Rosamund Burton heading
Creeping killer | Good Reading | May 2007, p. 34
Diabetes is the fastest growing disease in the world, affecting over 246 million people. Rosamund Burton spoke to Jennie Brand-Miller, one of the four authors of The New Glucose Revolution Diabetes and Pre-Diabetes Handbook, about this important contribution to our knowledge, and control, of this killer.

A million people in Australia alone have been diagnosed with diabetes, and, according to Jennie Brand-Miller, probably another million people don't know they have it.

Another shocking statistic is that one in four adult Australians has either diabetes or pre-diabetes. Pre-diabetes was not heard often years ago. If someone's blood glucose levels were high, but not elevated so far as to constitute diabetes, that person was likely to be told they had ‘impaired glucose tolerance’ or ‘a touch of sugar’ and sent home with no further advice. Today, people with pre-diabetes are believed to be at greater risk of cardio-vascular disease, heart attacks and strokes, and 50% will go on to develop full-blown diabetes unless they change their diet and lifestyle.

Diabetes has been around for thousands of years. The ancient Egyptians apparently recommended ‘a diet of fruit, grain and sweet beer’ for it. But diabetes is far more prevalent today, and one of the reasons for this is food processing. Many of the carbohydrates we eat are much more highly processed, and therefore more rapidly digested and absorbed, than those eaten by our ancestors as recently as 50 to 100 years ago.‘The combination of more very palatable energy-dense food and less exercise is just a double-edged sword,’ says Brand-Miller.

Professor Jennie Brand-Miller has been conducting research on the glycemic index for the last 25 years. In the early 1980s, along with fellow nutrition scientists, she started to study carbohydrates and question the effects of starches and sugars. The glycemic index (GI) is a scientifically proven measure of the effect carbohydrates have on blood glucose levels. Brand-Miller and her associates have measured the GI content of hundreds of foods. They have also tested the hypothesis that low GI foods were preferable to high GI foods in several different areas, including sport performance and diabetes. ‘It's even being applied to cognitive performance these days as well,’ she adds. ‘It may sound far-fetched, but our brains are totally dependent on glucose as their source of fuel’.

Twenty years ago, it was thought that the diagnosis of diabetes meant a sugar-free diet for life, but according to The New Glucose Revolution Diabetes and Pre-Diabetes Handbook that is no longer the case. Small amounts of sugary treats such as ice cream or chocolate a couple of times a week are fine. But whether someone has type 1 or type 2 diabetes or is pre-diabetic, the emphasis is on eating healthy foods, such as fish, lean meat, plenty of fruit and vegetables and nutritious low GI carbohydrates, as well as limiting salt, alcohol and foods high in saturated fats, and drinking plenty of water.

Eating regular meals, particularly breakfast, also improves blood glucose levels, so is important for diabetics. Research done in the USA shows that at the same time as obesity levels in American adults doubled, so the proportion of adults skipping breakfast almost doubled. ‘There is actually quite a solid base of evidence,’ says Brand-Miller, ‘that people who skip breakfast are more likely to be overweight’. Being overweight is one of the risk factors associated with diabetes.

Diabetes is an epidemic affecting not only the Western world, but also China, India and Africa. People of Northern European descent are the least prone to diabetes of all ethnic groups, but people of Aboriginal extract are very susceptible. ‘Aboriginal people were hunter gatherers for 50,000 years in Australia at least,’ explains Brand-Miller. ‘They didn't consume large amounts of carbohydrate foods, and certainly not large amounts of high GI carbohydrate foods. They ate lots of lean animal flesh, lots of fruit and vegetables, but not a great deal of starch’. Most Aborigines today, like other Australians, eat large amounts of starch, which is affecting their beta cells (these produce insulin, and insulin transfers glucose from the blood to the rest of the body). ‘The beta cell mass may not be as large [in Aboriginal people] as in other people, and it gives out more quickly than it does in other population groups,’ says Brand-Miller.

The New Glucose Revolution Diabetes and Pre-Diabetes Handbook is a comprehensive, practical guide. It discusses all the aspects of diabetes, including young children with type 1 diabetes, and gestational diabetes in pregnancy. In writing the book the authors did not want to preach and prescribe one definitive course of action. Instead the focus is on individuals developing the right diet and lifestyle for them.

There is a strong emphasis on the importance of exercise, as lack of it is believed to be another factor in the increase of diabetes. The book also includes recipes, a comprehensive chart of foods high in carbohydrate content, and in-depth guidelines on managing diabetes, or in the case of people with pre-diabetes, preventing it.

The New Glucose Revolution Diabetes and Pre-Diabetes Handbook by Professor Jennie Brand-Miller, Kaye Foster-Powell, Professor Stephen Colagiuri and Alan Barclay is published by Hachette Australia, rrp $35.00