~ Sticking It to Diabetes - Good Diet, Exercise Can Help Control Prevent Onset of Epidemic Disease

The Augusta Chronicle, 07-20-06

If you don't know someone with diabetes, there's a good chance you soon will.

A recent study found the occurrence of Type 2 diabetes has doubled over the past 30 years. Another estimated that a third of U.S. adults - more than 73 million - have diabetes or might be developing it.

Simply put, it's an epidemic, and it's driven by sedentary lifestyle and obesity, the upswing of which closely parallels the growth of the disease, says Kimberley Bourne, an Orlando, Fla., endocrinologist who treats diabetics.

Here's some good news: Most cases of Type 2 - once called "adult onset" - are preventable. You can head off the disease with lifestyle changes, says Dr. Robert Rizza, the president of the American Diabetes Association.

"In fact, if you stay lean and fit, you reduce your chances of getting the disease by 95 percent. It's almost totally preventable," he said.

The prescription? Diet and exercise.

Diabetes is a disease in which the body doesn't produce, doesn't properly use, or ignores insulin. The hormone regulates the metabolism of blood glucose - sugar - which fuels our cells.

When diabetes takes hold, glucose can build up in the body and coat blood vessels and nerves. Left untreated, the disease can cause an array of devastating maladies, including blindness, cardiovascular disease and kidney failure. When glucose interrupts nerve impulses and blood flow to extremities, diabetics sometimes are unaware of things such as cuts, scrapes and blisters, which might become infected. In severe cases, an amputation might be necessary.

Though the exact cause of diabetes hasn't been determined, research has repeatedly pointed a finger at obesity - usually a result of an inactive lifestyle and a poor diet - as perhaps the greatest risk of all. As weight increases, the pancreas pumps out more and more insulin to handle increased blood sugars.

"If the pancreas could make endless amounts, you might be OK," Dr. Bourne says. "But it says, 'I can't do it anymore.'"

By the time signs of diabetes show up - numbness in extremities, extreme hunger, frequent urination, excessive thirst, increased fatigue and blurry vision among them - the damage already has begun.

The ability to fend off diabetes is within almost everyone's grasp.

Exercise and a proper diet not only can help to decrease weight but also can take a bite out of high blood sugar.

"We used to think it (diabetes) was a slippery slope of progression," Dr. Bournes says, but research has found that the prescription can reduce blood sugars in diabetics and help those diagnosed as "pre-diabetic" to return to normal levels.

Prevention and early treatment of diabetes are paramount goals, says Mark Williams, the CEO of Community Health Centers Inc., which operates a network of central Florida clinics and offers diabetes screening.

"As a community, diabetes is one of those diseases that screams 'treat me early' so we can avoid complications, because complications are so very expensive," he says.

At the Florida Hospital Diabetes Center in Orlando, diabetics are proving that eating well and working out can help control the disease. Gym members test their blood before and after their workouts, and the difference they see in their blood sugar after exercising motivates them to keep on the move, says Paul Frickman, the center's exercise coordinator.

It's not unusual to see blood sugar tumble from, say, 140 to the normal range, which is between 70 and 100.

The benefit of a workout lasts from 24 to 72 hours. Another bonus: "When you exercise, sugar goes into your body without the assistance of insulin," Mr. Frickman says, so a diabetic's reliance on drugs might lessen.

Talar Glover, a clinical nurse specialist at the center, says today's supersize meal portions and fat- and sugar-laden foods, in addition to a variety of social conditions, are helping to fuel the disease.

Though many believe diabetes is about eating excess sugar, "it is not about sugars - it's about carbohydrates. They turn into sugar," she says. That's why diets should be based on a balance of meat, fruits, vegetables, dairy products and whole grains.

Today's go-go society, however, is largely stuck in the fast- food drive-through lane.

Balanced meals at home are rarer, Ms. Glover says, and children, who generations ago walked or rode bikes to school and played with neighborhood friends, are now shuttled to school and sitting in front of TVs and computers.

Many of the center's participants are models of how the disease can be contained. Joe Herring, 73, of Altamonte Springs, Fla., estimates he has lost about 40 pounds since he learned in 1993 that he had diabetes.

He watches his diet and gets to the center's gym twice a week. When he's not there, he walks or works out at home.

Mr. Herring's last blood work-up showed "everything well in line," he says. "You've got to take control of it, or it'll take control of you."

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