Blood Vessel Disease

Type 2 Diabetes – The Importance of Screening for Heart and Blood Vessel Disease

Expert Author Beverleigh H Piepers
Medical science is constantly at work finding more efficient and effective ways to detect heart and blood vessel disease early enough to treat it successfully. Researchers at the International Atomic Energy Agency in Vienna, Austria, used myocardial perfusion imaging (MPI) to detect any heart problems in people diagnosed with Type 2 diabetes but who have no signs or symptoms of heart disease. Their work was reported in the journal Nuclear Medicine Communications in November 2014.

Like all tissue in the human body, heart muscle needs blood to supply it with oxygen and the nutrients it requires to keep it doing its job. The coronary arteries supply heart muscle with blood but, when they are blocked parts of the heart can lack oxygen. This can cause some of the muscle to die if it is not remedied. Myocardial perfusion imaging (MPI) takes images of the heart, showing areas where the heart muscle is getting enough blood.

A total of forty-one Type 2 diabetics who had no signs or symptoms of coronary artery blockage were enrolled in the study and given an MPI. Another MPI was performed three-years later…

13 of these diabetics, or 32 percent, showed parts of the heart that were not getting enough blood.
3 years later, 8 of the 13 had normal blood flow into all the heart muscle. The amount of blood their hearts pumped into the circulation also improved due to treatment they had received over the three-year interval.
Type 2 diabetes is a risk factor for coronary artery disease because diabetics often have high blood cholesterol and fat levels which tend to block arteries. The obesity frequently seen in people diagnosed with Type 2 diabetes puts a strain on the heart. Also the sedentary lifestyle that frequently accompanies Type 2 diabetes, does not give the heart muscle the workout it needs.

To maintain a healthy heart, non-diabetics as well as Type 2 diabetics need to…

keep their body mass index between 20 and 24.9.
eating not less but the right kinds of foods, is a big help.
eating lots of salads provides roughage that helps slow down the absorption of carbohydrates, preventing blood sugar spikes.
going for a walk each day is helpful too, as is taking medications on schedule.
While Type 2 diabetes is clearly treatable, it is a complex disease that can be managed through a multilayered approach. The goal of treatment is not just to relieve symptoms, but to prevent a range of other diseases down the road. It is important for diabetics to make and keep their checkup appointments with their primary care doctor and also see a cardiologist every 5 years to check how well their heart is functioning. If the coronary arteries are too restricted for normal heart function, surgery is an option, but preventive medicine is always best.

Kidney Disease

Beating Kidney Disease

By Paul D Kennedy
You have two kidneys. They are shaped like beans with concave and convex sides and are about the size of a fist. They are located at the bottom of the rib cage, one to the left and one to the right of your spine.

Functions of kidneys

Your kidneys are multi-functional. But their main job is to get rid of waste. They remove the waste products that arises when you digest food and drink, as well as excess organic molecules (such as glucose).

They are an essential part of your urinary system. Kidneys filter your blood and remove water soluble wastes which are sent to your bladder. While producing urine, the kidneys also excrete wastes such as urea and ammonium.

Your kidneys also regulate electrolytes, maintain the acid-base balance, and keep your levels of salt, potassium and phosphorus in check. By maintaining the salt and water balance, and producing the enzyme renin, they help regulate your blood pressure. The kidneys also produce hormones that help make red blood cells, as well as an active form of vitamin D needed for the health of your bones.

As you can see, your kidneys are a vital part of your body’s processes and have a lot of work to do. Every day they filter enough blood to fill a large 200 litre bathtub and produce about half a gallon of urine.

Kidney transplants

Your kidneys are highly versatile and have built in redundancy.

If you are missing a kidney—some people are born with only one kidney—or if one of your kidneys is damaged or has been removed, the remaining one can grow until it is nearly as large as two kidneys together. That helps the sole kidney do the job of both.

