Type 2 diabetes can be avoided

<p>Type 2 diabetes did not exist 100 years ago, for the most part. Poor eating habits, lack of exercise and genetic susceptibility are responsible for the epidemic we see in America today.</p><p>Type 2 diabetes is a lifestyle-dependent disease. We all need to exercise at least 30 minutes six days a week, eat low-fat, high-fiber diets, and keep our waists smaller than 40 inches around.</p><p>Sound familiar? Well, it's true. And we have heard this message over and over again in so many different forms that I fear we have tuned it out.</p><p>But we should listen, because Type 2 diabetes is preventable. Perhaps if you know what happens to the body with diabetes before you know it -- before it has even been diagnosed -- you will be motivated to address your own personal risks.</p><p>Long before diabetes causes symptoms, there usually exists a condition called "insulin resistance" or "impaired glucose tolerance," or IGT. Our bodies break down much of the food we eat into the simple sugar called glucose. In a healthy state, insulin is supposed to move glucose from the blood into the body's cells, where it is either burned for energy or stored for future use.</p><p>With IGT, there is still plenty of insulin available but the body is unable to use it, so the glucose stays out in the bloodstream. Small and fragile blood vessels are particularly susceptible to glucose damage, and this leads eventually to kidney failure, limb amputations and blindness.</p><p>People with diabetes are also two to four times more likely than people without diabetes to develop heart disease. Nerves become painful or dangerously numb when damaged by high glucose levels, and too much sugar causes erectile dysfunction that may not be reversible. All of these changes can be occurring silently during the years of insulin resistance, long before diabetes has been diagnosed.</p><p>So how do you know if you have impaired glucose tolerance? First, assess your risk. Anyone who is overweight, has elevated cholesterol, leads a sedentary lifestyle, has a relative with diabetes, had diabetes during pregnancy or has high blood pressure is at risk for IGT and Type 2 diabetes.</p><p>The risk goes up after age 45, but we are now seeing escalating rates of Type 2 diabetes in adolescents and children. Although IGT can affect people of all races, African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders are more susceptible.</p><p>Measure your waist: If you are a man with more than a 40-inch waist or a woman with more than 35 inches, then you are at risk. Anyone with risk factors should be screened for IGT; simple blood tests ordered by your physician can make the diagnosis.</p><p>The good news is that Type 2 diabetes is preventable, especially if you know you have IGT. According to a recent large study, people with IGT who took medication were able to reduce their risk of developing diabetes by 31 percent. Those who did not take medication but instead made positive lifestyle and diet changes reduced their risk by a much larger 58 percent. Lifestyle changes worked even better for participants over the age of 60, reducing their risk by 71 percent.</p><p>This information is empowering, essentially putting continued good health within our own control, independent of insurance companies, doctors and health care systems.</p><p>We've come a long way in the past 100 years. Type 2 diabetes used to be diagnosed when the damage was already affecting quality and length of life.</p><p>Many people today still have the attitude that they can ignore their health until there is a good reason to change, reasoning that if they aren't feeling sick there's no need to go looking for trouble.</p><p>But our ability to diagnose insulin resistance early and take measures to prevent its progression into Type 2 diabetes has made a difference. So maybe it's worth it to exercise a little more, eat better, and lose that extra fat around the waist. This kind of change could save your life.</p><p>Dr. Stacey Kerr, a longtime Sonoma County family physician, graduated from UC Davis Medical School and is certified in her specialty by the American Board of Family Medicine. Her columns are not intended as a substitute for hands-on medical advice or treatment. Consult your health care provider before adhering to any recommendations in this column. E-mail comments to drkerr@the-doctors-inn.com.</p>