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Curbing the Diabetes Epidemic


By Scott Isaacs M.D.

You probably keep hearing about the epidemic of diabetes because it has been going on for the past 30 years. The rate of diabetics continues to climb in the United States and throughout the world. Once considered an unusual diagnosis, diabetes has become one of the most common forms of chronic illness in the world today.

According to a 2011 report by the Centers for Disease Control and Prevention, 26 million Americans have this condition and 79 million have prediabetes. In 2008, the CDC reported 23.6 million had diabetes and 57 million had prediabetes. In 1993, there were 15 million people with diabetes and there was no such thing as prediabetes. 27% of people with this condition or 7 million people have not yet been diagnosed. More than one quarter of Americans over the age of 65 have diabetes and half have prediabetes. 35% of Americans over age 20 have prediabetes. It is important to diagnose prediabetes because complications traditionally associated with diabetes like eye, nerve and kidney problems can occur in the prediabetic state. The increase in diabetes rates is due to several factors:

* increasing rates of obesity
* people with diabetes are living longer
* new criteria for diagnosing diabetes

If you have diabetes or prediabetes, it's important to get a diagnosis to prevent complications. People with prediabetes can work aggressively on diabetes prevention by losing weight, becoming more active and getting healthier. A major government-funded study, known as the Diabetes Prevention Trial evaluated patients with prediabetes. The study found that diet and exercise can reduce the risk of progressing from prediabetes to diabetes by 57%. Medications were also found to decrease a person's chances of developing diabetes, but not nearly as effectively as good old diet and exercise.

Reversing insulin resistance is a critical step to preventing diabetes, since it's not incurable. People who are genetically disposed to insulin resistance, still can avoid obesity, diabetes, and a host of other ailments. The answer to this resistance is a healthy diet and lifestyle. Even modest diet and lifestyle improvements can improve resistance to diabetes and dramatically lower your risk of getting complications like heart attacks, strokes and early death. Although improved nutrition and increased physical activity are the best way to treat insulin resistance, medications can improve insulin resistance and can treat many of the complications of insulin resistance. Vitamins, minerals and herbal supplements can also be helpful, but should be a substitute for diet and exercise.

In my experience as an endocrinologist, medications alone are never adequate. I've been known to say "you can out-eat any medication." But when combined with the right type of diet and daily exercise, medications can be very helpful. The most common medication used to treat insulin resistance is metformin, but a whole host of other medications can have an effect, either positive or negative. If you are gaining weight or have been told that your blood sugar level is elevated, you should ask your physician if you might have insulin resistance.

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