This means that you can donate a kidney to someone else, such as a member of your family, a friend or even a stranger. Thousands of people do so every year and stay perfectly healthy afterwards. In fact, kidney transplants are the most common organ donations in the world.

Kidney stones

Kidney stones are pieces of hard solid matter made in the kidneys from minerals in the urine. They are formed when there is too much of a particular substance (such as calcium) in your urine. They can vary in size from as tiny as a grain of sand to as big as a pearl or (rarely) a golf ball.

Kidney stones usually go down the urinary tract and pass out when you urinate. Indeed many stones are formed and passed without causing symptoms. But if the stones grow large enough (at least 3mm) they can block the urethra. This causes pain, beginning in the lower back and radiating to the groin. Other symptoms include nausea, vomiting, fever, blood in the urine and painful urination.

One of the major causes of the formation of stones is dehydration due to a low intake of fluids. The risk of forming kidney stones is increased when you eat lots of animal protein, salt, refined sugars, fructose, and high fructose corn syrup. Drinking grapefruit and apple juice also increases the risk.

Developing kidney stones can run in the family. The best way to prevent stones from developing is to drink enough fluids that you produce more than two litres of urine every day, and adhere to a low-sugar, low-salt diet that contains minimal animal protein. You should also avoid drinking colas.

How kidneys are damaged

There are two broad types of damage to your kidneys:

– acute kidney injury, and

– chronic kidney disease

Acute kidney injury

Acute kidney injury, also known as acute renal failure (ARF), is a sudden loss of kidney function. There are many ways in which this can happen. ARF can occur following:

– a sudden reduction in the flow of blood to the kidneys due to a traumatic injury with severe loss of blood

– damage to the kidneys due to shock from a severe infection

– damage from toxins or certain drugs

– obstruction of the flow of urine

– complications during pregnancy

Runners who don’t drink enough fluids when competing in long-distance endurance events can suffer a sudden breakdown of muscle tissue. The breakdown releases myoglobin, a protein found in muscle tissue which only appears in the bloodstream after muscles are injured; this protein can damage the kidneys severely and result in ARF.

Chronic kidney disease

Kidney damage that lasts longer than three months is known as chronic kidney disease (CKD). It is particularly dangerous because you may not have any symptoms until considerable (often irreparable) damage has been done.

The two most common causes of CKD are:

– diabetes (both types 1 and 2), and

– high blood pressure

Other causes of CKD include chronic viral illnesses (such as HIV/AIDS and hepatitis B and C), urinary tract infections within the kidneys themselves, inflammation following a strep infection, congenital defects, toxins, some medical drugs, and the use of recreational drugs that are injected. You can also damage your kidneys by eating too much animal protein and not drinking enough water.

Your kidneys are made up of millions of extremely small filtration units which purify your blood and send the waste products out into the urine. These tiny filtration units can be damaged by high glucose levels (diabetes) and high blood pressure (hypertension).

Unused glucose in your bloodstream is filtered by your kidneys and then normally reabsorbed back into the bloodstream. However there is a limit to the rate at which the kidneys can filter and return glucose. When this limit is exceeded—as it can be if you don’t get your diabetes under control—your kidneys become stressed from over-work and the glucose starts to spill into the urine.

Your kidneys are particularly sensitive to high blood pressure. At the same time, they play an important role in the regulation of blood pressure and if they have been damaged, they can lose some of their ability to keep blood pressure down.

The problem is circular—high blood pressure damages the kidneys and damage to the kidneys can contribute to high blood pressure.

Beating kidney disease

In the early stages of the disease there are usually no symptoms. But as things get worse, changes in bathroom habits—having to go more or less often—can signal a problem. You may also feel tired, have muscle cramps, lose your appetite, and have swollen hands or feet and dry, itchy skin.

The only fix is to regulate your blood pressure, using medication prescribed by your doctor, and beat the effects of diabetes by following a low-sugar, low-fat, low-salt and high-fibre diet and avoiding eggs and dairy products.

