Harvard Health Publications

Explosion in diabetes isn’t inevitable

Posted By Patrick J. Skerrett On October 29, 2010

You can fight diabetes, one step at a time.

An alarming new report from the Centers for Disease Control and Prevention estimates that one in three Americans could have diabetes by the year 2050. The number is “just” one in ten now, and its price tag of nearly $200 billion per year is already straining the health care system and taking a toll on individuals and families.

Diabetes is a nasty disease. It tends to start quietly and move slowly, often taking years before it is noticed. Once it gets going, though, it affects virtually every organ and tissue in the body. Left untreated or poorly managed, diabetes is a major contributor to heart disease, stroke, kidney failure, blindness, amputation, and premature death.

It’s malicious on a personal level, too. It changes one’s relationship with food from a pleasurable daily experience to one of constant scrutiny and mistrust. I’m speaking from experience here, since I have been living with this intruder for some time. It caught me by surprise. I’m a skinny, fit, nonsmoker with no diabetes in my family treeā€”not exactly the poster boy for this disease.

Diabetes is a problem with blood sugar (also known as glucose), a fuel every body needs. Eat a bagel, sandwich, potato, or other carbohydrate-containing food and your digestive system turns the carbohydrates into blood sugar. Some is used immediately. The rest is stored for later in muscles, the liver, and fat cells. Insulin, a hormone made by the pancreas, is needed to usher glucose into cells. Some people can’t make insulin, or don’t make enough of it. In others, the tissues don’t respond properly to insulin’s “open up for sugar” signal. The end result is chronically high amounts of glucose in the blood. Over time, this can be toxic to cells.

Along with exercise and a good diet, medicines can help control blood sugar. But there’s no cure on the horizon.

Diabetes has been on the upswing since the 1960s, fueled largely by Americans’ penchant for eating too much and exercising too little. The combination of excess weight and inactivity makes tissues resistant to insulin, which snowballs into diabetes. The CDC’s new warning factors in the continuing spread of obesity and inactivity with the aging of the U.S. population, the higher risk for diabetes in rapidly growing minority populations, and improvements in medical care that help people with diabetes live longer.

Preventing diabetes sounds like it should be easy: Eat right and exercise more. But it isn’t. Millions of Americans don’t have easy access to fresh fruits, vegetables, whole grains, and other healthful foods. We’re bombarded by billions of dollars of advertising that encourages us to eat more. Poor building design, office work, unsafe neighborhoods, no time (or money) for gym in public schools, and other factors can make it a challenge to exercise or be physically active.

But we have to start somewhere. Taking a walk is as good a place as any. Invite your spouse or partner. If you have children or grandchildren, peel them away from the television or computer and take them along. Get a friend or two to join in. Do it again tomorrow, and the next day, and as often as you can. Just as a journey of a thousand miles begins with one step, the journey to beat diabetes can begin with one walk.

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