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The most troubling news about diabetes is that one major form of the disease (called Type II diabetes) has reached epidemic proportions. Why? Obesity is a major risk factor for this type of diabetes and, unfortunately, increasingly more Americans--including children--are too sedentary and too fat. Between 1990 and 1998, the incidence of diabetes increased 40 percent for people in their 40s; |
for people in their 30s, it went up nearly 70 percent, according to the Centers for Disease Control and Prevention. Although an estimated 16 million Americans have diabetes--a defect in the body's use of the hormone insulin--only half of them have been diagnosed with the disease. Furthermore, many people who are aware of their condition do not take it seriously enough, and they develop severe complications.
The facts and figures concerning diabetes are sobering. The disease is the leading cause of adult blindness in the United States and the single leading cause of kidney failure and non-traumatic amputations. Diabetics are at high risk for cardiovascular disease and have three times the normal risk of dying from stroke. This year alone, 160,000 Americans will die from diabetes. The condition costs the U.S. an estimated $98 billion in health care costs and lost productivity annually.
What is tragic about all this is that diabetics can live longer, healthier lives and significantly modify health problems associated with their disease by using intensive diabetes self-management strategies that include following a program of nutrition, exercise, medication and self-monitoring with the guidance of a health-care team. In other instances, diabetes can be avoided altogether by controlling weight and following diet and exercise recommendations.
What Is Diabetes?
When we eat, our body normally turns food into glucose (the sugar cells use for fuel), and a hormone called insulin helps the glucose get into body cells. In diabetes, however, too much glucose stays in the blood. As a result, two problems occur: body cells become starved for energy, and, over time, the high glucose levels can damage the nerves, eyes, kidneys, heart and blood vessels.
There are two main kinds of diabetes:
- The most common form of diabetes, accounting for 90 to 95 percent of all cases, is noninsulin-dependent diabetes (type II diabetes). People with this condition either don't produce enough insulin to control glucose levels or their cells simply do not respond to the insulin.
- Insulin-dependent diabetes (type I diabetes) is much less common but more severe. This condition is caused by damage to the pancreas, an organ near the stomach that contains beta cells, which produce insulin. Many things can destroy beta cells, but in most people with insulin-dependent diabetes, a glitch in the immune system causes it to attack the beta cells. Without insulin-producing beta cells, glucose builds up in the blood.
What is Insulin Resistance and Syndrome X?
Normally, the hormone insulin helps blood glucose enter body cells. But in some people with a genetic susceptibility--especially if they're overweight or inactive--the cells are unresponsive to the hormone, so the pancreas produces even more insulin to keep a lid on glucose in the blood. That excess insulin appears to cause Syndrome X, a metabolic disorder that increases the risk of developing diabetes as well as hypertension, heart disease and stroke. It may also lead to cancer because insulin can help make cells grow. In fact recently, Canadian researchers reported that women with breast cancer and high levels of insulin who received treatment were about eight times more likely to develop a recurrence and die of the cancer than women who had normal insulin levels.
Many people with insulin resistance (which may affect as many as 30 percent of all adults) also have a genetic flaw in their pancreas so that over time it fails to dispatch enough insulin to control glucose levels in the blood. The rising blood-sugar levels then result in type 2 diabetes. In order to nip this destructive chain of events in the bud, medical experts now encourage more glucose testing to catch and treat even slight blood sugar elevations.
There is a controversial theory concerning what types of food best control elevated insulin and glucose levels. Some experts argue that the traditionally recommended low-fat, high carbohydrate foods actually fuel the problem. They suggest increasing natural foods (legumes, fresh fruits and vegetables, whole grains, lean proteins like chicken and fish) and curbing starchy or refined carbohydrates (potatoes, rice, pasta, pretzels, bagels, rolls, white flour, cake, cookies, jams, soft drinks, sugar, fruit juices and alcohol). Meal planning to control diabetes is quite complex and requires that diabetics work closely with their dietitians and doctors.
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