Getting both your blood pressure and blood glucose levels under control is imperative because once your kidneys stop working your body begins filling up with wastes, fluids, and toxins. With your kidneys out of action, the only way to get rid of these is to go on dialysis—using a machine that acts as an artificial kidney, cleaning your blood—a very inconvenient, extremely messy and highly uncomfortable procedure.

If you allow damage to your kidneys to develop, you will end up needing kidney dialysis at least three times a week. In the end, you will probably need a kidney transplant.

Above all else, drink plenty of water. Check when you go to the toilet: is your urine clear to light yellow in colour? It should be—if you are drinking enough liquids.

Diabetes Burn Out

Diabetes Burn Out – I Have Been A Bad Girl

By Nadia Al-Samarrie
Diabetes is on your to-do list every day. At night, you cross out all the things you did to take care of yourself. The next day you wake up, to start all over again with diabetes being on the top of the list. Some days you feel like a champion. Other days you feel hopeless. Wondering if there really is a loving God.

Our society sets an unrealistic goal of perfection. More damaging, if you are not perfect in your self-care, then you get the inadequate head stamp of being non-compliant. Once you identify yourself with the non- compliant stamp associated with your self-care, hopelessness sets in. The daily task of self-care starts feeling like Bill Murray’s “Groundhog Day” movie. Every day you wake up, knowing the same scene is going to play over and over again.

I use to watch my mother test her blood sugars. The high reading on her meter made her feel hopeless. In fact, it discouraged her so much, she started testing less and less. I remember the first time I asked her what her blood glucose meter read, she replied, ” I have been a bad girl.” That was the first time I experienced my “Groundhog Day” moment with her. Every time we were together, and she experienced a less than satisfactory reading, I would remind her that her blood sugar readings are simply feedback. I would go on by pointing out how blessed we are to have technology that can read blood sugars, allowing adjustments to be made to her insulin.

The truth of the matter is, you can eat right and exercise and get a “good girl reading.” You can eat right and exercise and get a “bad girl reading.” It is not about being compliant vs. non-compliant. There are other conditions that affect your blood sugar that aren’t as obvious to you. Stress, medication for acute illness and some invisible variable can completely throw you off you game.

Be Easy on Yourself

If you were only to judge yourself by diet and exercise, then you are setting yourself up to identify with the bad girl camp. Be easy on yourself. The daily task of self-care is a job in itself. I do believe at times, we all feel that we have been dealt a hand that does not seem fair. However, when you look a little deeper and embrace the change, you find it gives you the strength you did not know you have. My mother passed away 11 years ago. She is still a teacher to me. The diabetes community I touch benefit from my experience with her.

Some of us go to school to learn a profession. For others, life teaches us our profession. My profession comes from my life experience with my family whom I loved so dearly.

Losing my mother and brother to diabetes had much to do with the hopelessness they felt. The impossible grind of trying to be perfect allowed denial to steer them into giving up.

This is my poem to anyone and everyone that feels a let down after seeing their blood sugar reading.

Blood Sugar Blessing

I have diabetes,

It does not have me

Blood sugar reading

Is a blessing to me

It’s simply technology

Reading me

I do not need to plea

Or kneel down fearfully

Knowing what I need to know

Helps me internally

My blood sugar reading

Is a blessing to me.

Diabetes is both Preventable and Reversible

Expert Author S Keiser
Diabetes is a chronic disease that comes with an array of serious health problems. The short list is kidney failure, blindness, loss of limbs and strokes.

Many people are not aware that they have this condition. More than 40 percent of people 20 or older have diabetes or pre-diabetes. Pre-diabetes is when you have a condition that will lead to diabetes within a few years. In order to prevent this from happening we have to change the way we approach diabetes and our diets/lifestyles. Removing the cause is what can reverse the disease.

What a lot of people don’t realize is that diabetes is both preventable and reversible.

