Tag Archives: Type 2 diabetes

Type 2 Diabetes

May 22, 2019 by
Illustration by Derek Joy

Everyone knows Type 2 diabetes is caused by bad foods. Everyone also knows you can reverse Type 2 diabetes by eating the right foods if you work hard enough to not give in to temptations.

Everyone is wrong.

A Complex Disease

Type 2 diabetes is a metabolic disease and there is no way to “reverse” it—although it can be put into remission. “It’s not just about insulin and body fat,” says Meghan McLarney, nutritionist and certified diabetes nutrition educator at Nebraska Medicine.

During her rotations as a student, McLarney kept encountering people with a diagnosis of Type 2 diabetes who “felt guilty about the disease,” she says. “The disease and the people are misunderstood. Everybody is blaming each other, but it’s a super-complex disease with a strong genetic component.” She adds that those affected often do not feel supported or get information they need due to assumptions—internal and external—that the disease is uncontrolled because of their eating habits. 

“Portion control alone will not fix diabetes,” McLarney says.

While diet is a primary treatment for the disease, it should be individualized to fit the person and their blood sugar management.

“For example, a low-carb diet might be good for a person who only has blood sugar spikes when they eat high-carb meals but it won’t make an impact on blood sugars for a person who has trouble with sugars rising overnight—that person might respond better to weight loss or a daily walk but not see a big benefit from a strict low-carb diet.”

“There is more than one way to treat Type 2 diabetes,” she continues. “And there is not one ‘diabetes diet.’” Recent research suggests that people with Type 2 diabetes may have issues with their brain not receiving the signal quickly enough that they’re full from a meal, causing them to overeat. If that’s the case, it’s not the overeating that causes the Type 2 diabetes, but rather the Type 2 diabetes that causes the overeating.

“It’s part of your DNA,” McLarney says. 

Typically, patients receiving a diagnosis of Type 2 diabetes are encouraged to exercise more, eat smaller portions, reduce their intake of sugar and simple carbs, and increase their intake of vegetables and fruit. The goal is to control blood sugar, and while many patients turn to high-protein diets (or even high-fat ones, such as the ketogenic diet), McLarney says that diets “wear people out.”

“Avoid all-or-nothing and instead think long term. Talk to a diabetes educator to make sure any diet you want to try is safe for you.”

McLarney says patients over the age of 40 often find weight loss to be “an uphill battle,” adding “It’s harder to lose weight because our metabolism slows down with age.” Weight loss helps control Type 2 diabetes because it typically involves exercise, which actively uses blood sugar as energy, she explains.

“If someone found a dietary cure for diabetes, I’d be working with those people. It’s not fair to say it’s simple.”

McLarney says that within Type 2 diabetes, there are different “types,” making it impossible to make one blanket dietary suggestion appropriate for all people with the diagnosis. There are eight possible metabolic problems with Type 2 diabetes, called the Ominous Octet. “You might have one of the eight, or you might have all eight,” she says.

More Complications

For adults over 60, the challenges and risks from diabetes become even greater. McLarney says there are unique factors involved for this age set, and encourages them to seek more frequent assessment of their nutrition and medical care.

“Older adults need the same amount of vitamins, minerals, protein, carbohydrates, fats, and fluids as they did in younger years,” she says. “But overall calorie needs are decreased.” This is why it’s easy to lose muscle mass, strength, and overall nutrition status when trying to lose weight.

McLarney recommends meals that include carbohydrate foods high in nutrients—Greek yogurt, beans, whole grains, low-fat milk, and high-fiber fruits such as strawberries and pears are excellent choices.

Because some medications influence the absorption of vitamin B12, it’s also important to take supplements. Those with vegan and vegetarian diets are especially at risk for a B12 deficiency, so McLarney says regular screenings of B12 status are important.

She adds that depression and mental status changes are more likely in older adults with vitamin deficiencies, as well as older adults with diabetes. For this reason, they should be regularly screened for both.

Another special concern for older adults is hypoglycemia, also known as low blood sugar (defined as any number under 70). Cognitive deficits among older adults have been associated with increased risk of hypoglycemia, and, conversely, severe hypoglycemia has been linked to increased risk of dementia. 

