The worldwide epidemic of Type 2 diabetes is a “public health humiliation,” the editors of the esteemed medical journal The Lancet argue in this week’s diabetes-themed issue.
The journal’s lead editorial argues that Type 2 diabetes is largely rooted in reversible social and lifestyle factors that a medical approach alone is unlikely to solve.
“The fact that Type 2 diabetes, a largely preventable disorder, has reached epidemic proportion is a public health humiliation,” the editorial says.
The issue includes studies, which will also be presented at this week’s meeting of the American Diabetes Association in Orlando, Fla., that describe advances in drugs as well as a greater understanding of the disease and the control of blood glucose levels.
“But there is a glaring absence,” the editorial argues, ” no research on lifestyle interventions to prevent or reverse diabetes. In this respect, medicine might be winning the battle of glucose control but is losing the war against diabetes.”
The journal calls for a collective approach to boost opportunities for physical exercise and reduce the abundance of calorie-rich foods.
Reducing the burden of diabetes requires a major change in diet and routine, the editorial argues. The authors praise First Lady Michelle Obama’s Let’s Move campaign, which includes nutrition, activity and child health components.
The editorial also endorses the U.S. Department of Agriculture’s new guidelines, which aim to shift Americans’ eating habits toward plant-based diets.
Urban recreation that is readily accessible, affordable and includes safe areas for children is also a must, particularly in Asia and sub-Saharan Africa, which are experiencing large migrations from rural areas to urban centres, the editors noted.
via CBC News – Health – Type 2 diabetes a public health disgrace: Lancet.
]]>Great background article on diabetes and how lifestyle changes can reverse and prevent this disease.
Diabetes is not reversible and controlling your blood sugar with drugs or insulin will protect you from organ damage and death. That is what the medical profession would have you believe, but medication and insulin can actually increase your risk getting a heart attack or dying. The diabetes epidemic is accelerating along with the obesity epidemic, and what you are not hearing about is another way to treat it.
Type 2 diabetes, or what was once called adult onset diabetes, is increasing worldwide and now affects nearly 100 million people — and over 20 million Americans.
We are seeing increasing rates of Type 2 diabetes, especially in children, which has increased over 1,000 percent in the last decade and was unknown before this generation. One in three children born today will have diabetes in their lifetime.
Yet this is an entirely preventable lifestyle disease.
In a report in The New England Journal of Medicine, Walter Willett, MD, PhD, and his colleagues from the Harvard School of Public Health demonstrated that 91 percent of all Type 2 diabetes cases could be prevented through improvements lifestyle and diet.
Today, I want to review in detail this new way of thinking about diabetes and outline the tests I recommend to identify problems with blood sugar. Then next week I want to tell you exactly how to prevent, treat, and reverse Type 2 diabetes.
The Road to Diabetes Starts Early
Diabetes is often undiagnosed until its later stages. Insulin resistance, when the body becomes resistant to the effects of insulin, is primarily what causes diabetes.
When your diet is full of empty calories, an abundance of quickly absorbed sugars and carbohydrates (bread, pasta, rice, potatoes, etc.), the body slowly becomes resistant to the effects of insulin and needs more to do the same job of keeping your blood sugar even.
High insulin levels are the first sign of a problem. The high insulin leads to an appetite that is out of control, and increasing weight gain around the belly.
High levels of insulin are warning signs — they precede Type 2 diabetes by decades.
Insulin resistance and the metabolic syndrome associated with it is often accompanied by increasing central obesity, fatigue after meals, sugar cravings, high triglycerides, low HDL, high blood pressure, problems with blood clotting, as well as increased inflammation.
These clues can often be picked up decades before anyone ever gets diabetes — and may help you prevent diabetes entirely.
If you have a family history of obesity (especially around the belly), diabetes, early heart disease, or even dementia you are even more prone to this problem.
Most people know about the common complications of diabetes such as heart attacks, strokes, amputations, blindness, kidney failure, and nerve damage. Some may even know that it increases your risk of dementia and cancers and can cause impotence.
But most people don’t realize that insulin resistance or pre-diabetes can be just as bad causing heart attacks, strokes, dementia, cancer, and impotence — decades before you get diabetes.
In fact many people with pre-diabetes never get diabetes, but they are at severe risk just the same.
Mark Hyman, MD: Are Diabetes And Insulin Resistance Really Reversible?.
]]>Once considered a ‘western’ disease, diabetes has become an increasingly a global problem. The International Diabetes Federation predicts that the number of individuals with the disease will increase from 240 million in 2007 to 380 million by 2025. An estimated 60% of those cases will be in Asia. In North America and Europe the disease most often hits people in their 60s and 70s, but in Asia, it is increasingly hitting the young and middle aged. Asia’s diabetics are also thinner: Reviewing 20 years of research on diabetes in Asia, the study’s authors, scientists Frank Hu of Harvard’s School of Public Health and Juliana Chan of the Chinese University of Hong Kong, found that in Asian populations the risk of diabetes starts at a lower Body Mass Index, or BMI, a measure calculated by dividing weight in kilograms by height in meters squared.
In Asia, as elsewhere, weight still does matter; obesity and diabetes are clearly linked. The problem, the study found, is that measures of obesity are one-size-fits-all. People with a BMI above 25 are generally considered “overweight,” and those with a score above 30 are labeled “obese” and therefore generally considered more at risk for the disease. But focusing on fat alone misses a chunk of Asia’s epidemic, says Hu. “BMI doesn’t tell the whole story.”
Reviewing over 200 studies on diabetes in Asia, researchers looked at a host of socio-political and cultural shifts that have changed the way Asian people live and eat. The twin processes of rapid economic development and urbanization are partly to blame, says Chan. Changes that took place over 200 years in Europe have been accelerated in Asia, leading to what she describes as a “mismatch” between people’s genetic make-up and their habits. Food is more abundant today across Asia than it was, say, 100 years ago, but bodies have yet to adapt. Says Chan: “We are five foot three, but we eat like we are six feet tall.” (Read “Gastric Bypass May Be Less For Helpful for Diabetics.”)
Though packing six feet worth of food into a five-foot frame is never advisable, it may be particularly dangerous for Asians, the study found. Because of the metabolic mismatch Chan describes, some people may lack the cells to store excess fat. Instead of bunching around the buttocks or amassing on the arm, extra fat builds in other places, like the liver. Many Asian people, particularly South Asians, are also more prone to abdominal obesity, the study noted. Skinny people with thick middles are particularly prone to developing Type II Diabetes, which helps explain why the disease is spreading in places where people are, on average, quite thin.
The cost is huge. Type II diabetes is linked to a host of illnesses including heart disease, stroke and kidney failure. The World Health Organization predicts these diabetes-linked chronic diseases will cost China alone about $558 billion in lost productivity and healthcare costs over the next decade, taking a large bite out of the country’s hard-fought economic gains. And so it is across the continent — unless things change. Professor Hu is cautiously optimistic. The good news, he says, is that Type II Diabetes can be controlled with prevention and treatment. He hopes the study will convince policy-makers to spend big on both. That’s a pricey proposition, to be sure. But then again, health is a pretty good investment.
]]>