Type 2 diabetes

The Physiology

Type 2 Diabetes is metabolic disease. It is a metabolic disease because the process of breaking down food and drink into energy for your body to use, is incapacitated.  It's not working because the insulin (the guy who piggybacks glucose to cells) isn't allowed to open the cell door (receptor) to let glucose in or, the pancreas (the organ which releases insulin) is fatigued and overworked and has ceased producing enough insulin to carry the glucose.  Type 2 diabetes is diagnosed at the point where blood glucose levels are high, termed hyperglycemia.  

What happens first generally is insulin resistance where the pancreas is still producing insulin to counteract high blood glucose but the insulin isn't able to unlock the muscle cells or liver cells to lower blood sugar.  So, the pancreas produces more insulin which at a high threshold, opens the cell walls and this process works, for a while.  Eventually though, the pancreas cannot keep up with the high production of insulin and blood sugar levels elevate and sickness unveils.  

It is believed that free fatty acids (the rogue fats) cause disruptions to the enzymes within the cells and this is why insulin cannot help let glucose into the cells.  So fats are part of the problem.  But not just any fats.  Triglycerides, trans fats and saturated fats are the worst and they are in all the really unhealthy foods (bakery treats, fried foods, cookies etc).  Fats with omega 3's (like fish) are good, they actually help to control blood sugar.  Also carbohydrates which are easily converted to glucose are part of the problem.  Foods such as breads, pastas and potatoes should not be eaten regualary.  Vegetables are carbohydrates too, however they contain a lot less energy (glucose) than complex carbohydrates (pasta, bread etc) and so don't shoot blood glucose levels too high.  

We know type 2 diabetes is a massive problem in the first world.  Millions of people are diagnosed with this disease and are medicated to maintain normal blood sugar levels, however if lifestyle changes aren't made, the medication isn't enough to prohibit health complications.  Ultimately it's another scenario where treating the symptoms rather than the cause doesn't stop the problem.  It is now understood that although information is powerful in assisting in decision making, it does not facilitate behavior change.

  Type 2 diabetes is a reversible disease which can be removed with positive lifestyle changes of improving diet and exercising.  

Motivating a healthier lifestyle

It is believed that lifestyle change can be helped by:

  • focusing on the benefits of making the change
  •  instilling belief that you have the capability to succeed
  • enlisting social support to see you through the tough times

But before we even get to this point we have to motivate change. 

Motivation and intention to change behavior are strongly related with an individuals beliefs regarding the ease or difficulty of changing this behavior.  This is in relation to an individuals belief in their personal skills, resources and opportunities to make a change.  This ties back to beliefs as the beliefs we hold about our capabilities affects whether we make good or poor use of the skills we have (Bandura, 1991).

For a goal to be followed through consistently enough to create change it has to be important to the individual and the individual needs to feel confident in achieving the goal.  

We can improve importance if required for health requirements, say for example you have diabetes and you know you really should exercise and eat well but you find you are always making excuses as to why this doesn't happen.  We then can improve the importance of the health choice by educating clients on the health consequences and exploring goals and values.  This one's a biggy.  If there is a difference between current lifestyle behavioral choices and values, this realization can improve importance to change behavior. 

Improving confidence in achieving behavioural change reflecting on previous successes, breaking the goal into smaller more manageable steps, addressing barriers such as time, money etc and looking for a social support network to assist with healthy change.


Yours truly,

Chloe Midalia


"The fire inside you is real.

and so is the danger of putting it out,

with time, habits, losses,

broken people, places & things.

So how do we keep the fire lit?

So far the only thing I've found

that helps is finding something

you love, and tending to it.

No matter what anybody says,

and they will say a lot, especially if

they've quit tending their own fires.

your fire will frighten them.

Make your fire into a ritual,

something that nourishes you to the bones,

then put that same fire into everything you do

and everyone you meet."

 - Jose Chaves