McLarney says it’s important to know that a normal part of healthy living is talking with someone about your struggles, and this is especially important with a chronic disease. She says there are programs at the Engage Wellness Center at UNMC for anyone who needs help managing their diabetes.

For her part, McLarney says she takes a holistic view with her patients, asking them about their lifestyles before making recommendations. “It’s a health literacy issue explaining what their role is instead of blaming them. We have to make an effort in healthcare to ask not just how people eat, but how they learn and think.”

Visit unmc.edu/engage for more information.

This article first appeared in the May 2019 edition of 60PLUS in Omaha MagazineTo receive the magazine, click here to subscribe.

A Professor in Motion Stays in Motion

April 27, 2017 by
Photography by Bill Sitzmann

The sun barely penetrated the narrows of the canyon. Kris Berg, Ph.D., scrambled over dusty red rock, carefully avoiding the steep cliffs that plunged down 50 yards on either side of him. History and geology combined with each footprint he left behind.

While most come to Las Vegas to roll the dice, Berg would rather hike with his wife in the outdoors, taking in the natural beauties of the world (which he accomplished during a recent winter trip).

Berg is a self-described exercise nut. The physical fitness bug struck him at a young age. When Berg was just 12 years old, he was diagnosed with Type 1 diabetes. Rather than a healthy boy, people saw him as fragile and sick. In high school, Berg’s coach even kicked him off the football team.

“I’ll show you. I’ll be so healthy that no one would do that again,” Berg thought.

After his family moved, a new doctor told Berg to experiment. So Berg lived his life, not letting diabetes limit his physical abilities.

“Exercise is such a powerful thing,” he says. “People are always looking for a magic pill. It’s right in front of us.”

He played multiple sports in high school and college. The science behind it all stimulated and fascinated him. With a doctorate in exercise physiology from the University of Missouri in hand, Berg began teaching at the University of Nebraska-Omaha.

“Top to bottom, front to back, he is enthusiastic,” former student Robert Buresh says.

Kris Berg, Ph.D.

UNO had no laboratory at the time so Berg developed one with the backing of the dean. Berg, a prolific researcher, made ties with the University of Nebraska Medical Center. He developed an exercise physiology lab geared toward an investigative-driven program which would look at the human body from a scientific angle.

He soon started a special exercise program for Type 1 and 2 diabetes. His own brother had passed away from the disease at 32. Berg spent years of his career dedicated to informing the public on the positives of exercise to help regulate blood sugar.

Berg’s interest never wavered. He tackled osteoporosis next. The Strong Bones Program was born, helping the elderly build up confidence and mobility to avoid falls.

“We were very fortunate Berg initiated this program,” Berg’s former colleague Josie Metal-Corbin says. Although a dancer and yoga enthusiast, 65-year-old Metal-Corbin took the class for the added strength training and sense of community. The classes soon combined into the Adult Fitness Program.

After four books, more than 200 articles, and 45 years at UNO, Berg hung up his tennis shoes last May and retired. However, retirement didn’t stop him from doing what he loves.

Berg still finds time to visit with graduate students who need his help on papers, and he spends two hours or so a day researching.

“I wanted to go on being physically active regardless of age,” Berg explains.

Long and lean at the age of 73, Berg follows a diverse workout plan. He smacks the ball around on the tennis court four or five days a week. The physical and mental “chess match” keeps him sharp. He also still shovels snow, pulls weeds, and hikes.

“I have a tremendous enjoyment of exercise. I never get bored,” Berg says.

At the gym, Berg avoids the machines, preferring resistance training (similar to his classes). He stresses the importance of maintaining coordination and mobility. His goal—for himself and for others—is to prevent age from becoming an obstacle to living life. 

The Adult Fitness Program is open to members of the general public age 50 and older. The supervised fitness class takes place twice a week at UNO’s Health, Physical Education, and Recreation (HPER) Building. The program costs $36 for three months; parking costs $54 for three months. Contact the UNO Exercise Physiology Lab at 402-554-3221 or exphyslab@unomaha.edu to enroll.

Visit unomaha.edu for more information.