Explosion in diabetes isn’t inevitable


Former Executive Editor, Harvard Health

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 tree—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.


  1. kayus-endocrinologist lover

    P.j i quite concur with your article sub headline that diabetes can betackled one step at a time.But what is disturbing from reading thgis piece of diabetes is that the body needs the glucose that causes diabetes when it can be absorbed to th tissue through the insulin.

    But what happens if there is a shortage of insulin can we say it is natural,genetic or due to eating habit.?Can an endocrinologist treat diabetes if i may ask?
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  2. David Hastings

    Diet is definitely the main culprit in kids early age of getting diabetes. Not only the sugar in the coke that we drink but also in the pizza chips that our kids eat everyday. This must stop!

  3. Meredith

    I highly recommend Gary Taubes’ books to anyone at risk for, or dealing with diabetes. There are new solutions that work. Years ago, my brother was diagnosed with Type 2 diabetes and he got rid of it by eating a high protein, low carb diet. I have a sister who was obese and diabetic. She had the Bariatric surgery, got down to a normal size, and the diabetes was gone. it can be done with diet. But not eating breads and pastas and rice.

  4. Gary M Hogen

    I heard about a study dealing with stomach an/or stapling/lap bands. That on having this done that 60% of people after do not have diabetes and that your study may leak this to a stomach disease/viruses. What I would like to know? 1. is how or what test is used? 2. Autoanibodies that are antibodies gone bad.. If you can point me to more on these subjects.

    Thank you

    Gary M Hogen

  5. Dadams

    How often should blood sugars be checked when only on oral medication and a diabetic focused eating plan? Once a day, twice a day, before every meal or is a quarterly A1C all needed?

  6. Stephanie

    You need to explain that diet and activty helps prevent Type 2 diabetes not type 1. There are many misconceptions with type 1 and type 2 diabetes.


  7. Marc Hoffman

    Let me add my experience to that of Thomas Fouts. As my A1C crept above 6.0 my doctor asked me if I wanted to treat it aggressively. Having had a mother with Type 1 who died when I was 22, over 40 years ago–and being compulsive–I threw myself into discovering a course for my lifestyle that might control this disease.
    I worked with a dietician and become more consistent with daily exercise–using feedback from daily nutitional analysis (web-based calorie and food type diary) and fasting blood sugar readings to determine it was my panceas which was not properly regulating my overnight glucose levels. We worked on the metformin dosing and I really limit the carbs. But I lost weight, my fasting readings became normal and best of all my A1C has been below 6 for almost a year. I am fortunate that I can lose weight and exercise regularly–But if you can, you should try because I live with the inevitability of needing increasing drug therapies to control my diabetes but I am thrilled that for now I can maintain a normal, non diabetic, blood sugar level and continue to avoid the worst effects of the disease.

  8. sally

    Mr. Fouts, I totally agree with you, people just are not that interested and another person commented on people just accepting that they have diabetis and not being their own advocate when the low’s and high’s occur……….but I also think the Dr’s that are not endocrinologist do not know enough to treat us for diabetis……… and am finding this out more and more as I speak to other’s as well. I am changing Dr’s. at this time and date due to this. Dr’s , unless diabetis is their specialty DO NOT get but 6wks training from what I have been told……….and they are very limited in thier knowledge. Maybe I am wrong on this next issue as well, but I notice that as I aged, my treatment from a Dr. was not thorough enough and I experienced this as I grew older when I would have any problems………. and I have a great PPO and medicare secondary…and if it ahd not been for my nursing I would not ahve been compelled to demand a test be run and I was always right as to what wwas going on .We with diabetic and other problems need (very simply)to be our own advocate and fight for ourselves. Medicine is not what it used to be and I feel the Dr.’s now are pharmacist with M.D.s after their name.

  9. Thomas Fouts

    When I was diagnosed with type 2 diabetes my head spun like an F5 tornado with thoughts of amputations, blindness and needles! Turns out what really scared me was changing my eating habits!

    I did the research (6+ months of obsessed research) to find out just how I “got” diabetes, and how I was going to NOT have the type 2 diabetic condition anymore. What I learned from interviewing 100+ diabetics was shocking.

    Only 3 out of 100 people living with diabetes were actually trying to “reverse” the condition. The rest just blindly accepted that they were diabetics and “give me a pill”!

