Diabetes is running rampant in America. In 2004, the Department of Health and Human Services estimated that every 25 seconds, someone in America is diagnosed with diabetes. In 2005, the Centers for Disease Control and Prevention (CDC) estimated that 20.8 million Americans have diabetes – 7 percent of the population.According to the CDC, diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both. Insulin is a major component of the digestive process. When we eat, the liver converts carbohydrates into glucose. At the same time, the pancreas produces insulin. Both insulin and glucose are distributed throughout the body through the blood stream. Brain and muscle cells use insulin to absorb glucose, which the cells burn for energy.The CDC describes the four types of diabetes:
- Type 1 diabetes develops when the body’s immune system destroys the cells in the pancreas that make insulin. According to the CDC, this form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes may account for 5-to-10 percent of all diagnosed cases of diabetes. Risk factors for Type 1 diabetes may include autoimmune, genetic and environmental factors.
- Type 2 diabetes usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the cells need more insulin to absorb glucose, the pancreas gradually loses its ability to produce insulin. Type 2 diabetes has been associated with obesity, physical inactivity and increased age but is increasingly being diagnosed in children and adolescents. Type 2 diabetes may account for about 90-to-95 percent of all diagnosed cases of diabetes.
- Gestational diabetes is a form of glucose intolerance that occurs in some women during pregnancy. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5-to-10 percent of women with gestational diabetes are found to have Type 2 diabetes. Women who have had gestational diabetes have a 20-to-50 percent chance of developing diabetes in the next five to 10 years after pregnancy.
- Other types of diabetes result from specific genetic conditions, surgery, drugs, malnutrition, infections and other illnesses. Such types of diabetes may account for 1-to-5 percent all diagnosed cases of diabetes.
According to the National Institutes of Health, the symptoms of Type 1 diabetes include increased thirst, weight loss in spite of an increased appetite, nausea, vomiting and abdominal pain. These symptoms are so sudden and severe that Type 1diabetes rarely goes undiagnosed for more than a few weeks.Type 2 diabetes often goes undetected for years because its symptoms – increased thirst, urination and appetite; fatigue, blurred vision and frequent or slow-healing skin infections advance slowly. Type 2 diabetes is most often diagnosed by a doctor as part of a routine physical exam that includes a fasting blood glucose test. The American Diabetes Association estimates that 6.2 million Americans have Type 2 diabetes and don’t know it.Researchers at the NIH have found that 80 percent of people with Type 2 diabetes are overweight. Scientists suspect that being overweight causes cells to change, impairing their ability to use insulin to absorb glucose from the blood stream. The HHS states that people are overweight because they eat too many calories and don’t get enough exercise.Like medical professionals nationwide, Jean Baumann, a nurse at the Penrose St. Francis Diabetes and Renal Care Center in Colorado Springs, is seeing more and more overweight kids with Type 2 diabetes. She said she attributes this trend to “processed food and fast food,” adding that “kids today are more sedentary.”The ADA suggests losing weight through a combination of increased physical activity and dietary changes to prevent heart and kidney disease, blindness and circulatory system damage that is characteristic of late-stage Type 2 diabetes. The CDC has found that exercise and weight loss also can prevent or delay the onset of Type 2 diabetes among high-risk adults.The ADA recommends that pre-diabetics, diabetics and adults aim for a minimum of 30 minutes of any exercise that “increases your heart rate and causes you to break a light sweat most days.” That includes walking, gardening, yard work and swimming. The ADA also recommends 60 minutes of exercise each day for children and teens.Any exercise program should be gradual, starting slowly with perhaps three 10-minute walks per week, eventually increasing the time and the number of walks.Along with exercise, dietary changes are key to preventing and controlling diabetes. To prevent heart disease, traditionally the ADA has recommended a low-fat diet and a balance of proteins and carbohydrates with a focus on vegetables that include spinach, broccoli, cabbage, cauliflower, carrots, tomatoes and brussel sprouts.New nutritional research, however, has shown that a low-carb diet may be more beneficial than the traditional ADA low-fat diet. The ADA has posted on its Web site the results of a Swedish study of obese patients who switched from a low-fat diet to a low-carb diet. After 22 months, the patients’ glucose tests showed marked improvement. The ADA now acknowledges that “foods high in carbs – bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas and sweets – raise your blood sugar levels the most.”Margo Gasta, a registered dietician in Monument, agrees. She uses a holistic approach to guide her clients to reduce their carbohydrate intake, but also advises that they make room for the occasional favorite high-carb food to avoid feeling deprived and the need to binge. “Everyone has foods they like and don’t like, so each person needs a plan tailored to their individual preferences,” Gasta said. She also recommends taking magnesium and B vitamins, as well as fish oil and fiber supplements to improve cardio-vascular health. “Exercise is really important, too,” she added. “The more muscle mass you have, the less insulin resistance you have.””It has to be about carbs,” Baumann said, but she said a diet like Atkins, which promotes a diet of protein, is “not a healthy way to go.””You need carbs for brain power,” she said. “Our philosophy is to make the patients in charge of diabetes.”
Lessons for mitigating diabetesThe Department of Health and Human Services has noted that about 40 percent of American adults from age 40 to 74 are “pre-diabetic,” and many of them will develop diabetes within 10 years. “Recent studies have shown that people with pre-diabetes can successfully prevent or delay the onset of diabetes by losing 5-to-7 percent of their body weight,” said Dr. Frank Vinicor, director of the CDC’s diabetes program.That 10 to 15 lbs. can reduce the risk of developing diabetes by 58 percent, according to the ADA.
Diabetes resourceswww.cdc.govwww.diabetes.orgwww.diabetes.org/all-about-diabetes/chan_eng/i3/i3p4.htmto “Rate Your Plate”
www.diabetes.org/risk-test.jsp to assess diabetes risk
www.hhs.govwww.nlm.nih.gov
