DIABETES

Diabetes: What is it?
Article By: Joan Raymond; Reviewed by: Jessica Smerling, RD

What can you do to reduce your risk of diabetes? For starters, a little weight loss goes a long way.

JANUARY, 2008—Although there's still a lot we don't know about diabetes, one thing we do know is how closely the condition is tied to the obesity epidemic. The incidence of type 2 diabetes has doubled in the last 30 years among middle-age Americans.

Twenty-one million people now live with type 2 diabetes, and an estimated 41 million are considered to have prediabetes (elevated blood-sugar levels could develop into full-blown type 2 diabetes).

"Despite the sobering stats, this disease isn't an inevitability," says Martin Abrahamson, MD, senior vice president and clinic medical director at Joslin Diabetes Center in Boston.



Whereas not everyone will be able to reduce to zero their risk of developing type 2 diabetes (a genetic predisposition to the disease, for example, ups your odds), the National Institutes of Health declares that "diabetes prevention is proven, possible and powerful."

If you have prediabetes — your blood-sugar levels are higher than normal but lower than those of a person with diabetes — your risk of getting the full-blown disease is especially high, says Gregg Faiman, MD, an endocrinologist at University Hospitals of Cleveland. Still, don't assume that you're out of the danger zone if you don’t have prediabetes: If you are overweight or have other risk factors, you should take immediate steps to decrease your risk.



Fortunately, simple lifestyle changes, coupled in some cases with medication, can help keep the disease at bay.

Lose weight, lower your risk
If you're trying to lose weight, you're already on the right path to diabetes prevention. Although experts once thought that consuming a lot of sugar led to diabetes, we now know that diabetes isn't caused by a specific food or ingredient. Taking in too many calories, however, leads to obesity, which is a major risk factor for the disease.

Type 2 Diabetes
Diabetes is a disease that prevents the body from producing enough insulin or using insulin correctly. Because insulin’s job is to help regulate glucose (sugar) levels, either of these problems may result in dangerous fluctuations in blood-sugar levels. Type 2 diabetes:
Is a condition in which cells do not use insulin properly, sometimes causing the pancreas to lose the ability to secrete a sufficient amount of insulin
Formerly called adult-onset diabetes, can develop at any time
Accounts for 90 to 95 percent of diagnosed cases of diabetes
Can help to be prevented with healthful eating, regular physical activity (at least 30 minutes daily), and weight loss
Risk factors: family history, obesity, high blood pressure, a history of gestational diabetes, and a diagnosis of prediabetes
May be treated with oral medication


Fortunately, dramatic weight loss isn't always essential: Losing just 5 to 7 percent of your body weight can reduce your risk of developing diabetes by as much as 58 percent, according to the Diabetes Prevention Program (DPP), a major study that has tracked more than 3,200 diabetes-prone individuals for three years. In fact, the DPP found that losing weight through "intensive-lifestyle counseling" was more effective in preventing diabetes than was taking metformin, a drug that regulates glucose levels.

Move it, lose it
Exercise makes a difference, too — and you don't have to run a marathon. In addition to cutting calories and fat, people in the DPP's intensive-lifestyle group exercised an average of 150 minutes per week (mostly walking). Need more proof that moderate exercise makes a difference? There's plenty: A study at the University of Pittsburgh on Pima Indians, a group prone to type 2 diabetes, found that those who engaged in moderate regular physical activity (walking for 30 minutes a day, for example) were less likely to develop diabetes over a six-year period.

A new Finnish study, published in the journal Diabetes Medicine, found that people with a large midsection (a risk factor) were 4.2 times less likely to be diabetic if they exercised for 30 minutes five times a week.

Bottom line: You have the power to stay healthy
What you weigh, what you eat and how active you are may mean the difference between struggling with type 2 diabetes (and related complications) and never having to.