The IDF has identified the two most common medications for type 2 diabetes as: a) metformin and b) Sulfonylureas (Piamonte, 2015). The former is the medication intended to help reduce insulin and to enable body cells to utilize insulin properly and is usually the initial medication for type 2 diabetes. The latter on the other hand, is a stimulant for insulin production of the pancreas and includes glimepiride, gliclazide, glibenclamide, tolbutamide and glipizide (Piamonte, 2019).
In terms of dietary recommendation, the quality and quantity of food matters like the reduction of animal protein and fat in the diet but more on green, leafy vegetables, fruits with low glycemic value ( Asif, 2014).
It also eliminates the consumption of refined sugars like those in cakes and pastries, soft drinks, candies which can easily be absorbed in the blood and cause a spike in blood glucose and instead encourages the controlled consumption of complex carbohydrates like whole grains, seeds, beans and legumes (Asif, 2014). A reduction of salt is also observed and a cut-down on alcohol and smoking.
Physical exercises are highly recommended to reduce stress, lose weight and to lower down triglycerides in the blood (Asif, 2014) as well as blood glucose.
More recently, intermittent fasting is introduced as a faster and more effective intervention for type 2 diabetes which have resulted in the removal of insulin injections, oral medications, weight loss and a reversal of the insulin resistance (Furmli et al, 2017). Intermittent fasting also referred to as therapeutic fasting strictly abstains from caloric intake whether food or drinks for specific hours and days.
The concept of therapeutic fasting was inspired by the principles set in bariatric surgery which is also another intervention to address obesity and diabetes (Furmli et al, 2017). Bariatric surgery refers to the process of putting a band on the upper portion of the stomach to limit food intake (Teijiran et al, 2008). This is the restrictive procedure. The other form of bariatric surgery is known as malabsorptive which refers to the reducing the contact between food and the intestine area (Teijiran et al, 2008). However, since the procedure is quite costly and expensive, and not exactly without risks, bariatric surgery did not become a popular and preferred option (Furmli et al, 2017).
The International Diabetes Federation recently launched an online project for type 2 diabetes prevention through their website. In the said program, voluntary participants are asked to fill up a short online assessment form which will establish the probability of developing type 2 diabetes in the next ten years. The questionnaires were patterned after the Finnish Diabetes Risk Score (FINDRISC) and the results include recommendations on how to prevent developing it.
The most basic of the prevention measure is of course, regular blood sugar testing apart from physical exercises and a healthy diet.
III. Stress : Definition and its Effect on Health
3.1 Stress Defined:
Stress is defined as the body’s reaction to trying situations and changes in the environment and life in general, which creates pressure or strain on the body, and even trauma (Kandola, 2018). This reaction triggers the secretion of hormones which brings the body to an alert. Response or reaction to stress may be short-term (acute) or long-term (chronic) (McEwen and Sapolsky, 2006). A prolonged state of alertness and strain can bring serious damage to the body and result to different illnesses (Kandola, 2018). Prolonged stress also affects the state of the mind and causes mental disorders (Thoits, 2010).
The effects of stress on health are alleviated when people develop self-esteem, a network of support and a level of expertise (Thoits, 2010). This supports the theory that stress is a result of a failure to keep or maintain social ties or bonds that are important to a person resulting in emotional distress (Slavich, 2016).
Stress is also defined as a state of mental constraint due to problems and other negative stimulants from the environment and social conditions which develops diseases in a person (Bhargava and Trivedi, 2018). They (Bhargava and Trivedi, 2018) further defined it as an experiential circumstance or condition where a person feels overwhelmed by demands that are beyond his or her available resources. They also cited Selye’s (1956) definition of stress which refers to threatening external forces affecting the balance of an organism (Bhargava and Trivedi, 2018). Stress if short-term is not damaging, but prolonged ones are considered chronic and harmful (Kandola, 2018).
Stress is also observed to multiply and increase when the initial stress situation begins to affect or overflow to other aspects or stages of life like the example of the effect of negative childhood experiences to the adolescence stage of that child (Thoits, 2010). The stresses faced by parents also affect their children (Thoits, 2010).
3.1.1 Oxidative Stress Defined:
Another type of stress which is normally encountered in the researches on type 2 diabetes is the so-called oxidative stress which is the overproduction of oxygen radicals in the cells which affects the defense elements like antioxidants and enzymes resulting to oxidative damage to lipids, proteins and DNA (Gagne, 2014). This in turn develops mutation, in the case of damage to DNA or the cell growth inhibition like in the case of cancer (Gagne, 2014). Toxicity and stress combined is oxidative stress which may be a reaction of radiation, immune system action or the presence of xenobiotics or the heightened chemical reaction or secretion (Gagne, 2014). Oxidative stress may be developed through lifestyle leading to the development of the disease like nutrient imbalance, sleep deprivation and ketosis (Rains & Jain, 2011). Oxidative stress also affects insulin signals (Rains & Jain, 2011).
3.2 Stressors Defined;
Stressors are defined as triggers or factors that create stress (Slavich, 2016). This includes a wide-range of factors from life-threatening or dangerous situations to facing one’s fears and weaknesses and so on and so forth. They include not only the changes in one’s life but also the recurring events that make it difficult for a person to cope (Thoits, 2010) like trauma and other negative happenings. Stressors are those circumstances that frustrate or interrupt the usual course of one’s daily goal and plan (Slavich, 2016).