Dr Alan Barclay has more than 20 years of experience as a dietitian, including 16 years at Diabetes Australia.
Dr Alan Barclay has more than 20 years of experience as a dietitian, including 16 years at Diabetes Australia. Contributed

Living with diabetes? It's time to throw this book at it

IF YOU don't have diabetes, it doesn't mean you should ignore the flashing red light.

Diabetes affects 1.7 million Australians and costs the country more than $14 billion a year.

Globally, diabetes has reached pandemic proportions. It's now the number one chronic disease. According to the International Diabetes Federation, almost one in 10 adults or 382 million people have diabetes - type 1, type 2 or gestational - worldwide. This is expected to be nearly 600 million by 2035.

There is no cure and scientists don't yet fully understand its causes. However the latest research into type 2 diabetes reveals it may be reversible. A healthy diet and exercise can help manage blood glucose levels.

Clinical trials show one in eight people with type 2 diabetes can put their condition into remission for 2-10 years by losing weight and following a healthy lifestyle.

It's also been discovered that nearly six out of 10 people with pre-diabetes - those with higher than normal blood glucose levels but below diagnosis level - can prevent type 2 diabetes.

Dietitian and chief scientific officer at the Glycaemic Index Foundation Dr Alan Barclay says simply making healthy lifestyle changes has had dramatic results for some people with type 2 or those at risk.

"There is increasing evidence that you can at the very least delay the development of type 2 diabetes. Even if you do end up developing type 2 diabetes, if you treat it aggressively soon after you are diagnosed, you may be able to put it into remission using a variety of medical and non-medical treatments," he says.

Dr Barclay has written a book, Reversing Diabetes, based on meta-analyses of clinical trials over the past 10 years. His book, featuring 70 recipes designed for those with diabetes, has also received acclaim by the health conscious as a practical cookbook for the whole family.

Each recipe lists the full nutritional information, including glycaemic index (GI) and glycaemic load (GL) estimates and meets the Diabetes Australia nutrition guidelines.

Mireille Merlet-Shaw

Dr Barclay is quick to reinforce it is not a diet but a lifestyle based on personalised nutrition and cultural background.

The former head of research for Diabetes Australia has a vested interest in the disease many know nothing about. His grandfather had type 2 diabetes, his wife has type 1 and their two children both faced increased risk of developing type 1 or 2 diabetes. He says they are his inspiration in the field.

"Diabetes has a variety of complications, the most deadly is heart attack and stroke. The risk of having a heart attack is two to three times higher if you have diabetes - the same as if you have already had a heart attack in the past. But also it can cause blindness, kidney disease and amputation.

"As more and more people get diabetes at a younger age it will not only have a profound effect on the health budget, but also affect people's ability to work. It's really an economic issue as well as a major health issue."

Age, underlying genetics, physical inactivity and poor nutrition are among the many reasons why type 2 diabetes has trebled. "Because our population is aging and unfortunately we are gaining weight, it does mean we are all becoming at risk to diabetes.

"People from certain ethnic backgrounds are more prone to getting diabetes than others, unfortunately Asian people are one of those groups who are more prone. Other groups are Arabic people and people from the Mediterranean, indigenous people and Polynesians."

Dr Barclay's book points to recent clinical trials that found lifestyle intervention could reduce the chance of those with pre-diabetes from developing type 2 by more than 50%.

"You only have to lose about 7.5% of your existing body weight and you can actually prevent pre-diabetes from going into type 2 diabetes.

"In order to lose weight, you roughly need to eat 2000-2500 kilojoules less per day. The average adult consumes about 8700 kilojoules a day, so that's almost cutting your food by a quarter."

Dr Barclay says a low-GI diet may lower the risk of developing diabetes by up to 45%. Previous trials have also shown a low-GI diet can improve glycaemic control and risk factors for heart disease among type 2 diabetics.

He says while there is no convincing evidence one can reverse or delay type 1 diabetes yet, a healthy lifestyle is still the best way to prevent common complications.

He also points out that while it is possible for some type 2 patients to reverse their diagnosis, even to the point they can come off their medication, it is not indefinite. Age and weight gain can trigger its return.

So what steps should you take? "Swap it, don't stop it".

"Change what you eat - go for healthy foods. Watch what you drink and limit soft drink and alcohol consumption. And of course, be physically active each day. It is also a good idea to check in with your GP."

Recipes and images from Reversing Diabetes by Dr Alan Barclay (Murdoch Books) $35 in bookstores and online.



Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas that produce insulin. It is a common chronic childhood condition.

Type 2 diabetes is a progressive condition in which the body becomes resistant to the normal effects of insulin and/or gradually loses the capacity to produce enough insulin in the pancreas. Type 2 has strong genetic and family related risk factors and commonly occurs in adults over the age of 45 years. It accounts for 85% of diabetes and is increasing at the fastest rate.

Gestational diabetes is a form that occurs during pregnancy and usually goes away after the baby is born.

Source: Diabetes Australia

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