Diabetes is a metabolic disorder, which reduces the ability of the body to control the amount of glucose in the blood. According to Public Health England (PHE), 3.8m people are estimated to have diabetes in the UK, and about 1 million have the condition but have not been diagnosed. People of Black African-Caribbean descent have a greater risk of developing diabetes compared to the Caucasian population. People with diabetes can live long and fulfilling lives if the condition is well managed. Uncontrolled diabetes, however, can lead to devastating and costly complications, such as: retinopathy (blindness), kidney disease, amputations, stroke and heart attack.
There are two common types of diabetes:
Type 1 affects around 10% of the diabetes population in the UK, and develops when the pancreas cannot make any insulin – the hormone that moves glucose from our body to the body cells where it’s used for energy. Insulin usually occurs in younger people (under 40) but can develop at any age.
Type 2 affects approximately 90% of the diabetes population. Obesity is the most significant risk factor for developing type 2 diabetes, accounting for 80-85% of the overall risk of developing the condition(1). People with the following conditions are usually more at risk:
- people over 40 years of age (or 25 years or over, if from a Black Ethnic Minority background)
- people who have a parent, brother or sister with diabetes
- women with a waistline bigger than 80cm (31.5in) and men with a waistline bigger than 94cm (37in)
- women who have polycystic ovary syndrome (PCOS), or have had gestational diabetes
- people known to have pre-diabetes
Diabetes is the fastest growing health threat of our times, and an urgent public health issue. It is estimated that the NHS spends about £10 billion on diabetes every year – about 10% of its budget(2).
As Christians, we should not become a burden to the NHS. The Bible says we are the salt of the earth (Matthew 5:13), we should therefore add value to the nation and not be a drain to the system. Diet is fundamental in the management of diabetes: a healthy balanced diet, coupled with physical activity for type 2, and carbohydrate counting, with physical activity for type 1. A healthy balanced diet is low in fat, high in fibre, and has adequate amounts of carbohydrate foods (slow carbohydrate release options, with low glycaemic index, eg. wholegrains). Careful controlling of carbohydrate portions in the diet will help maintain optimal blood glucose levels. We will focus more on diet in Part 2 of this article.
As a registered dietician (RD) working in the specialist area of diabetes for about 15 years, it greatly saddens my heart when I come across people from Black African-Caribbean descent with this diagnosis, who are not compliant with their medication due to religious beliefs. In Proverbs 14:15-16, the Bible advises about searching for reliable information, and alludes to the naïve or inexperienced being easily misled. Whilst faith is important, it is very risky to simply heed someone telling you not to take your medication!
Although no one actually admits to us plainly in clinic, that they have been told by their pastor/spiritual leader not to take their medication, we do hear comments such as: “I have been told I don’t have diabetes” and “I believe I can fight this” are usual clues. There are also instances where we ask clients if they have been taking their medication as prescribed, and they give a positive response. However, after being tested, there has been no improvement whatsoever in HbA1c (glycated haemoglobin – a blood test which measures long-term diabetes control).
Our follow-on discussions usually progress to the client needing insulin injections for better diabetes control, and the response is usually “Please give me 2-3 months and do the blood test again.” Lo and behold, on their return to our clinic at the stipulated time, we notice a dramatic improvement in glycaemic control, due to their compliance to the medication. I always wonder why this should be happening in this day and age. Yes, God heals! However, when you are sick you should also see your doctor – God uses them too – just like you should see your pastor for spiritual healing and growth. We must be wise, and careful about whom we listen to, on issues relating to our health.
Let’s add value to the nation and play our part by: eating a healthy balanced diet; taking prescribed medication if applicable, and exercising more, so we can live our lives purposefully.
1. Diabetes UK – State of the Nation (England) 2016
2. Public Health England report (2016)
Modupe currently works in the NHS, and is also one of the directors of Food for Purpose (FFP).