What are Diabetes?

Every food eaten induce a rise in glucose, or blood sugar, which the body uses for energy. This results in the release of insulin – which is a normal, healthy response to a meal. Insulin unlocks the body’s cells to let glucose in so it can be used for energy. Insulin helps regulate blood sugar. When its job is done, blood levels of insulin go back down. The optimal functioning of the body requires that glycaemia, which represents the concentration of sugar in our blood, be precisely regulated. Its level must remain within a narrow range to keep the body working optimally. If blood sugar chronically exceeds a threshold of normality -High blood glucose-, there will be a significant increase in the risk to develop severe long-term body damage and dysfunction (particularly targeting organs like the eyes, kidneys, nerves, heart and blood vessels.) Taken together, these abnormalities are common symptoms characterizing diabetes. Criterias used to diagnose diabetes and pre-diabetes are fasting plasma blood glucose concentration (FP BG) and the value at 2-hours post-ingestion (2-Hr OGTT). (And high blood glucose represent a fasting plasma glucose level higher than the level that would minimize risks to health.)

(cf. Digest 8)

Who are people suffering diabetes?

Approximately 415 million people are affected by diabetes worldwide and it is estimated this will increase to 642 million people by 2040. Several Types of diabetes can be observed:

Type 1 diabetes (T1D): A condition where the body does not produce enough insulin. It generally occurs during childhood or adolescence.

Type 2 diabetes (T2D): A chronic condition where the body’s insulin in not working effectively. It occurs when the body doesn’t produce enough insulin, or the body’s cells develop resistance to insulin.This is the most common type of diabetes. It commonly appears after the age of 45 years (but T2D in childhood has the potential to become a serious public health issue leading to adverse health outcomes). Obesity is a major driving force in the worldwide epidemic of T2D.

Gestational diabetes: A temporary condition that occurs in pregnancy and carries long-term risk of T2D. It is generally diagnosed during the second trimester of pregnancy and is a condition associated with insulin resistance and glucose intolerance.

How to manage diabetes

The World Health Organization states that promoting healthy diets and increasing physical activity will help reduce the occurrence of obesity and T2D, and will accrue additional benefits by reducing complications among people with all types of diabetes. Also controlling blood glucose level, through a combination of diet, physical activity, and if necessary medication, is imperative to help improve outcomes associates with diabetes.

With T2D in particular, it is advisable to avoid an excessive postprandial glycaemic response but when evaluating your diet to face diabetes, calories or nutrients aren’t the only factor to consider. Foods are much more complex than a single nutrient, or even the sum of their individual nutrients. Many dietary factors, nutritive and/or bioactive, mediate the relationship between food intake and health. The protein quantity and quality of foods, for example, are contributing factors to their effects on glucose control. Protein content shows effect on lowering glycemic response. It is well documented that protein and amino acid ingestion can increase the ability to secrete insulin, and this effect is particularly important in subjects with T2D. But the ability to modulate insulin secretion and insulin sensitivity varies with the source of protein, and there are many more factors involved in glycemic management than just insulin.

Glycemic index (GI), a key tool for diabetics

The glycemic index (GI) of your food, expresses the speed and intensity of the glycaemic response after eating a particular food. This index goes from 100 to 0.  Glucose is rated at 100, and the closer to 100 a food is rated, the more it increases blood sugar levels. Generally, GI values of foods are classified as low GI (GI≤55), medium GI (55<GI<70) and high GI (GI≥70). High-glycemic foods cause a rapid spike in your blood sugar, while those with a low glycemic index (GI) cause a slower increase. Choosing low GI foods allows people to reduce the GI of the diet.

Enjoying a bowl of yogurt won’t cause a rapid blood sugar response.  GI values of plain and sweetened yogurt are lower than can be expected based on their carbohydrate content. One of suggested explanation is that during the fermentation process, lactic acid is formed, and it may reduce glycemic response by slowing gastric emptying. Another stronger suggestion stipulates that the varying amounts of fat and protein, nutrients, which are known to reduce glycemic response, could also play a role. Swapping yogurt for other foods containing added sugars could therefore reduce the GI of the diet.

However, the glycaemic load (GL) is even more relevant; in addition to the GI, this takes into account the amount of carbohydrate actually consumed.

Many researches on diabetes show an impact of yogurt

More and more studies indicate there may be a beneficial association between yogurt and Type 2 diabetes. Current data suggest that the promotion of yogurt consumption could, in the long term, contribute to a reduction in the prevalence of Type 2 diabetes (T2D). A large-scale and robust evidence strongly suggests that yogurt intake is associated with a reduced risk of type 2 diabetes with a linear relationship: when the frequency of consumption of yogurt grows, the risk of developing T2D decreases. A recent meta-analysis about yogurt consumption and the risk of T2D, based on 12 prospective studies and including 438,140 individuals and 36,125 cases of incident diabetes, unveiled a 14% lower risk of T2D for a yogurt consumption around 80-125 g per day, compared with non-yogurt consumption.  Other studies have been done with women with gestational diabetes. Researchers tested the effect of vitamin D-supplemented yogurt in pregnant GDM (Gestational diabetes mellitus) patients and found an improvement in insulin resistance and lipids profiles. Yogurt, supplemented with vitamin D, could be a simple daily habit to improve insulin metabolism and lipid profiles in pregnant women with GDM.

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