A call to action for diabetes prevention

According to a new study published in The Journal of the American Medical Association, almost 50% of American adults were found to suffer from diabetes or pre-diabetes. To reiterate, this is HALF of our adult population—29 million have diabetes and 86 million have pre-diabetes. There is hardly an American who does not either have the disease or its precursor, or knows someone with it.

These alarming findings are a national call to action to intensify widespread efforts to prevent Type 2 diabetes and its devastating complications. According to Dr. Loel Solomon, Kaiser Permanente's vice president for community health, "We can't treat our way out of the diabetes epidemic...[this] compels us to solve the problem upstream." Efforts must be on prevention, early detection and lifestyle changes.

Dr. Nina's What You Need To Know About Type 2 Diabetes and Prevention

What is diabetes mellitus?

A metabolic disorder where glucose cannot travel from the bloodstream into the cell and function as a fuel that gets converted into energy. There are two basic classifications of diabetes—Type 1 or insulin-dependent diabetes and Type 2 or non-insulin dependent diabetes which comprises 90% of all cases.

Both involve issues with insulin, a hormone that functions as the key to allow entry of insulin into the cell. In Type 1 diabetes, the pancreas does not make insulin, likely due to autoimmune destruction of insulin producing tissue. It is not preventable.

In Type 2 diabetes, either our body does not produce enough insulin or cells do not properly respond to insulin, known as insulin resistance. It can result from genetics, as well as poor diet, physical inactivity and obesity.

Pre-diabetes is a precursor of diabetes where people are experiencing insulin resistance. And according to The Centers for Disease Control and Prevention, only about 11% of pre-diabetics are aware of their status.

What are complications of diabetes?

Vision problems and blindness, stroke, heart disease, kidney disease and failure, limb amputations and impaired wound healing and immune system function. In fact, complications from diabetes is a leading killer that results in approximately 70,000 American deaths every year.

Why is screening important?

Early disease detection or pre-diabetes detection allows for the implementation of lifestyle changes that can reverse, prevent or delay diabetes. And for those with diabetes, it can prevent devastating complications. Speak with your healthcare provider in regards to your risk and testing.

What lifestyle changes can I make to prevent diabetes, decrease my chances of converting from pre-diabetes to diabetes, or stave off complications of diabetes?

• Physical activity—get moving! Regular physical activity can help lower blood sugars, lose weight, and boost insulin sensitivity (combats insulin resistance). Although recommendations vary, aiming for at least 30 minutes of moderate-intensity aerobic activity 5 or more days of the week is a good start. And we also need to be cognizant of inserting physical activity throughout our day. Sedentary activities such as sitting, which we do in classrooms, at work or while watching television can result in insulin resistance. Interrupting sitting time with a short walk or going up a flight of stairs can reduce the impact of prolonged sitting.
• Fill'er up with fiber—Fiber plays an impressive role for a material that does not get absorbed by our body. It is abundant in fruit, veggies, nuts and legumes and passes from our mouth to our porcelain bowl intact. In doing so, it adds bulk and provides a sensation of feeling full, resulting in decreased food and calorie consumption. Additionally, fiber can "soak" up sugar in the intestines preventing it from being absorbed and raising blood sugar levels.
• Maintaining a healthy weight—One study showed that lowering a pre-diabetic's weight by just 7% resulted in a 58% lower incidence of diabetes and a 39% lower incidence compared to treatment with diabetes medications. The science behind this is that fat cells send signals to other cells to decrease their insulin receptor activity, thereby causing insulin resistance. And, too, fat cells signal to our liver to increase glucose production. This combined effect leads to an increased concentration of glucose in the blood.
• Smoking cessation. One study showed that smokers are 30 to 40 percent more likely to develop Type 2 diabetes compared to nonsmokers. And diabetics who smoke have a difficult time controlling their blood sugar levels. Additionally, smoking, in and of itself, takes a toll on our heart, as well as the vessels that feed the brain, kidneys and eyes. The combination of increased blood sugar levels and the effects of smoking is like a one-two punch that can result in knocking out these organs.
• Quality sleep. Sleep deprivation elevates stress hormones which then go on to elevate blood sugar levels. Additionally, poor sleep elevates ghrelin levels, a hunger hormone. This increases our appetite for high-calorie and high-fat foods. And if that's not enough, a sleepy brain results in a reduction in rational decision-making abilities. We become less likely to reign in our impulse to consume unhealthy foods.

Knowing what diabetes is, getting screened when appropriate, and implementing lifestyle changes are keys to success when it comes to combating the disease. With half of the American adult population affected by it, we need to take steps individually, as families, and communities to tackle it and prevent its complications.

I have addressed Diabetes before – and it bears repeating to help clarify and reinforce that we can take actions to help reduce diabetes. There is urgency in this message as diabetes has risen so sharply that it is now commonly referred to as an epidemic. The importance of addressing risk factors (pre-diabetes, hypertension, dyslipidemia and obesity) cannot be overstated – and equally important is a call to action to each of us to do our part in helping to prevent and treat these conditions. Lifestyle modification with attention to a healthy weight and physical activity is paramount. Bottom line, the growing prevalence of obesity and physical inactivity threatens to undermine all of our recent gains to prevent and control chronic disease – take action, today! With relentless determination we can and will make a difference to diabetes for current and future generations. This is a battle we must all take action to win.

This article is for general information only and should not be used for the diagnosis or treatment of medical conditions and cannot substitute for the advice from your medical professional. Dr. Nina has used all reasonable care in compiling the current information but it may not apply to you and your symptoms. Always consult your doctor or other health care professional for diagnosis and treatment of medical conditions or questions.

Dr. Nina Radcliff is dedicated to her profession, her patients and her community, at large. She is passionate about sharing wise preventive health measures.