Sixteen million Americans have Type 2 diabetes. Nearly one-third don’t even know they have it. Diabetes in Americans in their thirties has increased 70% in the last ten years, of those aged 40-49 there has been an increase of 40% and aged 50-59, a 31% increase. Type 2 diabetes is often accompanied by carrying too much extra body weight. In many cases it is a disease of lifestyle and has not only a frightening effect on our overall health and well-being, but also our economy. The annual economic cost of diabetes is estimated at $98 Billion and with more cases in younger and younger Americans each year, the costs will have an enormous effect on our future health care economy.
The hidden issues are the complications with diabetes (or prolonged levels of high blood sugar). Diabetics have 2-4 times the risk of death from heart disease and stroke. Over 70% of people with diabetes have High Blood Pressure. Diabetes is a leading cause of blindness in adults. Diabetes is the leading cause of end-stage kidney disease. Sixty to seventy percent of diabetics have mild to sever nervous system damage. Diabetes also leads to increased severity and frequency of gum disease.
The most important way to prevent (or manage) a disease is to know if you’re at risk or not. You are more likely to develop diabetes if:
There are rarely signs or even symptoms. A blood test for fasting (no food within 12 hours of blood draw) glucose will tell you and your health-care provider if your body is having difficulty keeping blood sugars at safe, normal levels. Fasting blood sugar of 100 to 125 mg/dl indicates Pre-Diabetes, also known as Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT). Blood sugars higher than 126 mg/dl, means a diagnosis of Type 2 diabetes.
Insulin Resistance is also an important factor to know about and a term used frequently. Insulin is released by the body (pancreas) after we eat. Insulin tells our tissues (our muscle tissue, fat tissue, liver cells, etc.) to absorb glucose, lowering levels in the blood stream. When a person is insulin resistant, the normal levels of insulin do not signal absorption of glucose into the tissues. So, if there are high levels of insulin and high levels of blood sugar…our vessels and certain other organs take a beating (the vessels that transport our blood have to have normal levels of blood sugar and insulin to function properly).
The first line of defense in prevention and management is exercise and healthy food patterns (our diets). The Diabetes Prevention Program, which was a large research trial aimed at discovering whether diet and exercise or metformin (a medication called Glucophage) would best prevent or delay the onset of Type 2 diabetes in people with Pre-Diabetes (or Impaired Glucose Tolerance). The study showed that exercise and diet were nearly twice as effective as metformin (a diabetes medication) at reducing risk of progressing to Type 2 Diabetes. As expected, when a combination of all three (healthy diet, exercise and medication) was done, the results were the most dramatic.
The same therapies (exercise, diet and certain medications) are keys for preventing pre-diabetes from becoming diabetes and also management if you have a diagnosis of diabetes.
First, physical activity as part of your daily life is the basis for healthy blood sugar levels. Moving your muscles helps your body burn energy (from food we eat), thus exercise make you more efficient at using your food. Taking the stairs instead of the elevator, walking whenever possible, etc. (you get the picture) are important as part of your daily activity. Secondly, 200 minutes per week, or about 30 minutes everyday. Even 10 minute sessions throughout the day will show improvement.
A more important first line of defense against diabetes is “what shouldn’t I eat regularly?” The answer will not surprise you. Sweets (soda, candy, cakes, pastries… you know the foods) and refined carbohydrates (foods made from white flour, ‘enriched’ flours, sugar and sugar-containing foods) will significantly raise blood sugars and cause weight gain if eaten in excess.
The foods that help keep blood sugars normal are beans (legumes) vegetables, whole fruits, whole grains (oats, brown rice, barley, quinoa, wheat berry, “sprouted” cereals and breads). Fish is an excellent source of protein and omega-three fatty acid.
There are numerous ways to begin to eat better and exercise. Find what motivates you and what you can do as part of your day-to-day, week-to-week, month-to-month routine. Remember that change over time is excellent and healthy. You can achieve good health if you remember that it’s about you, and if you remember that it’s about health. Strange “fads” and drastic procedures have never proven to result in long-term health.
You are in charge and every little bit that you can do for yourself to promote health will lead to a healthier body.
Tyler C, Johnston CA, Foreyt JP. Lifestyle Management of Obesity. Am J of Lifestyle Medicine. 2007;1(6):423-429.
National Diabetes Information Clearinghouse (NDIC) website:
American Diabetes Association Website: www.diabetes.org
Mokdad AH, Ford ES, Bowman BA et al. “Diabetes trends in the U.S.; 1990-1998.” Diabetes Care 23 (2000): 1278-1283.
Centers for Disease Control and Prevention. “National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2000.” Atlanta, GA: Centers for Disease Control and Prevention.