Type 1 diabetes is not known to be caused by weight gain or obesity. People who are Type 1 diabetics will always need insulin to prevent the high blood sugar that can cause many life threatening health issues. A high nutrient diet / lifestyle is imperative for the Type 1 diabetic. It is essential for health and a lengthy life. Type 1 diabetics can have healthy, normal and long lives.

By integrating a high nutrient diet in to their lives, the diabetic can lower their need for insulin. Their glucose and lipid levels can stay under control with the use of minimal insulin. The goal is for them to require less insulin to manage their diabetes.

I know the word “diet” has negative connotations. Try to not think of it as a diet. But as a lifestyle.

I am going to give you a short overview of the types of things that would be helpful for a high nutrient diet.

• You can have poultry, eggs and oils once a week or less.
• Fish and fat free dairy two times a week.
• The majority of your diet should consist of raw nuts and seeds, fruits, beans and vegetables.

Do your best to avoid sweets, cheese, milk and processed foods.

When you are on a nutrient rich diet your appetite and cravings will be reduced… hence the natural occurrence of weight loss will take place. You will lose weight and feel better. Then you will be motivated to stay on this high nutrient lifestyle. Remember you will feel better so you will now feel like getting some exercise. Exercise is an important factor in all of our lives. A sedentary lifestyle leads to a number of health problems. Get up and get moving as often as you possibly can. With exercise you will see your weight reduce even more.

Change is tough. I know. I’ve been there. But once you get started you will realize that it’s all worth it. Good luck on your venture to rid yourself of diabetes. Remember, only you can do it for yourself.

Children

Author Helen T Dellomes
About 29.1 Million Americans had diabetes and 86 Million adults had pre-diabetes in 2012 according to a report released by the Center of Disease Control and Prevention.

In 2010, these statistics were 28.8 and 79 Million, respectively showing an alarming increase. As incidence of Type 2 Diabetes progress more rapidly in children than in adults and is hard to cure. According to Dr. David Nathan, an author and Director of the Diabetic Center of Massachusetts General Hospital. “It’s frightening how severe this metabolic disease is in children.”

Before 1990, this disease is not prevalent in children. It is hard to treat diabetes in children and teens because the cause is not yet known. The rapid growth and hormonal change in poverty can be the reason but this remains to be proven yet. Usual oral medicines that work in adults are not effective to about 50% of children treated prior to the research.

The issue on such findings is quite alarming as uncontrolled diabetes significantly increases the risk of heart disease, eye problems, nerve damage and kidney failure. A diabetic patient is also prone to amputation and lung disease. The longer the patient had the disease, the greater the risk. Children suffering from diabetes are most likely to have a higher risk than adults with diabetes.

Differences Found in Type 1 and 2 Diabetes

Type 1 Diabetes

This type of Diabetes occurs when the patient’s immune system breaks down and destroys the cells in the pancreas that make insulin, a hormone needed to control blood sugar levels. Patients with this type of diabetes need to take a regular dose of insulin.

Type 2 Diabetes

Diabetes Type 2 is said to be brought about by an obesity problem plus the inactivity in people with genetic imbalance. People with this type of diabetes has inborn tendency to put on weight and has an insulin-resistant condition. The pancreas of a patient with this condition is still producing insulin though not enough and the body fails to use it properly. High blood pressure and high level of cholesterol often signify this type. Initial treatment is a dietary program, daily exercise and oral medicine. Eventually, patients will be needing insulin as part of their medication.

Obesity as the Link

The alarming increase in the number of diabetic children was noted among Hispanic and black children coming from poor families in 1990. However, there had been reported cases among the American Indians even before that.

Obesity seems to have established a direct link to poor people with diabetes type 2.

2. Patients affected are those coming from families with single parents or children raised by guardians. Mostly came from families with a history of diabetes or with relatives with kidney failures or amputations. Stress also seems to play a lead role on the disease. Patients with this type of diabetes should be easily treated with a well-balanced diet and regular exercise but proves to have no effects on the children with type 2 diabetes.

