Diabetes complications are falling while number of cases continues to rise

Two reports released this week shed light on the current state of type 2 diabetes in this country, and their conclusions are both promising and sobering. First, the good news: An article in The New England Journal of Medicine shows that rates of diabetes-related problems like heart attack, stroke, and lower-limb amputation are down by more than 50% over the last two decades.

Now the bad news: during the same time period, the number of people with diabetes has soared, according to a report in the Annals of Internal Medicine. In the early 1990s, 5.5% of adults had diabetes. By 2010, the number had nearly doubled, to 9.3%. That translates into about 21 million American adults living with diabetes.

Although Americans are doing a better job of controlling their diabetes, they’re falling far short at preventing it. “The major reason why the prevalence of diabetes is going up is an increase in the number of people who are overweight and obese,” explains Dr. Osama Hamdy, medical director of the Obesity Clinical Program at the Harvard-affiliated Joslin Diabetes Center and author of The Diabetes Breakthrough, a newly published book from Harvard Health Publishing.

Nearly 70% of Americans are overweight or obese. And unless something is done to reverse this trend, millions more could edge closer to diabetes.

The obesity–diabetes connection

To describe how being overweight contributes to type 2 diabetes, Dr. Hamdy uses an automotive analogy. “You have more tissue in your body, so you require more glucose [sugar]. Just as if you have a bigger car, you need more gas,” he says. Insulin—the hormone that moves glucose from the blood into the tissues for use and storage—is like the key to that car.

The more sugar that enters the blood, the more insulin is needed to drive it to its intended destination. The pancreas can pump out extra insulin to meet the need, but over time, the body becomes increasingly less sensitive to it and the pancreas eventually reaches its insulin-producing limit. “Then you get diagnosed with type 2 diabetes,” Dr. Hamdy says.

The upside is that the process can be reversed. When you lose weight, you have less tissue, which means you need less sugar—and therefore less insulin. “You become more efficient, like a hybrid car,” says Dr. Hamdy.

In his own research, he’s found that losing just 7% of your body weight can improve insulin sensitivity by about 57%—more than diabetes drugs can usually do. “What we have seen is that once people start to lose weight in the very early stages of diabetes, they can actually reverse the entire course of the disease,” Dr. Hamdy says.

Minor changes, big results

The ability to reverse diabetes might seem dramatic, but the lifestyle changes needed to achieve it aren’t. The cornerstones of diabetes prevention—diet and exercise—can be easily incorporated into even the most hectic schedule.

Take exercise, for example. “Most people don’t know that if you do short bouts of exercise it is even more efficient than if you do longer bouts,” says Dr. Hamdy. People who can’t carve out time to get to the gym could actually see greater results just by incorporating three 10-minute exercise sessions into their everyday routine.

Here’s a sample schedule:

  • In the morning when you wake up, stretch for 10 minutes.
  • After you eat lunch, take a brisk 10-minute walk.
  • After dinner, strength train with light hand weights or an exercise band for 10 minutes.

Those three 10-minute sessions provide stretching, aerobics, and strength training—all essential components of a well-rounded workout. And if you do them every day, they add up to 210 minutes of activity a week.

An unhealthy diet can also be transformed with a couple of basic fixes. One is to divide your plate into three sections:

  • Fill one with lean protein—fish, legumes, beans, tofu, or skinless chicken
  • Fill another with green vegetables—spinach, broccoli, kale, or Brussels sprouts
  • Fill the third with whole grains—whole-wheat bread, brown rice, quinoa, etc.

The other part of the diet fix is learning how to listen to hunger and satisfaction cues to control portion sizes. Dr. Hamdy recommends assessing your hunger based on a five-point scale:

  1. Starving
  2. Hungry
  3. Ok—satisfied
  4. Full
  5. Stuffed

The goal should be to sit down to a meal when you’re hungry, and stop eating when you’re satisfied.

Preventing diabetes can be done, but it takes a real commitment to change. And until more people are willing to change their eating and exercise habits—and pass those habits on to their children—the obesity and diabetes rates will continue to rise.


  1. Sprei Murah Berkualitas

    Thank you, this article is very important me, i agree that are overweight or obese. And unless something is done to reverse this trend, millions more could edge closer to diabetes.
    The obesity–diabetes connection.
    many people do not thinking about that.. more exercise, diet and consume less sugar can helping to prevent diabetes

  2. Ceanix

    We find that in our field, diabetes is still a leading factor for the development of Frozen Shoulder. In fact, it is estimated up to 20% of diabetics will eventually develop a Frozen Shoulder. The common theory indicates collagen synthesis is at the heart of the matter, as referenced from aidmyfrozenshoulder.

