Diabetes is one of the deadliest--and most difficult--diseases to treat. That's not because there aren't plenty of safe, effective methods for controlling diabetes, a disease in which the body either does not produce enough insulin or does not use insulin efficiently. Rather, treatment is difficult because diabetes is often a disease of denial. "Being diagnosed with diabetes doesn't create an event the way heart disease does," explained Stacey Antine, MS, RD, director of corporate communications for Nutrition 21, Purchase, NY. While surviving a heart attack can inspire profound lifestyle and dietary changes, being pronounced diabetic doesn't usually have as much of an impact.
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Dissecting the disease
Diabetes is the sixth leading cause of death in the U.S., affecting over 18 million people, 90% of whom suffer from the preventable type 2 diabetes (1). One-third of those with diabetes don't even know they have it (1). And many more people are affected by pre-diabetes, a term used to describe people at high risk of developing diabetes. If the results of one cross-sectional study of American adults were extrapolated to the entire population, about 41 million, or 14%, would be in the pre-diabetic category (1).
Experts agree the diabetes situation in America is critical. Diabetic adults are two to four times more likely to die from heart disease than non-diabetics. They also have a two to four times higher risk of stroke. Blindness, kidney disease, nervous system diseases, amputations and dental disease are also far more common in diabetics than in the general population (1).
Unfortunately, the situation is only projected to get worse. The U.S. Centers for Disease Control & Prevention (CDC), Washington, D.C., recently issued the alarming news that children born in 2000 have a one in three chance of developing type 2 diabetes in their lifetimes (2). The dramatic rise in the incidence of diabetes is widely attributed to two main factors--an increasingly overweight and sedentary population.
For reasons that aren't completely understood, obesity decreases insulin sensitivity and exercise increases it. According to the U.S. Surgeon General, 61% of Americans are overweight or obese, as are 13% of children and adolescents (3). However, these statistics should be taken with a grain of salt, as the federal government changed its measurement standards in 1998, reclassifying 30 million adults as overweight with the new changes. Still, according to the CDC, only 15% of Americans regularly engage in vigorous physical activity, which is defined as three times a week for at least 20 minutes per session (2).
There's more to diabetes than just being overweight and sedentary, however. Genetics also play a major role. A family history of diabetes places one at high risk for the disease, and certain races are also disproportionately affected, particularly African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders.
What is Syndrome X?
Insulin resistance, at the heart of type 2 diabetes, is also a key factor in the development of Syndrome X (also called metabolic syndrome), which encompasses a series of conditions including visceral obesity (fat in the abdominal area), elevated blood sugar, elevated triglycerides, low levels of HDL cholesterol and high blood pressure. A person is diagnosed as having Syndrome X if three of these factors are present. If the insulin resistance is …
