The Diabetes Threat

The number of Americans diagnosed with type 2 diabetes rose from 1.5 million in 1958 to 18.8 million in 2010. That’s an increase of epidemic proportions. Even more disturbing, another 7 million Americans have type 2 diabetes, but don’t know it and, consequently, can’t take steps to control the disease. Altogether, over 8% of the U.S. population now has this potentially deadly metabolic condition.

  • Type 2 diabetes wreaks havoc on the body by raising the levels of glucose in the blood, increasing the risk of blindness, heart disease, kidney failure, nerve damage, and even Alzheimer’s disease.
  • Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be called diabetes. 79 million U.S. adults age 20 and older have pre-diabetes.
  • NIH studies have shown that losing just 6–7% of body weight and increasing physical activity can prevent or delay pre-diabetes from progressing to diabetes. 85% of people with diabetes are overweight.

Photo of a pair of sneakers with the text "November is National Diabetes Month -  Be Active - Make a plan to live well."

26 thoughts on “The Diabetes Threat

  1. How can I lose weight when I can barely walk? There must be a diet plan that I can follow. I walk effectively with my walker or “chair-lator”, but stand alone. Physiotherapy doesn’t seem to help much.

  2. I am guilty of not paying attention to this disease. At least for the most part. I suffer terrible with pain and numb feet and legs. I have a big problem trying to swallow metformin. I rarely see my doctor, transportation problems. I know it is a killer, all my relatives have it and one died from diabetis complications at 40 something. I guess the only thing I have changed is sugar supplements and I never cared for sweets, pies, cakes, etc. I will try to do better. Life is lonely. Vi

  3. Until we begin to have an unbiased conversation about how to truly prevent and treat diabetes, cases will continue to rise. We need to stop looking to individuals who are compensated by big Agra and Pharma for answers. Instead we need to start listening to the researchers conducting in-the-field experiments.

    Furthermore, dietitians and physicians lack a basic understanding of nutrition and how macro-nutrients are processed in the body. If we are to hope that this epidemic can be curtailed, we must first start by properly educating health professions. Instead we allow health professions to spew further nutrition and health information that has very little peer-review evidence supporting it.

    As a registered nurse, I would estimate that 95% of my co-workers are either pre-diabetic or diabetic. Despite numerous attempts to encourage proper eating habits and activity, the resounding answer I receive is either “I can’t” or “I won’t”. Beyond that is a level of denial that needs to be appreciated. The psychological aspect of diabetes is just as important as the biochemical and physiological factors.

    Finally, we can’t pretend that we are going to prevent diabetes by allowing individuals to have the same level of freedom that the currently do. Left to their own devices humans will engage in a behaviors that are fun or exciting despite being extremely harmful. I believe that sugary drinks and snacks should be taxed higher than cigarettes and alcohol.

    • This is a great comment. As a Holistic Nutritionist, I find many people eat what is convenient and foods that they crave. Most convenient foods are processed foods full of chemical additives. This is where the cravings come from – chemicals as well as sugar. So, I would add to the sugary drinks and snacks – processed foods. We need to get back to nature by eating whole natural foods not those “non-foods” that come in a package.

  4. Chronic illness such as type 2 diabetes is one of the biggest challenge for public health community. Child hood obesity and increase in incidence of type 2 diabetes in children is an emerging public health problem. Taking preventive measures and controlling environmental factors such as lifestyle and implementation of behavioral changes can help. Improved out patient care (early screening, proper diagnosis) can help in reducing hospitalization of patients with uncontrolled diabetes and can also help to reduce the high cost of treatment.

  5. With all due respect, Dr. Collins, this is a pretty low information message. “It’s the food, Francis.” Only about 20% of weight loss is due to exercise, while 80% is due to what we eat. Not just quantity of food, but quality. But, we understand your hands are tied and can’t disparage any food that corporate America has on offer. No one can without getting a free one-way pass to Lawsuit City. However, there are bookshelves filled with credible, science-based information about how toxic our food environment is; the internet is simply bursting with similar messages from highly credible sources. And, everywhere in the world, corporate America exports this low fiber, high meat, high corn sweetener and high dairy diet (and I’m just scratching the surface here), diabetes, cancer, heart disease and all the other ailments that are the leading causes of preventable death and chronic illness in Western societies who eat this stuff follows like night follows day (see Dr. Micheal Greger). This is just to let you know that we, what remains of the thinking public in this country, know the truth. It’s the food, Dr. Collins, it’s the food. Why not suggest a low fat, whole food, plant-based diet as the only science-based treatment (dare I say cure?) for type 2 diabetes (see Drs. Neal Barnard, John McDougall, Caldwell Esselstyn, T. Colin Cambell and all the free lectures on offer on the Vegetarian Society of Hawaii website-no affiliation here), as well as physical activity. That would add, say, 80% more value to your message. Thank you.

    • Nice job, Lawrence, in succinctly putting it out there. It IS the food and the special interests who are controlling food production and sourcing. Thank you.

    • Sir, you are right on the money with your reply to Dr. Collins. I will repeat your message: it IS MOST DEFINITELY the food. Thank you!

    • Sara – while both are called ‘diabetes’ they are actually very distinct diseases. Type 1s (approx 5% of the ‘diabetic’ population) cannot produce insulin at all (as their islets are continuously destroyed by the body’s own immune system). Type 2s produce insulin – but their body has become desensitized to that insulin – as if it doesn’t exist. [Many of] the causes of Type 2 are believed to be directly related to obesity and lack of a healthy lifestyle.

      While all humans (including Type 1s) would benefit from an appropriate diet and lifestyle, it is extremely important for Type 2s – as the evidence shows that losing weight and exercising dramatically reduces Type 2 diabetes and in many cases puts the disease into remission!

