The number of people suffering from diabetes grows year by year, a disease that damages many vital organs - the heart, eyes, kidneys and nerves. And yet, as it turns out, so little is needed to avoid this devastating disease. We are talking about it with prof. Ewa Pańkowska, diabetologist, director of the Institute of Diabetology in Międzylesie near Warsaw.
The statistics are alarming - in Poland, 2,730,000 people suffer from diabetes, and over 21,000 die every year due to its complications.
Diabetes mellitus is the first non-communicable disease recognized by the United Nations as an epidemic of the 21st century.
Children and adults get sick. We talk to prof. dr hab. Ewa Pańkowska, diabetologist, director of the Institute of Diabetology in Międzylesie near Warsaw.
- Why do we have diabetes?
Prof. Ewa Pańkowska: Diabetes mellitus type 1 is classified as an autoimmune disease, i.e. diseases in which the immune system attacks its own cells. We know the genes that favor it, but that doesn't mean it's a classic hereditary disease. It is a multi-factorial disease - we have a genetic predisposition, but it is different in type 1 diabetes and different in type 2 diabetes. In the case of type 1 diabetes, detected in children, 90% of the time no one in the family had diabetes. The point is that the presence of the gene alone is not enough. For a disease to develop, several negative factors must overlap. In contrast, type 2 diabetes has more to do with our lifestyle. Risk factors include "junk" food, chronic stress, viruses, vitamin deficiencies, polluted environment.
- Can we prevent type 1 diabetes, which often manifests itself in childhood?
E.P .: Since we still do not know its causes, it is difficult to talk about preventive measures. However, we know the factors that contribute to this disease. One of them is vitamin D deficiency. Another, often neglected, are viral infections, especially enteroviral infections, which are responsible for colds. Blood tests of children with newly diagnosed diabetes showed that they had IgM antibodies, the presence of which indicates a recent viral infection. What does it matter? Well, to the groupenteroviruses include Coxsackie virus. Its cell membrane contains the same proteins that are present on the membrane of beta cells in the pancreas. It is suspected that the immune system fights off the virus first and then fights anything that resembles it, including the beta cells of the pancreas. But I emphasize - the above-mentioned factors only contribute to the disease, but are not the main cause of diabetes.
- What else increases the risk of disease?
E.P .: Many clinical observations show that children born by caesarean section are more likely to suffer from type 1 diabetes than children born via vaginal routes. It is presumed that it is related to the different bacterial flora of the gastrointestinal tract in children delivered by caesarean section. As the baby passes through the birth canal, it comes into contact with the mother's bacteria and gains some immunity. In many situations, caesarean section saves the life of the child and mother, but I am concerned about demand caesarean sections. They not only promote type 1 diabetes (the risk is even doubled), but also problems with the respiratory tract. The method of feeding also matters. Breastfeeding a baby for six months significantly reduces the risk of developing diabetes, and if it lasts less than 3 months, the disease appears much more often.
ImportantIt is estimated that in 2035 the number of people with diabetes will reach 592 million. If all diabetics were treated as citizens of one country, they would form the third largest country after China and India. Currently, 2,730,000 people suffer from diabetes in Poland. Experts say that about a million patients are not aware of their disease.
- Does later life nutrition also matter?
E.P .: Yes - huge - for the development of type 2 diabetes, which mainly affects adults. However, we do not know how or if diet influences the development and course of type 1 diabetes, which is diagnosed in children. But it has been noticed that these children are bigger, more plump, and their pace of development is in the upper limits of the percentile grids. Scientists linked these facts and the hypothesis of acceleration, or accelerated development, was created. Children with type 1 diabetes are not obese, but are usually overfed, which is technically termed an oversupply of food. Breaks in eating are necessary for the proper functioning of the entire body, and above all for the good condition of the pancreas. When a young body gets too much food, beta cells in the pancreas are forced to work constantly, throwing out too much inspin. They are "overworked" and weaken over time, making them easy targets for viruses or their own systemimmune system. However, it should be emphasized that supplementation alone does not lead directly to type 1 diabetes, but may contribute to it.
- In type 2 diabetes, diet is crucial.
E.P .: Yes, this type of diabetes often occurs as a result of dietary errors - eating too much, eating in a hurry, too much simple carbohydrates in the diet (sugar, sweets, white flour products). In order to protect yourself against diabetes, it is extremely important to eat regularly and calmly, and to eat not too large portions, but more often. You should also pay attention to the glycemic index (GI) of the food you eat. There are carbohydrate products with high GI that raise blood glucose very quickly - they are digested and absorbed faster by the body. These include flour preparations, cookies, potatoes, some fruits. Their frequent consumption leads to the excessive secretion of inspin, which results in hunger, obesity, and eventually diabetes may develop. In order to avoid the development of the disease, you should limit them in your diet, but include low GI foods with each meal, i.e. green leafy vegetables, chicory, green beans, zucchini, leek, olives, tomatoes, cherries, pumpernickel bread, wholemeal bread and spelled, wild rice, nuts. In their case, digestion and absorption of nutrients is slower, so glucose levels rise gradually. Consuming products with low GI makes us feel saturated for longer, so we eat less, we do not snack. It helps you lose weight, regulate the pancreas and effectively prevent type 2 diabetes.
- Diabetes is also favored by stress. What mechanism works here?
E.P .: Stress is a normal reaction of the body to all changes - challenges and problems of everyday life. Then the "supply" of glucose to the blood increases, because the body requires energy to deal with a difficult situation (hence the appetite for sweets). The stress hormones adrenaline and cortisol trigger the release of glucose stored in the liver. And more glucose means more inspin. The more often this happens, the greater the risk of excessive levels of inspin in the blood. This leads to disturbances in carbohydrate metabolism and, in the next phase, to diabetes. It also promotes the deposition of fatty tissue, especially around the abdomen. It is well known that stressful situations cannot be avoided, but you can learn to reduce stress levels. You have to accept the fact that some things are simply beyond our control. We should rather focus on things that depend on us, i.e. on a proper diet and exercise that does notonly improves metabolism, but also releases relaxing endorphins. And this will protect us from diabetes.
According to an expertprof. dr hab. Ewa Pańkowska, diabetologist, director of the Diabetology Institute in Międzylesie near Warsaw"Zdrowie" monthly