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Avoiding Diabetes

The worldwide type 2 diabetes epidemic has been thoroughly documented.1,2 Yet despite extensive study and analysis, there has been little actual progress in slowing the spread of this chronic disease. Numerous medications such as metformin and glyburide are available to help counter the severe problems that result from unchecked diabetes. But if the person with diabetes doesn't assist in the process of getting well, the disease will continue on its unrelenting course. There are many important steps a diabetic patient can take to improve his or her health status. Better still, these same steps may be implemented by healthy persons to ward off type 2 diabetes in the first place.

In type 2 diabetes, the cells of your body become resistant to the effects of insulin. Normally, the hormone insulin promotes the absorption of glucose from the blood by muscle cells and fat cells. With insulin resistance, glucose fails to be properly absorbed by these cells and blood levels of glucose rise. Over time, some of this excess glucose is converted into fat, increasing the person's weight, causing high blood pressure, and placing undue stress on the heart. Further, prolonged exposure to excess glucose damages small blood vessels and nerve fibers, leading to significant pain along large nerve tracts (neuropathies), loss of circulation to and even amputation of a lower limb, kidney disease, kidney failure, eye disease, and blindness.

Thus, diabetes can be devastating for both patients and their families. The annual public health costs related to diabetes treatment are huge. Diabetes costs in the U.S. were $245 billion in 2012, representing $176 billion in direct medical costs and $69 billion in lost productivity. Worse, in 2012, 9.3% (29.1 million) of Americans had diabetes, up from 8.3% (25.8 million persons) in 2010. Costs of diabetes to patients, families, and society continue to rise.

The only feasible method of combating the worldwide diabetes epidemic focuses on individual initiative. Medical treatment, by definition, arrives after the fact, typically years after the diabetes process has been set in motion. Prevention is the best strategy. Adopting a lifestyle that, indirectly, leads to appropriate utilization of insulin rather than insulin resistance offers a real, effective solution to diabetes prevention. More than 20 years of research has demonstrated that 30 minutes of vigorous exercise a day, combined with a healthy diet and sufficient rest, will substantially assist a person in avoiding chronic diseases such as diabetes.3 Personal accountability and personal responsibility are called for. It is up to each of us to make such choices in the best interest of ourselves and our families.

1Vollenweider P, et al: HDLs, Diabetes, and Metabolic Syndrome. Handb Exp Pharmacol 224:405-421, 2015
2Skrha J: Diabetes mellitus--a global pandemic. Keynote lecture presented at the Wonca conference in Prague in June 2013. Eur J Gen Pract 20(1):65-68, 2014
3Orio F, et al: Lifestyle changes in the management of adulthood and childhood obesity. Minerva Endocrinol 2014 Dec 17. [Epub ahead of print]

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