Q. Glen, I am getting older, a little over weight and not exercising ! Should I worry about Diabetes?
A. As millions of Americans reach the age of 65 and beyond, you needn't have a degree in medicine to understand the seriously dangerous ramifications of an increasingly unhealthy, older society. In the near future, the number of people who are 85 years old will double -- and eventually triple. Currently half of this "oldest old" population is dependent and utilizes a large fraction of health-care resources. Should this be true for the baby boomers, it will certainly cause a national crisis. To make matters worse, if we continue to become more and more overweight, the increased development of adult-onset diabetes will wreak havoc on the health-care system.
Recently, New York issued the results of its first-ever Health and Nutrition Examination Survey. It found that 12.5 percent of New Yorkers had diabetes. Of these, 3 percent, or 207,000 individuals, were unaware they had the disease.
A total of 23.5 percent of the population had "pre-diabetes," defined by an elevated fasting blood sugar. Without intervention, these subjects will almost certainly develop diabetes in the next few years. The incidence of diabetes is lowest among white New Yorkers (10.6 percent), higher in Hispanics (12.3 percent) and blacks (14.3 percent) and highest in Asian New Yorkers (16 percent). These results are much higher than those of a nationwide Health and Nutrition Examination Survey completed about four years ago that indicated a national incidence of clinically diagnosed diabetes of about 7 percent.
This suggests that New Yorkers have a higher incidence of diabetes than the rest of the nation; I believe the reverse to be true. New Yorkers tend to be more active, walk more and have a lower risk of obesity than residents of most other parts of America. I suspect that if the national study were done now, results in many parts of the nation would be worse than New York's.
We are facing a health crisis of enormous proportions, and we need to act now. The cause is clear -- a higher risk of obesity combined with a sedentary lifestyle leads to diabetes in individuals who are predisposed to developing the illness.
Fortunately, diabetes can be prevented by weight loss and exercise. The journal Diabetes Care recently published a study that examined the relationship between risk of diabetes and exercise and weight. More than 68,000 women participated in the nurse's health study. The risk of diabetes was 16-fold higher in sedentary, obese women. This risk was reduced to 10-fold higher if they exercised. Sedentary thin women had only a two-fold higher risk of developing the disease than thin women who exercise. This led the researchers to conclude that controlling obesity was more important than exercise in preventing diabetes.
Clearly, obesity affecting Americans of all ages is leading to a higher incidence of diabetes. Obesity leads to a condition called insulin resistance, which means a greater amount of insulin must be produced to bring the blood sugar into normal range. If the body is unable to produce sufficient insulin, the blood sugar rises excessively, and diabetes develops. This in turn leads to heart attacks and strokes, blindness, kidney disease, an array of neurological conditions, loss of sexual function and a high risk of foot ulcers that can eventually result in amputation.
While the study found that nutrition and obesity played a stronger role than fitness and exercise in developing diabetes, I still believe it is important for anyone at risk of developing the disease to embark on a rigorous exercise regimen. Muscle is the most metabolically active tissue in the body. Increasing muscle mass increases the ability of the body to clear glucose and reduce insulin resistance. This can be best achieved by exercising vigorously with weights, which will build muscle and reduce fat. If you have already been diagnosed with diabetes or pre-diabetes, your condition may be reversed by combining exercise with an appropriate diet. The best example is former Arkansas Gov. Mike Huckabee, who had very serious diabetes. Having lost 100 pounds, he is now running marathons, no longer has any evidence of diabetes and has guaranteed himself a longer and better life.
A comprehensive approach is the key to reducing your risk of diabetes. Live a healthy lifestyle -- eat right, exercise (with weights), be an educated consumer of health care -- and you can prevent this devastating disease.
Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !
My mission is to provide you with "Trusted Advice for a Healthier Life."
Yours in good health