We Do Have an Epidemic: Diabetes

29 million Americans have diabetes. Here’s how to avoid becoming one of them.

Posted Oct 16, 2014

The word “epidemic” is thrown around too loosely.  Today it’s the “Ebola epidemic.”  Years ago, it was the “bird flu “epidemic.” While these illnesses are dangerous (Ebola is associated with an extremely high mortality), “epidemic” has a specific meaning and, therefore, real-world implications for you as an individual.

According to Merriam-Webster, epidemic means, “affecting or tending to affect a disproportionately large number of individuals within a population...”

By this definition, diabetes is an American epidemic.  More than 29 million Americans, greater than 9% of us, are diabetic, and close to two million new cases are added annually.  And get these numbers:  one in ten people age 20 or older and one in four age 65 or older suffers from diabetes.  One in four!

Diabetics suffer from numerous serious, life-impacting complications, including heart attack and stroke; non-healing leg and foot ulcers (increasing a diabetic’s amputation risk 25-fold); kidney failure (requiring dialysis); and blindness.

Not to mention having to regularly stick your fingers to check your blood sugar level, taking pills, and/or injecting yourself with insulin.

Sounds glamourous, huh?

But you can avoid becoming a diabetic epidemic statistic, and even many of you who have diabetes can reduce or end your dependence on pills and insulin.  In order to understand how, you first need a very brief primer on what diabetes is…

The cells of your body depend on two types of fuel to survive and function:  glucose (a simple sugar) and fat.  Even if you don’t eat sweets, you always have sugar (glucose) in your blood, as glucose also comes from the breakdown of carbohydrates found in pasta, bread, cereal, potatoes, corn, flour, and many, many other foods.   Insulin is the critical hormone which tells your cells to take in that circulating glucose for use as energy.  Insulin is produced and released into your bloodstream from the pancreas, an organ nestled deep within your abdomen.

About 10% of diabetics suffer from Type 1 diabetes, in which the pancreas does not produce enough insulin, so the body’s cells do not take in enough glucose, and excess glucose is left circulating in the bloodstream (“high blood sugar”) while the cells starve.  Currently, there is no known prevention for Type 1 diabetes, and these folks depend on insulin injections for survival.

However, over 90% of diabetics suffer from another form, Type 2 diabetes.  In Type 2 diabetes, the cells of the body develop resistance to (that is, they ignore) insulin.  The cells ignore circulating insulin and thus fail to take in enough glucose, again resulting in high blood sugar levels and starving cells.  Many medications for Type 2 diabetes aim at increasing cell responsiveness to insulin.

But what has this got to do with you avoiding becoming one of the millions of diabetics?  Here’s the scoop:  Type 2 diabetes is directly related to lifestyle choices.  While genetics play a role in your risk, there are clear, significant links between your behavior and your risk of developing Type 2 diabetes.

Likely the strongest risk factor for Type 2 diabetes is obesity.  Research suggests that the diets of heavy individuals alter cell function, ultimately reducing cells responsiveness to insulin.  Not surprisingly, two other significant risk factors are a poor diet and minimal physical activity.

So now you can guess the good news:  you can likely avoid becoming a Type 2 diabetic.  Avoid diabetic heart disease and stroke.  Avoid leg amputation and blindness.  Avoid kidney failure and life-long dialysis.

I’m not talking about unrealistic lifestyle changes. You don’t need to start going to the gym daily at sunrise for two hours of weights.  You don’t need to abandon all good-tasting food and commit to an all-vegetable diet.  Such unrealistic behavioral changes are at best short lived.  But you can incrementally change your behavior, taking small bites at a time (pun intended), and decrease your weight, increase your physical activity, and improve your diet.  And by doing so, you’ll truly decrease your risk of becoming a diabetic.

If you are currently overweight (a little or a lot), you can start making small lifestyle changes today which will help ward off Type 2 diabetes.  Rarely (or never) exercise?  Start slowly by walking on a level sidewalk or path for just 30 minutes a day, three times a week.  Not a sprint.  Not a jog.  Just a walk.  And if this is too much, don’t be embarrassed.  Reduce your walk time by a few minutes, and be proud that you’re taking ownership of your health and beginning your quest toward regular activity.  If 30 minutes thrice weekly is too easy, go for forty minutes or four times a week or include a small hill.

You don’t have to go crazy to begin owning your health and avoiding a diabetic future.  Be your own coach:  never make it so hard that you’ll fail and give up, nor too easy that it’s not (or no longer) physically challenging.  And if you aren’t a good self-coach, convince your husband, your friend, your neighbor, your grocer to join you.  You’ll be amazed that in a short time, you’ll have pushed yourself to longer, more challenging walks (or bike rides or runs) that you never would have believed you could do.  And if you are not overweight but rarely or never really exercise, you too should begin slowly and then steadily up the ante in order to prevent future weight gain and subsequent diabetes (you don’t honestly think all those older diabetics were obese as thirty-somethings, do you?).

At the same time, take the same approach to easing your way into a better diet.  Few of us can simply go cold turkey by giving up turkey (and fries and pasta and…).  Just start slowly, steadily pushing yourself over the months ahead.  Replace a fatty portion of a meal with fresh fruit or veggies.  Replace a second serving of pasta or potatoes with something whole grain (or, better yet, with no seconds).  Work your way to a more balanced diet, one that allows you the pleasure of bacon or fries or chocolate but is not only bacon and fries and chocolate.

And if you already have Type 2 diabetes, there’s still good news: studies show that as many as 20% of Type 2 diabetics can reduce or even completely come off their diabetes medications with weight loss, increased physical activity, and a healthier diet.  Talk about your second chances!

So that’s how you can avoid becoming (or remaining) a victim of the diabetes epidemic.  And get this:  these lifestyle changes will make you feel better, too!