Dealing with Diabetes

Leigh Erin Connealy , MD

The disease is at epidemic levels, but lifestyle changes can help manage – or even reverse -- the condition, while making you healthier overall.

November was National Diabetes Month, and with the holidays upon us, including holiday parties and over-indulgence, it is a good time to review the causes and treatments for this increasingly common disease. First, the statistics. According to the National Diabetes Fact Sheet for 2007, the latest data that's available:

• nearly 24 million children and adults in the U.S. live with diabetes;
• almost 18 million of them have been diagnosed, while close to 6 million are not aware that they have the disease;
• an additional 57 million individuals are considered “pre-diabetic,” meaning their glucose tolerance is compromised;
• every year, an additional 1.6 million new cases of diabetes are diagnosed in adults age 20 and older;
• in 2007 alone, estimated diabetes costs in the U.S. totaled $174 billion, according to the National Institutes of Health;
• if these trends continue, one out of three children born in 2000 will be diagnosed diabetes in their lifetime;
• some 2 million American children between the ages of 12 and19 have pre-diabetes;
• furthermore, by 2050, 48 million Americans could have type 2 diabetes, if these trends are not reversed.

These figures apply primarily to Type 2, or adult onset, diabetes. Type 1, also sometimes called juvenile onset diabetes, is a different, less common condition, involving the immune system. Although more and more young people are being diagnosed with Type 2 diabetes, the individuals most at risk for Type 2 diabetes are typically over the age of 40 and tend to sedentary and/or obese. African Americans, Hispanics and Native Americans are also at heightened risk.

How Diabetes Works

Every cell in the body uses glucose, a form of sugar, for energy. In order to access glucose in the bloodstream, the pancreas releases the hormone insulin. For various reasons, cells may become unable to recognize insulin or the pancreas may not make sufficient supplies. As a result, blood glucose levels soar and symptoms like fatigue, frequent urination, vision problems, and impotence may signal health complications that occurring in the body.

Long-term consequences of diabetes are serious. For example, the disease more than doubles the risk of heart disease or stroke. It may also lead to kidney failure, blindness, pain in the extremities, and other serious health issues.

Lifestyle Changes That Help

Now for the good news. Although there's no cure for Type 2 diabetes, eating a healthy, nutritious diet and exercising regularly can stop progression of the disease. What's a healthy, nutritious diet? For most people, that means fewer simple carbohydrates. In other words, leafy greens instead of French fries, fiber-rich brown rice rather than white, and a bowl of berries instead of a bowl of ice cream.

Keeping an eye on dietary fat sources is a good idea, too. Minimize intake of saturated and trans-fats, and choose olive oil instead whenever possible.

If excess weight is a problem, be sure to watch portion sizes. It's better to eat five or six small (200 – 300 calories) meals daily, than to overdo it with three large meals. Skipping meals is not recommended, either. Your body really functions best with a steady supply of nutrients throughout the day.

Exercise can be as simple as thirty minutes of walking most days of the week. (Be sure to consult your physician prior to starting an exercise program, especially if you've been sedentary or have other health issues.) Experts recommend gradually working up to more challenging activities, like cardio workouts.

Keeping Kids Diabetes Free

Like a majority of American adults, too many children are carrying excess weight that affects their health, particularly when it comes to developing diabetes. But new research shows there are ways to counteract this trend. For example, scientists at the Harvard School of Public Health found that just drinking one or two sugary beverages each day increases the risk of diabetes by 26 percent! Sodas weren't the only culprits; beverages like energy drinks, sweetened tea, vitamin water and fruit drinks were also linked to diabetes. Although the study focused on adults, children consume significant amounts of sugar-sweetened drinks, too, so replacing those with water could go a long way toward improving health.

For one thing, cutting back on sugary drinks would help with weight management, especially relevant since being overweight is linked to diabetes. Actively working to help young people achieve a healthy weight is a worthy goal. A new study published in the Journal of the American Medical Association found that teenage girls who are already obese have a 51% chance of becoming severely obese adults, while obese boys have a 37% chance. For parents who want to counteract this trend, it's important to focus on creating a “healthy household,” and stressing fresh, whole, low-fat, low-sugar foods and providing regular opportunities for movement.

In addition, childhood weight management may also require sufficient levels of vitamin D, as a new study from the University of Michigan found. Researchers found that children between the ages of 5 and 12 who had low levels of vitamin D gained weight faster than children whose levels of the nutrient were higher. A simple blood test can check for vitamin D deficiency. Follow your doctor's recommendations regarding supplement dosage. (Note: Even if your child's weight is normal, insufficient amounts of vitamin D have been linked a variety of health concerns, so testing is still recommended.)

Finally, don't overlook infant formulas as potential allies for children's health. Products made with goat's milk, for example, offer a superior form of protein, as well as minerals and immunoglobins that have a demonstrated ability to encourage healthy development of muscles, bones and the immune system, all vitally important to getting a good start in life. And, as we noted earlier, Type 1 diabetes is an immune system disorder.

Consider Supplements

Nutrients like chromium, alpha lipoic acid, vanadium, zinc and bitter melon may be helpful for individuals with diabetes. Combination formulas containing multiple nutrients, including these and others, are widely available; consult your physician for recommendations.

You may also want to speak to your physician about adding genistein, an extract from soy, to your daily regimen, especially if you're troubled by pain due to diabetic neuropathy or are concerned about vision issues associated with diabetic retinopathy. Three recent new animal studies have shown that genistein reduced pain and inflammation in both conditions.

With health care costs spiraling upward, getting a grip on the diabetes epidemic is more important than ever. Talk to your physician to learn more about what you can do to prevent or effectively manage this disease.