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    A Times Editorial

    Dealing with diabetes

    © St. Petersburg Times, published August 27, 2000

    Call it the couch-potato plague, although there is nothing amusing about the affliction. Diabetes cases in the United States have increased by one-third over the past eight years, frustrating public health officials because the disease is largely preventable. Not only are more Americans diagnosed with diabetes each year, but they are getting it at a younger age. Much of the increase can be attributed to obesity.

    More diabetes cases in the future means more blindness, more kidney failure and more cardiovascular disease. That is particularly alarming because the disease already strains our health care system.

    "We're having enough trouble taking care of people with diabetes today," said Dr. Frank Vinicor, director of the diabetes division at the Centers for Disease Control and Prevention and author of the latest diabetes study.

    It is important to differentiate between the two types of diabetes. Type 1 (also called insulin-dependent diabetes) can strike children or adults, usually because the body's immune system mistakenly destroys the insulin-producing cells of the pancreas; it accounts for only about 5 percent of diabetes cases. Type 2 occurs when glucose (sugar) levels in the blood increase and the body either cannot produce enough insulin or ignores the insulin; this condition is treated with diet, pills or insulin injections and accounts for about 95 percent of diabetes cases.

    In the past, Americans didn't get type 2 diabetes until they were past 45. Now, doctors increasingly see the disease in 30-year-olds, and even teenagers are diagnosed with type 2 diabetes.

    The main cause is obvious: obesity. With our high-calorie diets and sedentary lifestyles, Americans are growing fatter and putting more stress on their bodies. Over the past eight years, the percentage of overweight Americans increased from 44 percent to 54 percent, while the occurence of diabetes rose even faster, from 4.9 percent to 6.5 percent -- a 33-percent increase. There are 13-million to 16-million diabetics and an estimated 5-million undiagnosed cases.

    The American Diabetes Association has put a price tag of $98-billion a year on the direct and indirect costs of diabetes. Misery and the declining quality of life caused by the disease cannot be measured.

    What's to be done?

    "If we saw a 33 percent increase in infectious diseases like tuberculosis or AIDS, I believe there would be an understandable demand for action," said Dr. Vinicor. "We can't just view inactivity and overweight as purely a kind of cosmetic thing. It's got to be viewed as a serious public health issue."

    That means more public awareness and self-discipline are needed. President Clinton says he will seek $300-million over the next five years for research and education on both types of diabetes. Congress should give the request prompt consideration.

    We can do our part as well. Every pound of excess weight increases a person's chance of developing type 2 diabetes by 4 percent. Those diagnosed with diabetes and those at risk should reduce their calories, eat a low-fat diet and exercise more. Even short walks each day can make a difference. We are all soldiers in the war against diabetes.

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