Health

Preventing the future diabetes epidemic

By DR. DAVID LIPSCHITZ, Special to the Times
Published March 27, 2007

Within the near future, the number of people who are 85 years old will double - and eventually it will triple. Currently, about half of this "oldest old" population is dependent upon others and uses a large percentage of health care resources. Should this be true for the tens of millions of baby boomers, a national crisis will result.

To make matters worse, if our population continues to become more overweight, the increased incidence of adult-onset diabetes will wreak havoc on the health care system.

Recently, New York issued the results of its first Health and Nutrition Examination Survey, which found that 12.5 percent of New Yorkers have diabetes. Of these, 3 percent, or 207,000 individuals, were unaware they had the disease.

About 23.5 percent of that population had "prediabetes," defined by an elevated fasting blood sugar. Without intervention, these subjects will almost certainly develop diabetes during the next few years.

These results are much higher than those of a nationwide Health and Nutrition Examination Survey completed about four years ago, which indicated a national incidence of clinically diagnosed diabetes of about 7 percent.

A health crisis looms

But I suspect that if the national study were conducted now, results in many parts of the nation would be worse than New York's.

We are facing a health crisis of enormous proportions, and the cause is clear: A higher rate of obesity, combined with a sedentary lifestyle, leads to diabetes in individuals who are predisposed to developing the illness.

Fortunately, diabetes can be prevented by weight loss and exercise. The journal Diabetes Care recently published a study that examined the relationship between risk of diabetes and exercise and weight. More than 68,000 women participated in the study of nurses' health. The findings:

The risk of diabetes was 16 times higher in sedentary, obese women. But the risk was reduced to 10 times higher if they exercised. And sedentary, thin women had a two-fold higher risk of developing the disease than thin women who exercise.

The researchers concluded that controlling obesity was more important than exercise in preventing diabetes.

Obesity leads to a condition called insulin resistance, which means that a greater amount of insulin must be produced by the body to bring the blood sugar into normal range. If the body is unable to produce sufficient insulin, the blood sugar rises excessively and diabetes develops.

This in turn leads to heart attacks and strokes, blindness, kidney disease, an array of neurological conditions, loss of sexual function and a high risk of foot ulcers that can eventually result in amputation.

Heading off diabetes

While that large-scale study found that nutrition and obesity played a stronger role than fitness and exercise in developing diabetes, I still believe it is important for anyone at risk of developing the disease to embark on a rigorous exercise regimen.

Muscle is the most metabolically active tissue in the body. Increasing muscle mass increases the body's ability to clear glucose and reduce insulin resistance. This can be best achieved by exercising vigorously with weights, which will build muscle and reduce fat.

If you have already been diagnosed with diabetes or prediabetes, your condition may be reversed by combining exercise with an appropriate diet. A great example of this reversal is former Arkansas Gov. Mike Huckabee, who was overweight and diabetic.

He began a strict exercise and running regimen. Having now lost 100 pounds, he runs marathons and no longer has any evidence of diabetes.

Huckabee's future likely holds a longer, better life.

A comprehensive approach is the key to reducing your risk of diabetes. Live a healthy lifestyle - eat right, exercise with weights, be an educated consumer of health care - and you can prevent this devastating disease.

Gerontologist David Lipschitz holds both a medical degree and a Ph.D. and is the author of "Breaking the Rules of Aging." Write to him at askdrdavid@msn.com His Web site is www.drdavidhealth.com.

[Last modified March 27, 2007, 08:12:22]