    I put together a concept method for myself to defeat the “beast called diabetes and implemented my plan. It worked! 45 days later after being tested, I was completely out of even the pre-diabetes numbers!

    Many people were shocked at my transformation and asked how I accomplished my goal of vibrant health. So I wrote a short 100 page ebook called “The BetesBuster Plan” and distributed it to anyone who wanted to fight their diabetes. Not many takers. Seems like people are too lazy to change, or are just content to take a pill or insulin.

    You are so right Mr. Skerrett in most every word you wrote. I do think we should start educating kids in school about how every morsel of food they put in their mouth affects their body in one way or another. I just don’t know at what age this would be most beneficial.

    Thanks, I will print your post and pin it to my wall so all that enter my office can read it. Gotta start somewhere.

    Thomas Fouts

    • Avatar
      P.J. Skerrett

      Thomas — Thanks for your comments on my post. To me, one of the most difficult things about diabetes is knowing you’ll have it for a lifetime. And if you don’t do it right, that lifetime may be shorter than it should be.

      Exercising, adopting a diet that helps control blood sugar, and taking medications as needed are about the best any of us can do.

      Good luck in your fight!


    • Tudor

      Dear Mr. Fouts,

      Thank you for sharing your experience and giving us hope. Where can I get a copy of your ebook?


  10. healthcare

    in the world which rice is the main food diabetes is more terrified desease
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  11. healthcare

    diabetes become a most dangerous killer in the third world

  12. Natalie Sera

    I just plain don’t believe that Type 2 diabetes is going to be as prevalent as the “experts” say it is, because in order to get it, you have to have the genetic susceptibility. There are far more obese couch potatoes that DON’T have diabetes than those who do. You can’t just extrapolate current trends and expect them to continue indefinitely.

    I am also not convinced that ANY grains are healthy — even whole grains spike my blood sugar, so I avoid them entirely. That plus avoidance of potatoes and rice has really helped, and I have lost 18 lb. since October. Only 10 lb. to go before I reach BMI 24.9. America has yet to catch on to the idea that low-fat may NOT be the way to go — when we started limiting fat in our diets, the only other way to get calories was to eat carbs, and the incidence of obesity started rising at the same time. Of course, correlation does not prove cause, but it’s an important place for continued research.

  13. george white

    Although I don’t have diabetes myself I do have a niece who does. She is only 20 years old and doesn’t have a hair on her head – and doctors put the cause down to her having diabetes. You will be able to imagine what this is like for a young girl. Anyway I scour the web looking for articles that may help her so this is one that will be on it’s way. Thank you.

    • Gwen Poore

      I’d love to hear more about the affects of diabetes. My niece also has Type 1. She is 13 and has had it for 10 years. One of the posts stated that one affect could be hair loss. This would be very traumatic for my niece.

  14. Paintballing Ireland

    Absolutely splendid post! Loads of very helpful tips not to mention inspiration…People Can certainly Help to make a Major difference in the Fight Against Diabetes!

    Become a member of the American Diabetes Association’s and help to improve awareness of diabetes

  15. David W Johnson

    Diabetes is one of many ailments are civilized lifestyle has created for us. The further we get away from the unprocessed bounty of land and animal, the more diseases we’ll create. You have stated the cure, but McDonalds, cheetos, Bud Lite and the remote control are temptations too hard to ignore.

    Dentist in Jensen Beach Fl

  16. Kathi Robinson

    Thank you for an insider’s realistic view of the daily dilemma of a diabetic.

    Yes, we all know in a perfect world we should eat right and exercise daily, but somehow life also gets in the way when you are a very busy person.

    I know I made my own life and its restrictions but now that it is made I am not just going to chuck it all and say “heck with it, I’m taking a walk. I have responsibilities and I intend to fulfill them also.

    I try to fit in what I can when I can, I try to eat better continuously and I do take my medications almost religiously since I have factored them into my schedule. But I still have not ever been able to find a way to control by blood sugar swings with the aid of any forms of medications I have repeatedly been offered.

    Every few months to years my medication program gets changed -AGAIN – because they still have not found something that works.

    Actually, I seem to have better luck with just trying some lifestyle modifications that I managed to fit into my life. Although I am not in perfect control, I am a whole lot better now than I was for two other decades of the middle years of my life.

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