Fat, diabetes and complications

Tuesday, 6 October 2020

Diabetes complications – how do they happen?

Long term diabetes complications begin in your blood vessels. Blood vessels range in size from large vessels, such as those attached to the heart, to smaller vessels leading to the kidneys and eyes. These vessels carry blood all over the body transporting oxygen and important nutrients, such as glucose, which is vital for the brain and muscles to function. The blood is also the slip-stream for many immune cells that help to fight off invaders and help you heal.

Damaged and or blocked blood vessels can reduce or stop blood flow which can unfortunately lead to many long-term diabetes complications including a heart attack or permanent vision loss. This happens is the heart or the back of the eye is starved of oxygen and nutrients.

Living with diabetes reportedly increases the risk of blood vessel damage related conditions, such as heart disease and stroke, by three to four times.

Why does diabetes increase the risk of heart disease and stroke?

Diabetes in simple terms is too much glucose (sugar) in the blood. Persistent, higher than target, blood glucose levels cause blood vessel irritation and inflammation. This can result in the body going all out to try and fix the inflammation. Your immune cells rush to the site to heal. However when the blood is also full of other compounds, such as low-density lipoprotein (LDL)-cholesterol, the immune cells gather these too. This causes them to start to dysfunction, forming a fatty build-up (plaque) on blood vessel walls.

If this process continues the plaque can chip off, due to blood pressure/strong blood flow, and travel through to a smaller vessel where it gets stuck. This then blocks oxygen and glucose getting through to critical areas of the heart or brain, which can lead to a heart attack or stroke respectively. 

Can diabetes complications be prevented or delayed?

Similar to diabetes, blood vessel damage can be driven by age and genetics, which we have little influence over. However both can also occur due to the environment you live in and your behaviours.

Of course blood glucose, blood pressure and LDL-cholesterol levels can be lowered to within target ranges with medications and or blood vessels blockages can be stopped and or bypassed with surgery if needed. However if there’s a choice, most people would prefer neither of these options. This is where the silent power of day-to-day preventative health-gaining behaviours comes in, giving you significant control back over your diabetes care and wellbeing.

Health-gaining behaviours include:

There are many diabetes management balls that need to be juggled at any one-point-in-time when living with diabetes so it’s completely understandable that thinking about or doing all of the above can feel ‘all too much’ and result in little happening.

It’s important to remember that doing something is better than doing nothing. Starting small with something that is doable for you is critical to long-term success. You can eventually make a health-gaining behaviour become an effortless habit, as easy as brushing your teeth.

A simple way to keep blood vessels well-functioning is to swap saturated for unsaturated fat-rich foods.

How does the type of fat-rich food affect the risk of diabetes complications?

Dietary fat is important for your health. Your body uses fat as a fuel (energy) source, you store it for an energy reserve which also acts as insulation to keep you warm. It is also essential for your cells to function, including your brain cells, for making hormones (sex hormones and others) and vital for delivering important fat-soluble vitamins to the body such as Vitamin D, a vitamin associated with diabetes risk.

However not all fats are equal when it comes to well-functioning blood vessels and diabetes complication prevention.

Saturated fats are typically ‘hard fats’ at room temperature and animal based, such as butter, lard, ghee, the fat in (the white marbling within meats) and on meats (e.g. lamb and chicken skin) and cream. There are also some plant-based sources such as coconut and palm oil.

Eating significant amounts of saturated fats has been associated with higher levels of LDL-cholesterol. Whereas eating more unsaturated fat, fats that are typically liquid at room temperature and plant-based such as olive oil, avocado, nuts and seeds, decreases LDL-cholesterol. Some of these unsaturated fats, monounsaturated fats (e.g. olive oil and avocados) not only help to lower LDL-cholesterol but also increase the high-density lipoprotein (HDL) cholesterol, which is believed to have a blood vessel cleansing function, helping to reduce plaque formation.

Eating less saturated fats can be as simple as swapping them out for unsaturated fats

SWAP THESE saturated fat-rich foods FOR THESE lower in saturated fat or higher in unsaturated fat foods…
Fatty red and white meats Fish including oily fish (salmon, tuna, herring, sardines, mackerel)
Lean grilled meat (skinless with little marbling)
Processed meats; bacon, ham, salami, devon etc. Lean fresh grilled meats
Beef jerky Unsalted nuts and or seeds
Butter Olive oil spread, avocado, tahini, nut and seed spreads
Cream Nut creams, spreads and or pastes e.g. peanut butter, almond cream or butter
Lower fat dairy options such as natural yoghurt
Coconut and palm oil Canola, rice brain, peanut or olive oil
Palm-oil or coconut-oil rich food products; pastries, snack bars, biscuits, drinks and chocolates Palm-oil free pastries, chocolates etc.


Other tips for lowering saturated fat intake

  • Choose lean meats (minimal marbling) with fat trimmed and/or skinless
  • Enjoy fish including oily fish (fresh or canned) at least two to three times per week
  • Grill or steam meats instead of frying and or non-grill baking, roasting or barbequing
  • Swap butter, lard, ghee (solid fats at room temperature) fats when cooking or baking for mono or polyunsaturated oils such as canola oil, rice bran oil and peanut oil
  • Enjoy a small and varied handful (30g) of unsalted nuts most days of the week as a satisfying snack
  • Try and cook more at home and buy less take away and or fast foods including fried foods
  • Compare food labels per 100 grams (g) and choose foods with the lower levels of saturated fat (where appropriate)

Food choices with less saturated fat and more unsaturated fat are health-gaining choices that can make a big difference to LDL-cholesterol levels and can go a long way in helping to prevent and or delaying diabetes complications.


If you would like more information on dietary fats, or any other health-gaining behaviours to help prevent and or manage diabetes complications, please reach out to your healthcare team. Or call our helpline to speak with one of our diabetes health professionals on 1300 342 238.

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