The Emerging Diabetes Epidemic: Science Has Now Proven That Diet and Exercise Can Prevent Diabetes, but Motivating the Public Is the Biggest Challenge

By Perry, Patrick | The Saturday Evening Post, March-April 2002 | Go to article overview

The Emerging Diabetes Epidemic: Science Has Now Proven That Diet and Exercise Can Prevent Diabetes, but Motivating the Public Is the Biggest Challenge


Perry, Patrick, The Saturday Evening Post


Americans are facing a weighty problem. With more than 61 percent of adults and 14 percent of adolescents in the United States now classified as obese, we are facing an unprecedented epidemic in type 2 diabetes among both American adults and adolescents. And the disturbing rise of type 2 diabetes in America's youth has sent shock waves throughout the medical community.

"There was a time when you would virtually never see type 2 diabetes in clinics that take care of children," Dr. Ronald Kahn, president of the Joslin Diabetes Center, told us. "Now, for example, at Children's Hospital in Boston, I would estimate that between 20 and 25 percent of the children we see actually have type 2 diabetes."

But there is good news.

Recent findings from the Diabetes Prevention Program confirm that Americans can drastically reduce their risk of getting type 2 diabetes by taking steps to shed extra pounds with diet and exercise. The study was halted a year early because the results were so remarkable, demonstrating that diet and exercise coupled with moderate weight loss could reduce the risk of getting type 2 diabetes by 58 percent.

Results of the 3,000-plus-participant study were so impressive that the country's top public-health officials applauded the trial and its message of prevention.

"In view of the rapidly rising rates of obesity and diabetes in America, this good news couldn't come at a better time," said Health and Human Services Secretary Tommy Thompson. "So many of our health problems can be avoided through diet, exercise and making sure we take care of ourselves. By promoting healthy lifestyles, we can improve the quality of life for all Americans--and reduce healthcare costs dramatically."

To find out more about preventing the disease and the latest developments in treatment, including the use of gene therapy to treat diabetic neuropathy, the Post spoke with Dr. Charles Clark, professor of medicine at the Indiana University School of Medicine, editor of the medical journal Diabetes Care, and chair of the National Diabetes Education Program.

Q: Diabetes is cited as one of the most rapidly growing diseases in the United States. Is this true, and if so, what is behind this alarming trend?

A: Unfortunately, it is true. As you know, diabetes is a disease of genetic predisposition and changes in the environment. Our genes haven't changed in the last 20 years, so we have to look at our environment. Unfortunately, the changes in our environment have to do with the decrease in physical activity and eating more. The incidence of obesity has risen tremendously. The diabetes curve is following the obesity curve over the last five to ten years.

Q: How many people with diabetes remain undiagnosed?

A: We estimate that there are about 16 million people in the United States and about 180 million people with diabetes in the world. In the United States, about one third of individuals with diabetes are not diagnosed, so we can say there are about l0 million people with diabetes and another six million with the disease who do not know they have it.

Five to ten percent of these people have type 1 diabetes. We estimate in the United States around 600,000. The rest of the individuals have type 2 diabetes.

Q: Some individuals might say that since diabetes doesn't run in their family history, they don't have to worry about getting the disease. Could you address this notion?

A: It certainly is true that diabetes runs in families. There are certain people who are predisposed to diabetes. One group of people are those who have a family history, particularly a first-degree relative--a brother, sister, parent. And there are certain ethnic groups who are very predisposed to diabetes, such as the African-Americans, Asian-Pacific Islanders, Native Americans or American Indians, and the Hispanics. All of these populations are increasing in our more diverse society.

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