Diabetes It is one of the groups of chronic non-communicable diseases or NCDs (Non-Communicable Diseases) that are related to the body's abnormal metabolic system. Causes an increase in blood sugar. This can lead to complications such as coronary heart disease. macular degeneration chronic kidney disease and nerve endings deteriorate There are 4 types of diabetes, but 90% of all people with diabetes Suffering from type 2 diabetes (Type 2 Diabetes)

type two diabetes Diabetes is caused by insulin resistance. The body is unable to respond effectively to the hormone insulin. This causes less sugar to be brought into various cells, leading to hyperglycemia. Type II diabetes is caused by a combination of factors, including:

1. Obesity

It is a condition in which the body has accumulated more fat than the specified limit. Men have more than 28% fat and women more than 32%. The accumulation of fat increases inflammation within the body. Resulting in insulin resistance. If the Body Mass Index (BMI) increases by 2 kg/m2 The risk of diabetes increases by 23% in men and as much as 27% in women.

2. Poor sleep

Research has found that people who sleep less than 4 hours per day Blood sugar clearance was 40% slower and the insulin response to sugar was 30% lower than those who got enough sleep. Therefore, people with poor sleep quality Including the lack of hours of sleep, there is an increased risk of diabetes.

3.Smoking

People who smoke are 30-40% more likely to develop diabetes than non-smokers. Increased levels of nicotine in the body. Makes the muscles use less sugar. And the more you smoke, the more The risk of developing diabetes only increases. However, even after quitting smoking, But the risk of type 2 diabetes will remain for another 10 years.

4. Lack of exercise

As a result, sensitivity to the hormone insulin (Insulin Sensitivity) decreases and tolerance to glucose decreases (Impaired Glucose Tolerance), including a tendency to increase body weight. from not moving much of the body

5. Depression

It is related to neurotransmitters and inflammation that cause insulin resistance. Including increased secretion of the stress hormone (Cortisol), resulting in increased blood sugar levels.

6. High blood fat disease

An increase in LDL and a decrease in HDL lead to impaired beta cell function. Decreases insulin secretion

7. High blood pressure

Increases the activity of the sympathetic nervous system (Sympathetic Nervous System), resulting in a decrease in the body's absorption of sugar. This is the reason why insulin resistance gradually increases until it develops into diabetes.

8. Aging

The body of the elderly has decreased muscle mass. and increased fat accumulation Causes chronic inflammation (Chronic Inflammation) that leads to insulin resistance.

9. Ethnicity

Compared to whites, Asians and blacks are at increased risk of diabetes. Although there is no clear explanation But it may be related to genetic, physical, and environmental factors. Average Body Mass Index and Fat Accumulation Including insulin sensitivity (Insulin Sensitivity) that is less than white people.

10. Family history of diabetes

Reflects genetic and environmental factors. People with a family history of diabetes The risk increases approximately 2 times, but if it is a direct relative The risk increases up to 11 times more in people with a BMI greater than or equal to 35 kg/m² and a family history of diabetes. The risk is increased 26 times in people with the same BMI. But there is no family history of diabetes. There will be only a 6-fold increased risk.

Even though we cannot change our genetics, But we can change environmental factors. To prevent diabetes A study by the Diabetes Prevention Program (DPP) research group was published in The New England Journal of Medicine in 2002 looking at the effects of lifestyle changes. This reduces the incidence of diabetes by up to 58% compared to using the diabetes drug Metformin. That reduces the risk by only 31%.

It can be seen that behavioral modification is an important part in reducing the incidence of diabetes. There are various approaches that should be done together as follows:

• Take care of your body weight to be within the appropriate range.

Obesity and overweight It is the most important risk factor for type 2 diabetes. The goal is to lose 7% of your weight within 6 months, averaging approximately 0.5-1 kg per week by reducing body fat mass and maintaining muscle mass. The goal is that women should have no more than 32% body fat and no more than 28% for men.

• Eat a healthy and sustainable diet.

The important thing is to choose a diet that suits you. Can be practically practiced continuously for a long period of time Whether it is a low-fat or low-carbohydrate diet. Including choosing to eat food that comes primarily from plants (Plant-Based diet), choosing foods that are good for health. Not refined (Refined Food) and processed (Processed Food), emphasizing quality carbohydrates. It is a source of vitamins, minerals, dietary fiber such as whole grains, various types of nuts, vegetables, fruits, and low-fat meat.

• Do 150 minutes of moderate-intensity exercise per week.

Or at least 30 minutes per session, 5 times a week, such as brisk walking or aerobic dancing. Exercise increases the burning of fat in the body and stimulates muscle cells to respond better to insulin. You should do cardio exercises (Cardio Exercise) alternating with muscle training (Strength Training) and stretching (Flexibility Exercise).

• Get enough sleep.

At least 8-9 hours a day. You should adjust going to bed and waking up at a consistent time every day. And go to bed before 10:00 p.m. Importantly, avoid using various electronic devices such as cell phones and tablets at least 2 hours before bed. Because blue light inhibits the secretion of the hormone melatonin (Melatonin), making it more difficult to fall asleep.

• deal with stress

Try doing various activities to keep your mind calm and not distracted, such as meditating, walking, doing hobbies, and learning new things. Practice adjusting your attitude to see the world in a positive light.

• Avoid behaviors and things that destroy your health.

For example, refrain from smoking. Limit alcohol consumption

Changing lifestyle according toPrinciples of Lifestyle MedicineIt is an effective method for sustainable prevention of diabetes. Without having to pay expensive fees. You can start doing it yourself from today. For sustainable health

Reference source

• Ismail L, Materwala H, Al Kaabi J. Association of risk factors with type 2 diabetes: A systematic review. Computational and Structural Biotechnology Journal. 2021;19:1759–85. 
• Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. The lancet. 1999;354(9188):1435-9.
• American Diabetes Association. Standards of medical care in diabetes—2022 abridged for Primary Care Providers. Clinical Diabetes. 2022;40(1):10–38.