Type II Diabetes - A Growing Epidemic
If you are a woman, over age 40 and overweight, and you don't get enough exercise, you are at risk for type 2 diabetes, the most common form of this disease. A study from the Centers for Disease Control and Prevention shows that Type 2 (adult-onset) diabetes cases are increasing dramatically among women. Not only are women more likely to develop the disease than men, they also are disproportionately affected by its complications. Women with diabetes are seven times more likely to die of heart disease than are non-diabetic women. For men this ration is only two- to three-fold. Diabetic women also have a significantly higher incidence of congestive heart failure compared with men.
Diabetes develops when glucose can't get into cells and instead builds up in the bloodstream. Glucose is a simple form of sugar that supplies energy to the cells. The main source of glucose is food, mostly carbohydrates, that breaks down to sugar in the intestine and cause blood glucose levels to rise. In response, the pancreas releases the hormone insulin, which directs glucose from the blood into the cells, either for immediate use or to be stored in fat and muscle. In this way insulin returns blood glucose levels to normal.
In type 1diabetes, which develops in adolescence, the body cannot produce enough insulin to drive glucose into the cells, causing blood glucose levels to rise. In type 2, which starts in adulthood, the pancreas makes plenty of insulin, but fat, muscle, and other cells resist the normal action of insulin – a condition called insulin resistance. This leads to elevated blood glucose levels (hyperglycemia). In this same process, the liver produces more sugar as well as triglyceride-rich lipoproteins, which raise the LDL (bad) cholesterol and lower HDL (good) cholesterol. Blood pressure rises and abdominal fat increases.
Ninety percent of all diabetics have type 2 diabetes. Genetics, aging and some medications can cause insulin resistance, but the main non-genetic factors are overweight and lack of exercise. Of the 900,000 Americans who will be diagnosed with type 2 diabetes this year, 90% will be overweight. Recent research suggests that fat cells secrete a hormone named resistin that interferes with insulin action. The pancreas can compensate for insulin resistance for a long time by pumping out more insulin. But eventually it becomes exhausted and can't continue to produce high levels of insulin. As a result, glucose builds up in the blood and causes problems throughout the body. Diabetes can cause fatigue, nausea, frequent urination, increased thirst, and blurred vision. Uncontrolled, diabetes damages both large and small blood vessels, resulting in cardiovascular disease, blindness, kidney failure, and nerve disease.
Weight loss – through exercise, diet, or both – is essential in treating type 2 diabetes. Losing just 10 pounds can mean a return to normal blood sugar levels, even in women who are significantly overweight. Weight loss lowers insulin resistance and helps the body use its insulin more efficiently. Exercise may be the best way to prevent diabetes. The Harvard-based Nurses' and Physicians' Health Studies have found that women and men who exercise at least 5 times per week are about 40% less likely to develop diabetes than those who don't exercise. Dietary control centers on eating healthy meals and snacks on a regular schedule and shunning excess calories. Research last year in the New England Journal of Medicine found that a high-fiber diet (50 grams per day) lowered blood sugar levels by 10%.
But another factor is now being considered as contributing to the increase in type 2 diabetes--poor sleep habits. According to research presented at the annual meeting of the American Diabetes Association, young people who regularly got less than 6.5 hours of sleep a night had greater insulin resistance than people who got 7.5 to 8.5 hours of rest. Lack of sleep puts undue stress on the body. The body, in turn, releases a torrent of stress hormones that interfere with the way blood sugar, or glucose, is processed. And, a recent survey by the National Sleep Foundation found that more than 60 percent of Americans do not get the recommended eight hours of sleep.
About 16 million Americans have diabetes. In just the past decade, there has been a 40% increase in diabetes in the U.S. – and a 70% increase among people in their 30s. Diet (including five servings of fruit and vegetables a day), regular exercise (walking 20 minutes a day), and getting enough sleep, are the keys to lowering our risk of developing this unwanted disease.
For more information visit the following websites:
The CDC National Diabetes Education Program www.cdc.gov/diabetes/projects
The American Diabetes Association www.diabetes.org. The ADA has also published a book "The Complete Guide to Diabetes" which available on Amazon.com.
Web.MD diabetes information at http://my.webmd.com/condition_center/dia
