter high-fibre carbohydrates and half vegetables. “This is a good balance of the food that helps us feel energised and fuller for longer.”
Now onto those favourite foods. One of Phillippa’s clients loved fruit but his six-serves-a-day habit was causing spikes in his blood glucose levels. “Fruit is high in fibre and micronutrients that we need which is why its recommended for everyone including people with type 2 diabetes,” says Phillippa.
“However, in large servings the natural sugars in fruit can cause a blood sugar spike.
“So instead of having his fruit independently, we paired it with a meal. This meant the overall meal had the components to slow down how fast the carbohydrates were broken down in the fruit.”
For potato lovers who’ve had a slightly larger-than-recommended portion of carbohydrates, Phillippa recommends going for a brisk 15-minute walk after the meal.
“This really helps with insulin sensitivity, and you’ll find two hours later there's a reduction in blood glucose levels. That's a way people can still include the foods they love that might affect their blood glucose levels but still satisfy their health goals.”
Keep your support crew close
Want backup to make sure you stick to your new health goals? Set up your own diabetes support team.
Some key players include your GP, Diabetes Australia—whose membership provides access to diabetes-specific information from health professionals like Carolien—and an accredited practising dietitian, like Phillippa, accessed via Australian Unity’s HealthierMe or one you personally source who is endorsed by Dietitians Australia. Credentialled diabetes educators (CDEs) can also provide valuable support. This team of professionals can help create a healthy eating plan you’ll actually stick to.
Carolien also suggests working with an exercise physiologist, particularly if you have aches, pains or other medical conditions. “It can be a really good way to do more physical activity in a safe way without risking further injury or problems,” she says.
And finally, remember you don’t have to overhaul your life all at once. As Phillippa says, “Just focus on one thing. One small step will add up over time.”
Disclaimer: Information provided in this article is not medical advice and you should consult with your healthcare practitioner. Australian Unity accepts no responsibility for the accuracy of any of the opinions, advice, representations or information contained in this publication. Readers should rely on their own advice and enquiries in making decisions affecting their own health, wellbeing or interest. Interviewee names and titles were accurate at the time of writing.