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Healthy
Ways to Keep Diabetes at Bay
As we become fatter and continue to ignore the messages
to lose weight and exercise regularly, doctors aren't just
worrying about the increasing threat of heart disease.
The extra pounds and sedentary lifestyles are putting more
people at risk of diabetes.
In the past decade, the prevalence of diabetes has skyrocketed
40 percent -- from 4.9 percent of the population to 6.9
percent. And by 2050, the number of Americans diagnosed
with the disease will jump by 165 percent, experts predict.
Those worrisome rates dovetail with a disturbing increase
in the number of overweight Americans. In 1999, an estimated
61 percent of U.S. adults were either overweight or obese,
health officials estimate.
And those same officials hope to highlight the link between
excess weight and diabetes during November, American Diabetes
Month.
When diabetes is diagnosed in overweight adults age 30 and
older, it's most often type 2, in which the body doesn't
make enough of the hormone insulin, which transports sugar
from your blood to the cells for fuel. Or the cells ignore
the insulin.
In type 1 diabetes, the body doesn't produce insulin at
all, so those with this form of the disease must inject
insulin to keep their blood sugar levels under control.
But there's a third group of people flirting with trouble
-- the estimated 20 million Americans with a condition called
impaired glucose tolerance, which often precedes diabetes.
People with impaired glucose tolerance (IGT) have blood
sugar levels higher than normal but not high enough to say
they have diabetes. As many as 10 of every 100 persons with
IGT will develop diabetes each year, according to the Joslin
Diabetes Center in Boston.
If you have IGT, expect some strong suggestions from your
doctor to improve your health habits. Losing weight, exercising
regularly and eating more healthfully might just bring you
back from the brink of diabetes.
Embracing a healthy lifestyle is definitely worth the effort,
says Dr. Gerald Bernstein, past president of the American
Diabetes Association and an associate clinical professor
of medicine at the Albert Einstein College of Medicine in
New York City. While genetics plays a role in who gets diabetes,
he says, "the variables are exercise, diet and age."
By paying attention to exercise and diet and your weight,
it's possible to prevent or delay the onset of type 2 diabetes
for many years, Bernstein says. And doing so will limit
some of diabetes' dangerous complications, such as kidney
problems or blindness.
Impaired glucose tolerance also "puts you at risk for
cardiovascular disease even if you never get the diabetes,"
Bernstein says.
Motivating patients is difficult but doable, Bernstein says.
He leads by example. When the 70-year-old had an office
in uptown Manhattan, he'd regularly take a running break
in nearby Central Park.
He also stresses modest lifestyle changes, especially if
someone isn't used to exercise. "It doesn't have to
be running or anything dramatic," he says. Instead,
focus on having an active lifestyle -- take the stairs,
park farther from the store.
Adds Dr. Aramesh Saremi, another diabetes expert: "Brisk
walking a half hour a day most days of the week is enough."
Saremi is with the Phoenix Epidemiology and Clinical Research
Branch of the National Institute of Diabetes and Digestive
and Kidney Diseases. He evaluated 1,728 non-diabetic men
and women, tracking their physical activity for six years.
The more active the person, the less likely they were to
develop type 2 diabetes, she reported in the Oct. 1 issue
of the American Journal of Epidemiology.
For weight loss, another diabetes expert, Dr. Eugene Barrett,
refers his at-risk patients to a dietitian who can help
evaluate their diet and suggest changes that will result
in fewer pounds and better food choices.
The dietitian can also coach people in "intelligent
shopping," such as how to read labels for fat content,
says Barrett, president of the American Diabetes Association
and a professor of medicine at the University of Virginia
Medical School.
The study that most experts say proves the value of lifestyle
changes is called the Diabetes Prevention Program. In that
study, halted early in 2001 when the benefits of exercising
and losing weight became apparent, researchers looked at
3,234 people with impaired glucose tolerance. They compared
three groups: One made lifestyle changes such as losing
weight and exercising regularly; another group was put on
oral diabetes medication; and the third took placebo pills.
During the three-year follow-up, only 14 percent of the
exercise and weight loss group developed type 2 diabetes,
but 22 percent of the medication group and 29 percent of
the placebo group did.
Some people would rather pop a pill and avoid the necessary
lifestyle changes. And convincing people to lose weight
and exercise regularly can be frustrating, Barrett says.
But then along comes a patient who actually does make healthful
changes and delays the onset of the disease. "You feel
very good when someone figures it out," Barrett says.
Article Source: HealthDay
Article Author: N/A
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