The latest numbers from the American Diabetes Association (ADA) show that about 24 million people have diabetes, and an estimated 1.6 million more are diagnosed with it each year. But in many cases, the disease is avoidable with a commitment to lifestyle change.
An unbelievable 57 million Americans have pre-diabetes, which will most likely lead to Type 2 diabetes if not taken care of. “If those who are at-risk get fit, lose weight and start living healthier lives, they can make that risk disappear,” says Dr. H. Thomas Johnson, a SLUCare family physician. With Type 2 diabetes, the body does not produce enough insulin, or it becomes resistant to the insulin, Johnson explains. “Insulin helps regulate carbohydrates in the body. They can build up in certain areas and lead to complications.”
The typical diabetic is overweight and has a family history of the disease. “If you are 45 or older, have high blood pressure or abnormal cholesterol, and get no regular exercise, you are at an increased risk,” Johnson says, noting that diabetes is more prevalent among certain groups, including African-Americans, Asian-Americans and Latinos. Another risk factor is gestational diabetes, developed by about 4 percent of women during pregnancy. For those who have traits that fall under the high risk group, Johnson suggests using the risk calculator on the ADA’s Web site. “If you enter your information and family history, the calculator can tell you what your risk is of developing diabetes,” he explains.
Diabetes, along with high blood pressure and cholesterol, increases the risk of heart attacks and strokes, Johnson says. “You definitely don’t want to smoke,” he adds. “Smoking doesn’t cause you to have diabetes, but it can result in the same complications linked to diabetes, such as heart disease. Drinking excessively increases that risk as well.”
There are many ways to make that risk disappear, or at least delay the onset of diabetes, according to Dr. Humaira Naseer, a Missouri Baptist Medical Center endocrinologist. Being overweight or obese is one of the biggest obstacles to avoiding diabetes. “Pay attention to waist circumference,” she says. “Make changes if your waist is greater than 35 inches (for females) and more than 40 inches (for males).”
Lifestyle modification should be first and foremost, Naseer says. “There have been certain trials in which those at high risk for diabetes have sharply lowered their risk (by almost 60 percent over three years) by losing weight and following a healthy diet,” she says. Certain medications like Metformin or Glucophage also have been shown to delay the onset of the disease.
Once someone develops diabetes, the aim is to avoid the ensuing complications. “They are divided into two groups,” Naseer explains. “Microvascular diseases include anything related to the eyes, nerves and kidneys. Macrovascular affects the heart—heart attacks and strokes.” She says controlling blood sugar levels under a doctor’s care can have a major impact on managing the disease. “The risk of microvascular diseases can go down by 10 percent; macrovascular, by 20 percent.”
In addition to physicians, other health professionals also play a key role in helping to successfully manage or ward-off diabetes. Dotti Durbin is a diabetes educator and registered nutritionist at Washington University Heart Care Institute. She sees people who are at risk for developing Type 2 diabetes as well as those who have already been diagnosed with it. “We talk about strategies for reducing risk, which include weight management,” she says. “Reducing even a small of amount of weight (10 to 15 pounds) is important.” As for exercise, Durbin suggests starting with 15 to 30 minutes a day, then building up to 30 to 60 minutes most days of the week.
Eating healthier is another focus of diabetes prevention. “As a dietitian, I focus more on which foods are missing, in terms of making people’s diets healthier,” Durbin says. “Better choices include more whole grain, whole fruits and vegetables.” She also emphasizes low-fat and high fiber meals and portion control. “We are so indoctrinated, especially in a restaurant setting, to eat larger portions,” she says. “It’s so easy to eat beyond what we really need. A good strategy is to use smaller plates.”
Many households also struggle with planning good meals. “As we go on with the business of our lives, it’s challenging for many families to plan and prioritize when it comes to purchasing and making healthy meals,” Durbin says. “But if you educate yourself, there are easier ways to put good food on the table.”