Type 2 diabetes can be a 'devastating diagnosis' says expert

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Type 2 diabetes is the upshot of poor insulin production. The primary role of insulin – a hormone naturally secreted by the pancreas – is to regulate blood sugar levels. Without sufficient insulin supply, blood sugar levels rise and the results can be devastating. If you have type 2 diabetes, you must therefore find alternative means of taming high blood sugar levels.

According to research published in the journal Diabetes Care, skipping breakfast could prove catastrophic.

The research found people with type 2 diabetes who skip breakfast are at risk of triggering blood sugar spikes and further impairing insulin function.

The study, conducted by researchers from Tel Aviv University, adds to a growing body of research that emphasises the importance of breakfast for people with type 2 diabetes.

“Despite the fact that many studies have previously demonstrated the benefits of a high-calorie breakfast for weight loss and to regulate the glucose metabolism, very little was known regarding the effect of skipping breakfast on glycaemic spikes after meals throughout the entire day,” said Professor Daniela Jakubowicz, one of the principal researchers on the study.

The study involved 22 participants, each of whom had type 2 diabetes. The average age of the study group was 56.9 years old. Every participant ate the same diet for two days, which consisted of a balanced meal of milk, tuna, bread, and a chocolate bar.

On the second day, however, the participants did not eat breakfast. “We theorised that the omission of breakfast would not be healthy, but it was surprising to see such a high degree of deterioration of glucose metabolism only because the participants did not eat breakfast,” explains Prof Jakubowicz.

“For type 2 diabetic individuals, the omission of breakfast is associated with a significant increase in all-day blood sugar spikes and of HbA1c, which represents average blood glucose levels over the preceding three months.”

The researchers observed huge blood glucose (sugar) peaks of 14.9 following lunch, and 16.6 after dinner. After an identical lunch and dinner with breakfast on the first day, the participants peaked at 10.7 after lunch, and 11.9 after dinner.

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The study argues that including breakfast as part of your daily diet is more important than the specific foods you eat. Following a low-carb diet – or any other diet for that matter – will apparently have little effect on blood glucose levels if breakfast is skipped.

“This means that reducing the amount of starch and sugars in lunch and dinner will have no effect on reducing elevated glucose levels if diabetes individuals also skip breakfast,” said prof Jakubowicz.

The study was unable to explain exactly why skipping breakfast caused blood sugar spikes, but the researchers theorised that pancreatic beta cells “forget” what they are supposed to do if the time gap between meals is too long.

It takes the beta cells some time to remember, so insulin responses aren’t as effective as they should be for some time. The end result is heightened blood glucose levels.

Another theory is that going without food for so long increases fatty acids in the blood, which makes insulin less effective than it would otherwise be.

“In light of our study, we highly recommend that type 2 diabetics not skip breakfast, because it causes major damage to the beta cell function and leads to high sugar levels, even if they don’t overeat at lunch and dinner,” said Professor Jakubowicz.

The research did not examine the effects of skipping breakfast on people with type 1 diabetes. This will hopefully be the next step, the researchers said at the time.

Other health bodies echo this warning. The Centers for Disease Control and Prevention said: “Skipping breakfast – going without that morning meal – can increase blood sugar after both lunch and dinner.”

Other blood sugar triggers include:

• Sunburn—the pain causes stress, and stress increases blood sugar levels
• Artificial sweeteners—more research is needed, but some studies show they can raise blood sugar
• Coffee—even without sweetener. Some people’s blood sugar is extra-sensitive to caffeine
• Losing sleep—even just one night of too little sleep can make your body use insulin less well
• Skipping breakfast—going without that morning meal can increase blood sugar after both lunch and dinner
• Time of day—blood sugar can be harder to control the later it gets
• Dawn phenomenon—people have a surge in hormones early in the morning whether they have diabetes or not. For people with diabetes, blood sugar can spike
• Dehydration—less water in your body means your blood sugar is more concentrated
• Nose spray—some have chemicals that trigger your liver to make more blood sugar
• Gum disease—it’s both a complication of diabetes and a blood sugar spikes.

Type 2 diabetes – do you have it?

Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

• Peeing more than usual, particularly at night
• Feeling thirsty all the time
• Feeling very tired
• Losing weight without trying to
• Itching around your penis or vagina, or repeatedly getting thrush
• Cuts or wounds taking longer to heal
• Blurred vision.

Due to the vagueness of symptoms, type 2 diabetes is often diagnosed following blood or urine tests for something else, says the NHS.

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