World Diabetes Day: Nutrition and novel monitoring technologies key for prevention and management

14 Nov 2019 --- Non-communicable diseases such as diabetes and heart disease are seeing high occurrence, with hectic lifestyles and unhealthy nutritional habits contributing to the rise. An estimated 30.3 million people have diabetes globally, according to data from the US National Institutes of Health (NIH), while roughly 7.2 million adults are undiagnosed. In light of World Diabetes Day 2019, happening today, NutritionInsight speaks with experts on ways to tackle the issue. Prevention may be the key, with industry trends such as sugar reduction and personalized nutrition at the center.

Aside from a genetic predisposition, obesity and a high consumption of sugary foods and drinks are contributing to the prevalence of both Type 1 and Type 2 diabetes. Research has previously flagged that unless industry and consumers alike change the way they operate, diabetes will continue to pose a threat to health. This has led to the major industry trend of sugar reduction with an array of alternative sweeteners coming to the fore to provide a solution.

“Blood sugar levels must be kept within a narrow range to maintain healthy bodily functions. Insulin and glucagon are the main hormones allowing this regulation, and a balanced lifestyle is key for maintaining healthy blood sugar levels. Age and other factors can cause the body to reduce its ability to use insulin properly, leading to an increase of blood glucose levels. The challenge is to act before a potential onset of diabetes, as prolonged imbalanced glucose levels can dramatically reduce one’s quality of life,” notes Johannes Haerle, Senior Technical Manager at Evolva.

The cost is not only on health, however. According to the American Diabetes Association (ADA)’s Economic Costs of Diabetes in the US report, the total estimated cost of diagnosed diabetes in 2017 was US$327 billion, including US$237 billion in direct medical costs and US$90 billion in reduced productivity. 

“Nutrition plays a very big role in the management of diabetes. This year the American Diabetes Association published a consensus report titled Nutrition Therapy for Adults with Diabetes or Prediabetes. The report touches on important topics like individualized diets, medical nutrition therapy as a way to tackle the disease,” says Jo Mandelson, a Registered Dietitian Nutritionist and Nutrition Associate at the American Diabetes Association.

Resveratrol, a type of natural phenol produced by several plants, may provide another way to control blood sugar levels. Although nutrition is key, there is not a one-size-fits-all approach, according to Refaat Hegazi, Global Medical Director at Abbott. “It’s important for people with diabetes to find an eating pattern that emphasizes a variety of nutrient-dense foods in appropriate portion sizes to improve health while finding ways to maintain the pleasure of eating.”

Hegazi also says that employing the help of a registered dietitian can provide creative ways to add variety and healthy twists on favorite foods to make them more beneficial without depriving consumers of palatability. 

Sweeteners and resveratrol to control glucose levels
The use of sweeteners is barreling towards the mainstream. Major industry players are gravitating toward sweetener reformulations and inspiring innovation to respond to the growing need for sugar reduction. An Innova Consumer Lifestyle and Attitudes Survey (2018), found that nearly seven out of ten consumers across the countries surveyed (US, UK, France, Germany, China and Brazil) have reduced their sugar intake. This is particularly so among the over 55 age group, with consumers in France and Brazil the most likely to be reducing sugar in their diet. Consumers are also cutting back on sweet snacks more than savory.

“Sweeteners are a popular option among many people with diabetes. These include saccharin, neotame, acesulfame K, aspartame, sucralose, advantame, stevia, and luo han guo (or monk fruit). Replacing added sugars with sugar substitutes has the potential to decrease the daily intake of carbohydrates and calories. This could play a role in improved blood sugar control, weight and cardiometabolic control,” says Mandelson.

“However, there is research that states that there isn’t enough evidence to determine whether sugar substitution leads to a long-term reduction in blood sugar. Our take is that it’s a personal choice but when given the option, go with water more often than not because using sugar substitutes does not make an unhealthy choice healthy; rather, it makes such a choice less unhealthy,” she adds.

Resveratrol, a type of natural phenol produced by several plants, may provide another way to control blood sugar levels. Haerle says that resveratrol can be instrumental in supporting healthy blood glucose levels by increasing insulin sensitivity. This improves the clearance of blood glucose after a meal, as well as supporting healthy fasting blood glucose levels in general. 

“Resveratrol has been characterized as one of the most potent vasoactive ingredients and may support healthy blood glucose levels from another angle. Due to its vasoactive properties, resveratrol can improve blood circulation and thereby may supply sugar molecules, like glucose, more steadily to all bodily tissues, including the brain,” he adds.

Resveratrol can also support balancing healthy blood glucose levels by reducing blood sugar levels and increasing insulin sensitivity; however, only on a short-term basis. Much like other natural ingredients, resveratrol has a relatively short plasma half-life of around nine hours, meaning repetitious supplementation is the basis for continuous, long-term health benefits.

Technology takes over
Targeted nutritional approaches to prevention and maintenance are also a potential solution, with many companies releasing novel glucose monitoring devices and offering tailored nutritional advice.

In the future, device-derived data and the clinical insights produced from them will be the value driver in the world of medical technology.“There is a multitude of apps that help track food intake and exercise. Tracking is challenging for some, but even just a little bit of tracking helps individuals create awareness around the food they are eating or drinking. It can help someone learn more about the types of foods they are consuming, which may encourage a healthy shift in choices,” says Mandelson. 

According to Hegazi, new technology, like Abbott’s FreeStyle Libre 14 day system, have changed how people with diabetes test their glucose levels. The technology completely removes fingersticks, the one step that people with diabetes claim is the biggest reason they don’t test their glucose levels as often as they should. 

Just by scanning a reader or phone over a small sensor worn on the back of the upper arm, people with diabetes get a visual snapshot of real-time glucose levels, historical trends and patterns, and shows where levels are heading. With fingersticks, a person only gets one point in time.

“In the future, device-derived data and the clinical insights produced from them will be the value driver in the world of medical technology. Advanced algorithms and machine learning systems will analyze data in near real‐time. This will proactively surface clinically relevant trends and patterns, and will make personalized treatment recommendations,” Hegazi says.

Following the theme of the day, the International Sweeteners Association (ISA) has presented a new campaign in support of the Diabetes Awareness Month and World Diabetes Day. Entitled “Life with diabetes can be tasty: Gisèle’s story”, the video was developed as part of an ISA two-year campaign and seeks to raise awareness about the importance of the family and its role in supporting people with diabetes in their daily management of this chronic disease.

By Kristiana Lalou