The Canadian Diabetes Association revised their clinical practice guidelines back in 2003 for the prevention and management of diabetes lowering the consideration of screening for Type II diabetes to age 40 and over.
The Guidelines were published as a supplement in the December 2003 issue of Canadian Journal of Diabetes.
But world renown endocrinologist Dr. Christopher Kovacs, in St. John’s, Newfoundland and Labrador clarifies, “the at-risk age for Type II diabetes begins much younger, especially for anyone overweight or obese, and anyone with a first-degree relative with Type II diabetes.”
Dr. Kovacs is also an associate professor, and researcher with the faculty of medicine of Memorial University at the Health Science Centre, in St. John’s, Newfoundland and Labrador.
The guidelines also recommend lower targets for blood glucose (sugar), blood pressure, cholesterol and lipid (blood fat) levels for all people with diabetes.
Cholesterol and Blood Fat Increase Risk for Type II Diabetes
Some people may wonder what cholesterol and blood fat have to do with diabetes. Expert Dr. Kovacs explains the development of Type II diabetes:
“First of all, think of overweight and obesity, or more specifically fat in the abdomen, as causing ‘insulin resistance.’ The islet cells of the pancreas need to produce more insulin to do the job as compared to a person that is lean and does not have insulin resistance.”
With time, fat in the abdomen causes the islets to burn out and the pancreas can no longer make high levels of insulin. Thus, the blood sugar rises and the person has diabetes.
In the progressive burnout toward diabetes, the blood sugars after meals rise first. The fasting blood sugar is the last to rise. By the time the fasting blood sugar is elevated, many people have had diabetes on the basis of high blood sugars after meals, for years.
Genetics also Plays a Role with Type II Diabetes
The burnout is faster in some people than others. This is where family history and genetic plays a role. But, in a very real sense, diabetes is almost inevitable for anyone overweight or obese.
The complications of diabetes such as heart disease and retinopathy, are caused in larger part due to the rises in blood sugar and fats and proteins in the blood after meals. So, by the time the fasting blood sugar is elevated at least 50 percent of people already have complications of diabetes in the form of heart disease, retinopathy, neuropathy, nephropathy.
It is Not all Black & White When It Comes to Type II Diabetes
Unfortunately, there is not a black/white division between normal blood sugar level and diabetes. Instead, there is a continuum from normal through pre-diabetic to diabetic, with a lot of blurring of the boundaries, and a lot of damage being done before the person is first informed, or believes that there might be a problem.
And then there is the issue the newly diagnosed diabetic perceives that he/she just developed something, when in fact he/she has actually had the condition a long time and likely has complications of it already.
- A true normal fasting blood sugar is below 5.5 mmol/l.
- A true normal blood sugar two hours after eating is between 6 to 8 mmol/l.
- (mmol/l is the SI unit measurement used in Canada)
- A fasting blood sugar between 5.7 to 6.9 mmol/l means that the person is very likely in the pre-diabetic phase when complications are already developing.