UM experts say making moderate lifestyle changes can reduce your risk of this serious disorder, which is nearing epidemic levels.
Whether or not you have been diagnosed with impaired glucose tolerance or have any known risk factors for diabetes, it is important to watch your fat intake and exercise regularly. Below are tips from experts at the University of Maryland Center for Diabetes and Endocrinology to help you keep a safe distance between yourself and diabetes.
Have you had a hard day at work? Was it the kind of day that makes you want to just curl up on your couch in front of the television with a bag of chips and a pint of ice cream?
Hold it right there. Step away from the food and drop the remote control. As hard as it may be in moments of weakness to police yourself, you must try because a warm seat on the couch and too many empty calories could lead to diabetes.
Thanks to underused gym memberships and high-calorie/high-fat diets, type 2 diabetes is on the rise, striking people at younger and younger ages.
"Type 2 diabetes is a lifestyle disease," said Michelle Sheldon-Rubio, R.N., an education coordinator at the University of Maryland Center for Diabetes and Endocrinology. "We live in a world that likes to mega-size everything. You can't go anywhere and get the small portion anymore. After eating so much food day in and day out, you won't feel like getting up off of the couch and getting any exercise. Over time, this takes its toll on the body."
According to the American Diabetes Association, about 16 million people in the United States have diabetes, and about half of them don't know it. Those with type 2 diabetes far outnumber those with type 1 or juvenile diabetes. About 95 percent of all diabetics have type 2 diabetes.
Type 1 diabetes is an autoimmune disorder that inhibits insulin production in the pancreas. Insulin is the substance that carries sugar to our cells where it can be converted into energy.
Type 2 diabetes typically develops over time due to physical inactivity, heredity and poor diet. In type 2 diabetes, the cells don't recognize and properly use the insulin that the body produces. This is called insulin resistance.
Sugar or glucose that hasn't been converted into energy by the cells can damage your heart, your nerve endings, your kidneys and your eyes. Diabetes complications include an increased risk of stroke, high blood pressure, blindness, kidney disease and amputations of the limbs.
Risk factors for developing type 2 diabetes include the following:
Despite risk factors, type 2 diabetes can be prevented in many cases. According to a recent National Institutes of Health study, a healthy diet and walking for 30 minutes a day, five days a week are the best defenses against the disease. In fact, the study shows that the risk of diabetes can be lowered 60 percent by simply incorporating some moderate daily exercise and cutting down on fat intake.
"We aren't talking dramatic weight loss here," said Sheldon-Rubio. "People can improve their health significantly by dropping 10 to 15 pounds."
Alan Shuldiner, M.D., director of the University of Maryland Center for Diabetes and Endocrinology, said that people must really change their lifestyles if they want to get a handle on diabetes. It isn't enough to merely cut back on what you eat without adding more activity into your daily routine.
"A good example of the importance of physical activity is the Old Order Amish," Shuldiner said. "They are a physically active population that has half of the prevalence of type 2 diabetes as the general, white population in the United States. Diet and exercise go hand-in-hand. You really can't do one without the other and expect to see results."
Type 2 diabetes is showing up in increasingly younger patients, warn experts. Until recently, it was usually diagnosed only in adults over 30. But today, about 10 to 20 percent of all diagnosed childhood diabetes cases are type 2, compared with only 2 to 3 percent a few years ago. The sudden rise in what has traditionally been called "adult-onset" diabetes is so startling it is being called an epidemic.
Most of these cases are being diagnosed in early adolescence because the combination of obesity, physical inactivity and changes in hormone levels during puberty cause insulin resistance. But there have been cases of children as young as 4 developing type 2 diabetes.
"We have definitely seen an increase in the number of adolescents being diagnosed here in the Baltimore area," said Debra Counts, M.D., head of the University of Maryland Center for Diabetes and Endocrinology's pediatric endocrinology department. "Parents should make sure that their children understand the importance of a healthy diet and exercise when they are still in elementary school because it is very difficult to get them to break unhealthy habits by the time they reach their teenage years."
According to the National Institutes of Health, as many as 92 percent of all children with type 2 diabetes are substantially overweight, and about 40 percent are clinically obese. A body mass index over 25 is considered overweight, and a BMI over 30 is obese. BMI is the ratio of weight in kilograms divided by the height in meters squared. When excess weight begins to interfere with breathing, it is considered morbid obesity.
"We have genes designed for feast and famine," said Sheldon-Rubio. "The generations that came before us were a lot more physically active than we are today, and the varieties of food we have access to weren't so readily available to them. They could afford to consume more calories because they burned them off very quickly as a result of their active lifestyles. But today, few of us are engaged in physical activity eight to 10 hours a day, and the excess fat that gets stored in our bodies leads to insulin resistance."
With computers taking the place of physical interaction and the proliferation of high-calorie, high-fat fast food supplanting nutritionally balanced, home-cooked meals, it is no surprise that we are seeing more young people with diabetes, said Sheldon-Rubio.
Despite risk factors, a diabetes diagnosis isn't inevitable. And for those who have been diagnosed, life-threatening complications don't have to ensue.
"Some things are set in stone," Sheldon-Rubio said, "but diabetes isn't one of them. People get frightened when they hear diabetes and think they are going to go blind or lose a limb. Well, not if they change their diets and get off the couch they won't. Diabetes is nothing to run a way from. It is something you must face head on."