Type 2 Diabetes claims its toll on American children as medication seems not to be working well on them. Rapid growth and hormonal growth seem to be the reasons for it but still remains to be seen. The common factor apparent among patients is obesity and genetic disorder. Where will this lead the country in the future if no medication will be discover to cure the deadly disease?

Vegan

Should You Go Vegan To Reverse Diabetes?

Expert Author Paul D Kennedy
The diet I am using to successfully reverse my diabetes is a plant-focused one that is low in sugar, fat and salt, high in fibre and digested slowly. Though I eat some ultra-lean meat and fish, I avoid eggs, any products that include eggs, as well as all dairy products (milk, cream, cheese, yoghurt, etc). I also try to avoid processed foods as far as possible and drink plenty of water.

This diet can be described as quasi-vegetarian. It is helping me to control my blood glucose and beat my diabetes quite effectively.

But, though it is plant-focused, it is not a vegan diet. However, if I eliminated all animal products it would be a vegan diet.

But should I go vegan?

What is a vegan diet?

Vegans avoid all animal foods such as meat, poultry, seafood, eggs and honey, as well as anything that comes from an animal such as milk, cream, cheese, yoghurt, gelatine, colours and by-products.

A properly-constructed vegan diet is ultra-healthy. A research review (an assessment of available previous studies by an expert), which was conducted in 2009, indicated that vegan diets tend to be higher in dietary fibre, magnesium, folic acid, vitamin C, vitamin E, iron and phytochemicals than conventional omnivorous diets. They are also lower in calories, saturated fat and cholesterol.

But vegan diets can also be deficient in omega-3 fatty acids, vitamin D, calcium, zinc and vitamin B12. Planning a vegan diet so that it includes sufficient quantities of these nutrients can be challenging.

But when it is well-planned, a vegan diet appears to offer protection against some degenerative conditions, such as heart disease. Indeed, vegan diets are regarded as appropriate for all ages by the American Dietetic Association, the Australian National Health and Medical Research Council and Dieticians of Canada.

However, because plant foods do not normally provide vitamin B12 (which is produced by micro-organisms such as bacteria), vegans need to eat food that have been fortified with vitamin B12 or take a B12 supplement.

Becoming a vegan

If you follow a vegan diet you will reverse your diabetes, ie put off almost indefinitely the horrors of heart attacks, strokes, blindness, amputations of the feet, kidney disease and so on that number among the consequences of being diabetic. But going full vegan is not for the faint-hearted.

In fact, veganism can be quite tricky and getting adequate nutrition as a vegan requires a fair degree of knowledge about nutrition.

You will need to be creative in order to ensure that you will get the nutrients you might miss out on, such as essential proteins, omega-3 fatty acids, vitamin D, calcium, zinc and vitamin B12.

You will also have to spend a lot of time researching foodstuffs for understanding so you can decide what to eat and what not to eat, as well as reading food labels when you are shopping.

Here are some of the pitfalls you will have to overcome.

Protein

Proteins have many functions including repairing your bones and muscles, building cells, and helping with your immune system. They are also sources of energy. Thus an adequate supply of protein is essential to good health.

Protein is made up of amino acids. Many of these are synthesised internally by your body. But there are nine amino acids that your body cannot synthesise and these must be obtained in the food you eat. These are called essential amino acids.

Proteins obtained from animal sources contain all nine essential amino acids. Most plants, however, only deliver a few of them. The exceptions are soya, quinoa and hemp.

The remaining plants provide some of the essential amino acids, but the actual combination of these acids varies from plant to plant. As a vegan you need to eat a mixture of plants over the course of a day in order to ensure that you get the full complement of amino acids your body needs.

