University of Sydney researchers offer their expert advice on managing and preventing diabetes, leading up to World Diabetes Day 2017.
‘Women and diabetes – our right to a healthy future’ is the theme of this year’s World Diabetes Day on Tuesday 14 November.
With one in 10 women now living with diabetes and one in seven births affected by gestational diabetes, the campaign seeks to protect the health of mothers and children by improving access to screening, care and education.
We asked five of our women researchers working in the field to offer their view on how to manage and even prevent the condition.
A professor of human nutrition at the School of Life and Environmental Sciences and Charles Perkins Centre, Jennie Brand-Miller is also director of the Sydney University Glycemic Index Research Service and the Glycemic Index Foundation.
The Principal Investigator of the Australian arm of the PREVIEW study, the world's largest lifestyle intervention to prevent diabetes in individuals at high risk, Professor Brand-Miller says limiting adult weight gain is key.
“Study after study is showing that you can prevent or delay a diagnosis of type 2 diabetes. The single most effective decision is to make sure we don’t gain too much weight as adults (10 percent at the most). This means eating a high-quality diet with smart food choices and saving party foods for the party.”
“While many women with type 1 diabetes are now planning their pregnancies from a diabetes perspective, women with type 2 diabetes tend to fly under the radar,” says Adjunct Associate Professor Glynis Ross from the University of Sydney Central Clinical School.
“In addition, one in 7 pregnancies are now complicated by gestational diabetes that first develops during pregnancy but signals risk for later type 2 diabetes in the mothers,” she says.
“All pregnancies complicated by diabetes need to be managed well to avoid problems late in pregnancy and at delivery, as well as to reduce the children’s risk of future health problems including diabetes and obesity.
“Health providers need to be proactive about raising these matters with their patients.”
Precision medicine holds great promise for the future treatment and prevention of type 2 diabetes, according to Associate Professor Samantha Hocking from the Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders at the Charles Perkins Centre.
“Current treatment algorithms for diabetes utilise a ‘one size fits most’ approach and as a result, the treatment plan selected may not be the best management strategy for each individual,” she says.
“An alternative strategy is precision medicine, in which information about a person’s genes, environment and other characteristics are used to develop an individualised treatment plan to obtain the best outcome.
Ultimately, we hope to prevent metabolic diseases such as diabetes, by understanding the best lifestyle choices for an individual to maintain optimal health across the lifespan.
Dr Melkam A Kebede from the Charles Perkins Centre and School of Life and Environmental Sciences is researching the role of particular cells in the pancreas in the development of type 2 diabetes.
“Interestingly, despite the strong association between obesity and type 2 diabetes, the majority of individuals who are obese and have pre-diabetes do not develop diabetes,” she says.
“In fact, approximately 80 percent of people who are obese do not develop type 2 diabetes because cells in their pancreas are able to compensate for the insulin resistance.
“More research is needed to better understand how these cells behave under normal conditions and the reason they fail in people with type 2 diabetes, in order to develop more effective and targeted treatments for patients.”
Endocrinologist Professor Alicia Jenkins from Sydney Medical School believes a collaborative approach is required to effectively combat diabetes.
“Michelle Obama said ‘Communities and countries and ultimately the world are only as strong as the health of their women,” she says.
“This is so true for diabetes: half of all the people with diabetes are women, they are the mothers, grandmothers, wives, sisters, aunts, cousins, friends and neighbours of people with diabetes, they are the clinicians caring for women, men and children with diabetes, they are the researchers searching for better treatments and cures for diabetes, they are the advocates for better and equitable diabetes care.
“Let women and men work together towards the common goal of better outcomes for all people with or at risk of diabetes.”