  3. Anoop Kumar, MD

    Diet and exericise – or nutrition and movement as I prefer to call them – not only are essential to diabetes prevention and mangement, but to the prevention and management of many other chronic disease. The simple things we already know about seem to make the biggest difference.

  4. This study is useful to avoid early age diabetics thank you very much

  5. This article is very good for awareness to avoid diabetics In early age thank you

  6. Ross

    Being overweight not only leads to diabetes but puts a person at risk of heart attack & stroke!!

  7. www.faraweek.org

    Great Article Stephanie… i liked it so much, it was really useful to me and my husband. because in this old age we both are diabetic and the schedule you shared was worth following for the health of both of us. thank you so much anyways. 🙂

  8. Cindy

    Great article thanks for the post.

  9. Vince

    Round up the normal suspects . Is not it a fact that because of the explosion in the number of cases ;on a per thousand basis there are more people effected by complications from diabetes than lets say in 1970. Yet here again is the same dietary advice replace saturated fat :which several large studies have never been linked to one of the most serious complications heart disease with sugars {grains even whole grains] which has in fact been linked. A very recent study in the Annals of internal medicine March 2014 “Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis’ concluded ..” Current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of total saturated fats.” several studies have concluded the same. Yet no evidence of benefit exist.
    What part the demonetization of sat. fat played in the explosion diabetes . When you remove saturated fat from the diet you also remove flavor and what fills that void that would be sugar and to eliminate sat fat one of the recommendations has been to use trans fat loaded margarine. Hopefully this belief that sat fat is harmful will like HRT replacement to protect against heart disease fall against the data that simply does nor support it.

  10. wellbeing

    Type 1 diabetes accounts for about a tenth of cases and occurs when the insulin-producing cells in the body have been destroyed.Type 2 diabetes develops when the insulin-producing cells in the body are unable to produce enough insulin, or when the insulin that is produced does not work properly.

    Insulin enables the body to use sugar as energy and store any excess in the liver and muscle.If this fails, blood sugar rises and this can cause long-term complications, such as kidney damage.The NHS spends 10% of its budget on diabetes and 80% of this goes on treating consequences such as amputation, kidney failure, heart disease and stroke.
    Dr.Jeniffer Hudson (MIT)

  11. Nun Amen-Ra

    Dr. Osama’s analogy about insulin and automotive efficiency is amusing and imaginative. It isn’t very informative on a fundamental level however and it sure isn’t sufficiently abstemious for an Amenite’s ascetic outlook. There is no mention of the deleterious effect of excessive glucose as such on body tissues. No mention is made of glycation. No mention is made of the potential for fasting to suppress sugar concentration and thereby inhibit glucose-mediated tissue damage in diabetics or even in “normal” persons. The dietetic advice is abysmal–fish and chicken? On what empirical basis are they deemed dietetically ideal or adequate? These foods are among the most glycated items in the conventional diet. [As established by Drs. Helen Vlassara, W. Cai and colleagues from NYU among others.] Glycation, let us recall, is a chief complication of the diabetic state and a principal catalyst of aging. Add to this the abundant toxins in fish and the copious carcinogens [i.e. cancer-causing compounds] in animal flesh in general and the advice offered by Dr. Osama seems even more outlandish, arbitrary, and indeed perplexing. And the exercise advice is apparently aimed at octogenarians, nonagenarians, and centenarians. A 10-min stretch to start the day? No offense to aged persons, but is this a geriatrically-geared program? That’s paltry even for preventive purposes. If in indeed one is already suffering from the symptoms of diabetes, it is woefully inadequate. Fasting, food, supplements, and exercise are the ideal and appropriate interventions for diabetes (and many other age-associated diseases). As such, it should be taken a bit more seriously than these theorists/practitioners suggest. Those who seek substantive information and practical guidance as to how to optimize health, lengthen lifespan, and prevent and overcome a plethora of pathological conditions and diseases are invited to inform or avail themselves of the Amen Optimal Health Protocol (AOHP). Pardon the self-promotion, but the alternatives are not at all impressive or encouraging.

    –Dr. Nun Sava-Siva Amen-Ra, AOHP Arkitecton

  12. Joni

    Interesting piece. Just shows how weight can affect people in so many ways.

  13. Very informative article, it’s sure to give pragmatic solutions and hope to a diabetic patient. I am eager to share the knowledge with my mother who is a patient.

  14. Kenneth

    This is a very thoughtful, informative article; thank you for publishing it.

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