Here are some of the most important sources of plant proteins for vegans and which are suitable for reversing diabetes:

– quinoa (supplies all nine essential amino acids)

– soya and soya products such as soya milk, tofu and tempeh (also supplies all essential amino acids)

– beans, peas, lentil, chickpeas, kidney beans, etc

– seeds such as pumpkin, sesame and sun flower

– meat alternatives such as textured vegetable protein

Iron

Your body needs iron in order to produce haemoglobin, a substance in red blood cells that makes it possible for them to carry oxygen to the body’s tissues. If you suffer from anaemia (being deficient in iron) you will feel weak, tired, and irritable.

There are two forms of dietary iron: heme and non-heme.

Heme iron is derived from haemoglobin. You get it from foods such as red meat, poultry and fish that originally contained haemoglobin. Your body absorbs the most iron from heme sources. However, as a vegan, animal products are off the menu.

Non-heme iron is not absorbed as easily as heme iron. However, it is the form of iron added to iron-enriched and iron-fortified foods.

Non-haem iron is found mainly in the following foods that are suitable for type 2 diabetics:

– fortified foods such as breakfast cereals and wholemeal breads

– tofu

– textured vegetable protein

– wheat germ

– beans, red kidney beans, chickpeas, split peas and lentils

– dark green leafy vegetables such as broccoli, spinach and cabbage

– peas

– green peppers

– baked potatoes

– rice

– dried fruit such as apricots, raisins, peaches and prunes

You can enhance the absorption of non-heme iron by including a rich source of vitamin C in your meal. Here are some good sources of vitamin C:

– citrus fruits and juices

– Kiwi fruit

– berries of all kinds

– tomatoes

– potatoes

– peppers

– green vegetables such as broccoli, Brussels sprouts and spinach

However, even though it is an excellent source of vitamin C you should avoid grapefruit because, according to clinical trials, it inhibits the enzymes that metabolize certain medicines in your intestines. This increases the concentration of these medications in your blood to levels that could be toxic.

These medicines include statins for lowering cholesterol and drugs for controlling blood pressure. Grapefruit also blocks the action of antihistamines and some psychiatric medications. As I am taking statins to control my cholesterol levels, I never touch grapefruit or any other citrus fruit. As you can see from the list above, there are plenty of other good sources of vitamin C.

To ensure that all the non-heme iron you ingest is absorbed, you should avoid adding bran and wheat-germ to meals, as these decrease the absorption of iron from plant foods.

You should also note that the tannins in tea and coffee, as well as calcium, reduce the amount of iron your body can absorb from food. Thus you should not drink tea or coffee or take supplements containing calcium while eating. Instead, enjoy them between meals.

Calcium

Calcium is required for vascular contraction and vasodilatation, muscle function, nerve transmission, intracellular signalling, the secretion of hormones, and the formation of teeth and bones. Adults need about 800mg of calcium a day.

Dairy foods are the major sources of dietary calcium. As a vegan, you avoid dairy products, so you need to find significant alternative sources to meet your daily requirements.

Good plant-based alternative that can be eaten by type 2 diabetics include:

– calcium-enriched soya milk, rice milk, oat milk etc

– calcium-enriched fruit juices and drinks

– calcium-enriched tofu

– calcium-enriched cereals

– Chinese cabbage, kale, and broccoli

– dried fruit such as apricots and figs

– spinach (but its bioavailability-degree to which the body absorbs it-is poor)

Note that most grains only contain small amounts of calcium unless they are fortified. However, they can be useful sources of calcium if you consume them frequently.

Vitamin D

The term vitamin D refers to a group of fat-soluble compounds labelled D1, D2 and D3 which are responsible for enhancing your body’s absorption of calcium, iron, magnesium, phosphate and zinc.

Vitamin D is also essential for the control of cell growth, bone development, neuromuscular function, regulation of the immune system, stabilising moods, and lowering the risk of inflammation.

Your body can synthesize vitamin D3 from cholesterol when your skin is exposed to the sun. But, to synthesise sufficient vitamin D, you need to expose a large expanse of skin (without sunscreen) for 20 minutes a day. This is difficult in northern climates, so most of us don’t get enough vitamin D.