      (It doesn’t seem to matter how a Type 2 loses weight. There is a dramatic correlation between lap band surgery and Type 2s coming off insulin and the more severe medicines to control their diabetes). So the message is Type 2s – just lose the weight!

      Unfortunately for Type 1s, the result is far less dramatic and more qualitative than quantitative.Good control “may’ see you reduce your insulin intake – but will never see you stop taking insulin. It is believed that good BG [blood glucose] control may help avoid future complications – but there is also a school of thought that hereditary factors/genetic disposition may play a greater role.

      I’m a Type 1 (for 28 years) – and sometimes I wish they’d change the names to reflect the differences in cause, treatment and prospects of a cure/remission. Most Type 1s would do anything for a cure… weight loss/exercise would be the easiest hurdle to overcome.

  6. Am I correct in assuming that diabetes “wreaks havoc on the body” because blood glucose that should be going to cells is instead staying in blood vessels,
    1) depriving cells of energy and
    2) clogging up and potentially narrowing capillaries?

  7. Glad to see the directors blog playing an active role in promoting diabetes month. It’s also mens health month (also known as movember or no shave november) – mean if you’re over 40 it might be time to get your prostate checked!

  8. It is not a US problem alone, it is a global epidemic. In India some of the poorer parts of the states have patients with Type 2 because of genetic reasons.One resource that has worked well for me is the Type 2 diabetes group on yahoogroups. Plus we tend to use natural products like fenugreek and bitter gourd in addition to metformin. What I’m really concerned about is neuropathy in long term diabetics, and I’ve witnessed this in close relatives– what a nasty end.

  9. Take Note: I was diagnosed with type 2 diabetes at the age of 58. My doctor told me I probably had it for 15 years prior to diagnosis, but; because I was on such a big physical excercise plan it didn’t raise it’s head with regular visits to the doctor. I ate improper foods for the disease, but; again exercise allowed the behavior. Now, being on pill medication and exercise and proper diet I keep my blood sugar under control, however; all doctors tell me they really cannot say how much damage I have done before taking measures to control the disease. Once you have it, you must take control or you will suffer the evident, and possibly face an early entry into Heaven because of your stubborness to not take care of the problem.

  10. i can’t do the walking and running no way. legs are too sore and swollen to walk too far and stairs kill me. Neuropathy through out my whole body … I have tried a lot of things that just don’t work.

  11. @Mira
    It is not a US problem alone, it is a global epidemic. In India some of the poorer parts of the states have patients with Type 2 because of genetic reasons.

    Unfortunatly you’re right.

  12. As a health educator I work with both adults and children. The programs I work with adults help to make behavioral changes by making better healthy choices. Telling someone they need to exercise and eat healthier is not successful. However, teaching them how to set goals, overcome barriers, manage stress and time is the key. In addition, offering suggest for making healthier recipes, gaining different types of support through family, friends and co-workers gives them a sense of ownership and efficacy that helps make better lifestyle choices. Working with the children involves school’s administrator, school’s teachers, cafeteria staff, parents and community. The best practice is to coordination and collaboration amongst organizations.

  13. Has any consideration been given to”stem cell” research and its recuperating properties as it relates organ and cell regeneration? I would be willing to entertain the idea of being in a study for this if it would help myself and others that have this disease. Please respond with information if a study is underway. Thank You.

    • Thanks for your question, Carl. The NIH Director’s Blog’s does not provide specific medical advice to commenters. But if you’d like to learn more about clinical studies for diabetes, including some that involve stem cells, check out http://www.clinicaltrials.gov.

      ClinicalTrials.gov, which is a service of NIH, currently lists more than 135,000 studies for a wide range of conditions, including type 1 and type 2 diabetes.

  14. All said, we live in an environment where not everybody understand the implication of such things on their health, and they don’t even have people around them willing to educate them. The mass media are not just enough …

  15. It is unfortunate that we would need to resort to increased taxing to get the attention of people and force them to stop buying foods that are harmful to themselves. I wish that there were more information out there to promote natural supplements that would help.

  16. Stem cells, genetic identification of RISK, pharmaceuticals and doctor to patient discussions about losing weight are not going to solve the diabetes type II and possibly III (when the brain is no longer able to process glucose) “epidemic”. Words are used to describe what is occurring when one develops diabetes II or other chronic preventable, non-communicable diseases (CAPNCD), like “a threat”, an attack” we need a “war on” (take your pick – cancer, diabetes, heart disease). CAPNCD are not external enemies! They are caused by addiction. Addiction is a part of the human condition. That is why there will always be some cigarette smokers, alcoholics and obese folks and why prohibition is not a solution.

    The best way to curb the “food” addiction, which is essentially an addiction to the trifecta of sugar, fat and salt (too much, unnatural and made into highly palatable products) – so well described in Dr. David Kessler’s book, The End of Overeating – is to create a new type of tax. This tax would need to be within a complete model of changes to reduce consumption (think of the message on cigarette packages, no ads etc) and be specific to potentially addictive but legal substances that are RISK factors for CAPNCD. Call it RISK! It worked to reduce tobacco smoking (albeit not called RISK). It can work if unhealthy food becomes more expensive and less accessible than healthy food. It is not a matter of how to do it (I have figured that out without being an economist or financial guru becasue I care very, very much about our dysfunctional health care potpourri and the effect of ever rising health care costs and equality of access to health care. Rather, it will be a matter of a “revolt of the taxpayers (of all weights) to realize how sugar, fat and salt addiction not only disables and kills people but also how we end up paying for the health care through income taxes and insurance premiums…

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