Holidays in the midst of sweets, pandemic and Diabetes

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Psychological stress from the pandemic often leads to constant nervous nibbling. However, with the help of the Christmas holidays, when all family or friendly gatherings are always completed with meals and plenty of calories, a disastrous combination is created. The risk of appearing overweight after the end of the holidays is a serious and not at all pleasant possibility.

Weight gain or sweets the biggest risk for type 2 diabetes mellitus (SD2);

“The incidence of diabetes increases linearly with weight gain. This is now proven by many studies. Mainly obesity or overweight due to increased calorie intake rather than diet (even “high-calorie, high-calorie food”) is considered by most studies to be the most important aggravating factor for the onset of Diabetes “.

A recent 2018 study from Canada, however, aimed to assess the impact of different food groups and macronutrients on insulin sensitivity and secretion in a prospective manner over 2 years. Increased sensitivity of our body to insulin implies a reduced risk of Diabetes.
This was the first prospective study with a long duration (2 years) that investigated the impact of nutrition quality on prevention and better regulation of SD in young people.

The results of this study confirmed that increased intake of good quality fruits, vegetables, fiber and animal foods, ie low in fat, is associated with improved insulin sensitivity, thus lowering blood sugar levels in children with a family history of obesity. This study also showed that, on the contrary, increased amounts of saturated fatty acids (animal fats) are associated with increased insulin resistance (decreased sensitivity) and of course increased risk for SD2.

Overall, this study highlights the importance of balanced, high-fiber meals as well as the importance of quantity control in preventing those at risk for prediabetes and better blood sugar control for those who already have type 2 diabetes. .
Of course, many sweets and foods that contain easily absorbed carbohydrates (high glycemic index, eg syrups, white rice, etc.), if consumed in quantities by people with SCD, are sure to raise prices and deregulate their diabetes. Less calories, better nutrition quality is the message.

Slight weight loss causes a dramatic reduction in the risk of type 2 diabetes

Losing an average of just 13% of your body weight reduces your relative risk of developing type 2 diabetes by about 40% in obese people, among many other health benefits, according to a large “real world” study in half a million adults.
Other findings related to the same study are that moderate weight loss offered a 22% -27% reduction in the risk of apnea, 18% -25% hypertension and 20% -22% dyslipidemia.

The study involved more than 550,000 adults in primary care in the UK. In the real-world data analysis, people who had lost 10% -25% of their body weight were monitored for 8 years to see how this affected the consequent risk of obesity-related conditions. The results were presented during the European and International Conference on Obesity (ECOICO 9/2020).
“Weight loss was real-world without artificial intervention and gained a real reduction in the risk of many obesity-related conditions.”

SARS 2 (COVID-19) and people with SD: Who is most at risk?

People who have had their diabetes for a long time, smokers, the obese, those who have other chronic diseases (eg heart disease, autoimmune diseases, etc.) and older people (70 years and older) are at greater risk of becoming seriously ill.

Obesity is one of the most important risk factors for complications and mortality in SARS 2 infection (COVID-19), but also in infections from other causes. The correlation is proportional, that is, the higher the weight, the greater the risk of complications.

The incidence of childhood obesity in North America has increased significantly in recent years. Unfortunately, the same happens in our country.

42% of boys and 38% of girls in Greece are overweight, while obese are 20% of boys and 14% of girls, according to the latest data from the Childhood Obesity Surveillance Initiative (COSI) of the World Health Organization (WHO) WHERE).
These data, for the period 2015-2017, were presented at the conference of the European Society for the Study of Obesity, which took place in Vienna between 23-26 May 2018.

Childhood obesity has been linked to an increased incidence of prediabetes and / or type 2 diabetes. Obesity at all ages has been linked to both poor regulation and an increase in dramatic complications in diabetes. in type 2, but also in type 1.
The COVID-19 epidemic will subside, obesity and diabetes will exist over time

Obesity, Diabetes and Their Relationship to COVID-19

In a large international study recently published in the journal Lancet, for patients admitted to the intensive care unit (ICU) with COVID-19, the main finding was a proportional linear correlation between body mass index (BMI-BMI) and the need for invasive mechanical ventilation. It was found that the likelihood of developing severe respiratory distress (ie intubation – mechanical ventilation) gradually increased with increasing body mass index (BMI), regardless of diabetes, hypertension, dyslipidemia or smoking.

The risk was higher for the elderly and men, but the next most important risk factor for developing severe pneumonia if infected was obesity.
Study data also show that better blood glucose control is associated with better outcomes in COVID-19, especially with respect to lower risk of hospitalization, intubation and death.

In short, obesity is a bad predisposing factor, while good regulation of sugar overall before infection, but also during the disease is a key factor for a happy end result.

Golden rules for everyday life but also holidays, holidays, Diabetes and COVID-19 and other infections

It is especially good for health to adopt a diet, especially during the holidays, with an emphasis in addition to sweets, vegetables, abundant fiber intake as well as low-fat and good carbohydrate foods (fruits, whole grains, etc.). ).
This is a sensible and smart behavior for the days when the most common fun is gastronomy.
Trying not to “put on” pounds during the holidays requires will and restraint. Family support and involvement in dieting, encouraging and supporting a daily exercise program especially for older people, is very important to achieve discipline and proper behavior in ourselves.

Physical exercise, even if it is a simple daily walk, a bike or a treadmill, it will also help our psychology and improve our immune level much more than the naive and often dangerous overconsumption of vitamin C.
These behaviors will help people with Diabetes stay low in sugar and have better regulation that has been proven to protect against any infection. We can enjoy the holidays and vacations while taking care of our physical health.

Writes:

Antonios P. Lepouras, Pathologist – Diabetologist,

Director of the Pathology-Diabetology Clinic and the Metropolitan General Diabetes Center

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