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Facing America's Diabetes Epidemic

Dr. Manny Alvarez

A recent study has linked type 2 diabetes with a higher incidence of breast cancer among women, adding to the already large pile of health problems that have been linked with the chronic disease.

The statistics for Type 2 diabetes are staggering. There are more than 20 million Americans with Type 2 diabetes, a high sugar condition caused by poor nutrition, being obese, and a lack of exercise—factors that can all mostly be prevented.

About two-thirds of the people with Type 2 diabetes have been diagnosed, which leaves about 6 million people walking around with undiagnosed diabetes. That’s a huge number of people who have a very serious disease and don’t know it. And that makes Type 2 diabetes, like hypertension, another silent killer.

Unlike Type 1 Diabetes, Type 2 diabetes is not a failure of the pancreas, but an inability to produce adequate amounts of insulin for a body that is out of control. On top of that, the insulin that is being produced is not acting the way it should, a situation called insulin resistance that occurs when the insulin can no longer stimulate the cells to process the sugar in the blood. This causes the sugar to build up in the blood, ultimately doing damage to the heart, eyes, and kidneys, and creating small-vessel disease.

Type 2 diabetes is now an epidemic, and if not corrected in this generation, it will probably be responsible for most of the strokes, hypertension, and cardiovascular disease that we will encounter in our sixties and seventies. Type 2 diabetes is especially common among African Americans, Latinos, Native Americans, and certain Asian populations.

Most people develop Type 2 diabetes because they are overweight. Basically the human body does two things: it takes in calories, and it burns calories. When you consistently bring in more calories than you burn off, all those extra calories turn into fat. That fat first gets stored in the abdomen and the intestines, and then it begins to infiltrate the muscle mass of our body. And what you end up with looks very much like a marbleized piece of sirloin that you see at the butcher shop. That marbleization is one of the hallmarks of people with Type 2 diabetes.

If you keep piling on the extra calories, the pancreas, whose function begins to slow down anyway with age, is no longer able to meet the demand for large quantities of insulin needed to metabolize all that sugar in the blood.

If you were to lose weight, a significant amount of weight, I mean, your Type 2 diabetes could disappear almost overnight. Yes, it’s that simple. I, myself, was a diabetic. I had very elevated sugars. I was overweight, excessively stressed, and exercise-phobic. I had a very clear, black-and-white case of Type 2 diabetes. So I lost 50 pounds; I now exercise three times a week, and I’ve maintained that weight loss.

Today, I am no longer diabetic. If, like me, you have not had Type 2 diabetes for very long, and if you can overcome it by simple weight loss, you will end up with no permanent damage to your organs.

If you have any choice in the matter, diabetes is a road you don’t want to go down. Just to give you an idea, here are a few numbers:

—Heart disease from diabetes accounts for 65 percent of deaths in diabetics.

—The risk of stroke is two to four times higher in diabetic patients than in nondiabetics.

—Seventy-three percent of adults with diabetes have hypertension.

—Diabetic retinopathy, which is damage to the vessels of the retina, creates about 24,000 cases of blindness in America every year.

—Diabetes is the leading cause of kidney failure.

—One-third of people with diabetes have gum disease.

—About 10 percent of pregnant women who are diabetic may experience a spontaneous abortion or have children with major birth defects, including spina bifida.

—About 82,000 people lost a foot or a leg last year because of diabetes.

The list of damage diabetes does to the body is virtually endless. If you are a diabetic, you must learn to prevent complications and stay ahead of the game. Being a diabetic is a full-time job, and there are several measures you will have to take to ensure you keep your health on track.

—You will constantly have to monitor your cardiovascular risks by monitoring your blood pressure and keeping it under control.

—You will have to watch your cholesterol levels.

—You will have to visit your ophthalmologist regularly to ensure you don’t development retinopathy.

—You will need very comprehensive dental and foot care.

But, most important, you will have to monitor and control your sugar levels. Several times a day you must take a glucose reading either by using Accu-Chek or doing a finger prick. You will look at your morning sugar and at your sugar two hours after you eat. For the most part you want your morning sugar to be less than 100 milligrams per deciliter, and you want your postdinner values, usually two hours after you eat, to be 120 and 130 milligrams per deciliter.

If your sugar is high, you will need either to inject yourself with insulin or to take an oral hypoglycemic. This kind of supply-and-demand treatment model may soon give way to more convenient methods, made possible by new research into diabetes. Devices are now being developed in which a sensor that continuously monitors your sugar levels triggers a tiny pump when your blood sugar is elevated to release small doses of insulin.

Other new research is focusing on the possibility of transplanting the pancreatic cells, called isolet cells, into those who need them, in the hope of restimulating insulin production inside their body and minimizing the amount of insulin that needs to be injected. The hope is that this research will one day lead to a cure, whereby insulin will once again be naturally produced in the body. But as of right now, diabetes is not cured; it is treated.

Diabetes can be managed. Ultimately, if you’re talking about juvenile diabetes and you start very early in the game by getting diagnosed and getting effective treatment, you can probably expect a normal life expectancy, but it’s a very dedicated type of life.

If you are now in your forties and you develop Type 2 diabetes, and you continue for a decade or more without any checks and balances, it’s very unlikely that you’ll make it into your late seventies or eighties. There’s just not enough time in the pot. In other words, if you are 40 years old, 50 or more pounds overweight, with high blood sugar levels and high cholesterol, and you don’t exercise and you don’t watch what you eat, you will without doubt see the effects 10 to 15 years from now.

By the time you’re in your sixties, you will most likely have hypertension, stroke, and cardiovascular disease. Don’t go there.

Ask Dr. Manny: Sweet Questions

“I’m a fifty-five-year-old woman with two married daughters. We all have a sweet tooth in our family, and I’m worried that we might all become diabetic. Can people who eat a lot of sweets become diabetic?”

No. If you exercise and for the most part follow a balanced diet, you can like sweets and not become diabetic.

“Can people with diabetes eat sweets?”

If it’s part of a healthy lifestyle involving a good diet and exercise, a diabetic can eat sweets.

“Can you catch diabetes from someone else?”

No, though some people think they can. Diabetes is probably largely a matter of genetics for Type 1 and lifestyle factors for Type 2.

“Are people with diabetes more likely to get colds or other illnesses?”

No. Your immune system is not compromised when you have diabetes. However, people with diabetes should get regular flu shots because any infection can interfere with blood-sugar management.

Dr. Manny Alvarez serves as FOX News Channel's (FNC) Senior Managing Editor for Health News. Prior to this position, Alvarez was a FNC medical contributor.
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