In addition, your body’s ability to synthesise vitamin D declines with age, which is why a majority of older adults are deficient in vitamin D.

A lack of vitamin D can have devastating effects. When your body isn’t absorbing enough calcium because it is not synthesising enough vitamin D, it begins taking calcium from your bones. This interferes with the health of your bones and, if it goes on long enough, leads to osteoporosis.

Thus, whether you are a vegan or not, you need to ensure that you have other sources of vitamin D. Here are some suggestions that are suitable for vegans and type 2 diabetics:

– some fortified brands of milks, yogurts and desserts made from soya (but check the labels for sugar and salt)

– a few fortified breakfast cereals

– mushrooms

– cod liver oil

Vitamin B12

Vitamin B12 is a water-soluble vitamin that is normally involved in the metabolism of every cell in the human body. It has a key role in the normal functioning of the brain and nervous system, and in the formation of blood. Thus vitamin B12 is essential for the maintenance of normal nerve function and healthy blood cells.

This vitamin cannot be made by animals, plants or fungi. Only bacteria and archaea (single-cell micro-organisms) have the enzymes required for its synthesis, although many foods are a natural source of B12 because they contain the necessary bacteria.

Vitamin B12 is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products. However it is generally not present in plant foods. So vegans can easily become deficient in B12, with an increased risk of damage to their nerves, and should take vitamin supplements every day. If you are a vegan, you should also have regular blood tests for vitamin B12 deficiency.

Here are some sources of B12 suitable for vegans and type 2 diabetics:

– textured vegetable protein

– fortified dairy alternatives

– breakfast cereals

– fortified brands of rice drinks and oat drinks

– nutritional yeast

– vitamin D supplements (at least 5mcg a day; any excess is excreted in the urine).

Omega 3 fatty acids

We need omega-3 fatty acids for numerous bodily functions, such as controlling blood clotting and building cell membranes in the brain. Omega-3 fatty acids are associated with many health benefits, including protection against heart disease, stroke, and damage to the eyes and nerves.

Our bodies cannot make omega-3 fatty acids, so we must get them through food.

We can get two basic types of omega-3 fatty acids in our diets: [1] alpha-linolenic acid (ALA), from vegetable sources, and [2] eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both from fatty fish (which vegans cannot eat).

Here are some good sources of omega-3 fatty acids suitable for both vegans and type 2 diabetics:

– vegetable oils made from soybeans, rapeseed (canola), linseed and flaxseed

– some green vegetables, such as Brussels sprouts, kale, spinach, and salad greens

– sea vegetables such as seaweeds

– hempseeds

– DHA supplements made from algae

Our bodies can convert some ALA into the essential EPA and DHA we need but the conversion isn’t very efficient. To optimise the conversion, you should avoid foods that are high in trans-fats and saturated fats (which you will do naturally as part of your diet), and limit oils that are high in linoleic acid, such as safflower, sunflower and corn oils.

As you don’t eat fish, you might consider a supplement made from algae-derived DHA or a linseed-based supplement.

For good health, you need at least one rich source of omega-3 fatty acids in your diet every day. If you are not eating foods rich in omega-3 fatty acids you should take an omega-3 supplement of 500 mg per day.

Nutritional supplements

If you are serious about eating a vegan diet, you must remember that by not eating any animal products (meat, fish and dairy) you could be missing some vital micro-nutrients from your diet. Thus you should take supplements containing a full range of dietary vitamins and minerals.

I’m a type 2 diabetic and follow a plant-focused but not a vegan diet. Here’s what I take every morning:

– one general all-purpose multivitamin

– a separate tablet containing 4mcg of B12

– a separate tablet containing 400mg of calcium and 2.5mcg of vitamin D

– a separate tablet of high-strength cod-liver oil with vitamins D and E

I also sprinkle a large teaspoon of cinnamon onto my porridge (oatmeal) or other cereal as it seems to have a very positive effect on my blood glucose levels.