LIFELONG HEALTH Undetected diabetes on rise, can be deadly

— Diabetes has become progressively common in America. Excessive weight gain leads to a condition often referred to as “metabolic syndrome,” in which the ability of insulin to pump glucose out of the blood and into cells is impaired. In a significant percentage of the population, this leads to elevated blood sugar and the development of diabetes. Fortunately, with systematic lifestyle changes, the condition can be reversed.

In many overweight people, diabetes can remain undetected for years until complications from the disease insidiously develop. Unfortunately, the ramifications of unchecked diabetes can be deadly.

Diabetics are much more prone to develop cholesterol deposits in arteries, leading to coronary artery disease, strokes and impaired blood supply to the lower limbs, causing peripheral vasculardisease. Diabetes also leads to kidney damage, cataracts and retinal disease, a leading cause of blindness and degeneration of the nervous system.

This, in turn, promotes the development of peripheral neuropathy, a condition that causes burning, numbness and tingling in the arms and legs. Particularly alarming is blockages to tiny blood vessels in the lower leg which, when coupled with impaired nerve function, can lead to ulcers that never heal or devastating disease of lower limbs cured only by amputation.

The earlier the diagnosisand the more compulsively blood sugar is regulated, the less likely serious complications will develop. The approach to treating diabetes depends on the level of the blood sugar over time and the effectiveness of the prescribed medications.

Most overweight adults have Type 2 diabetes, also known as noninsulin-dependent diabetes. Systemic monitoring of blood sugar and the response to medications will determine whether one, two or three oral medications are needed to bring the blood sugar back to normal levels. In the event that oral medications fail, treatment with insulin is often the next step.

Because diabetes has many complications, most patients are on multiple medications to prevent heart disease, lower cholesterol and triglycerides, protect the kidney, and manage any pain caused by peripheral neuropathy.

While medications canprove extremely helpful in managing diabetes, serious lifestyle change is the most important component to maintaining health and preventing complications. A recent study published in the journal Diabetic Care showed that an intensive lifestyle intervention to lose weight and improve physical fitness reduced health costs and significantly decreased the need for medications both for diabetes and other conditions.

The study, titled Look AHEAD (Action for Health and Diabetes), followed 5,145 overweight patients with Type 2 diabetes who ranged in age from 45-76. After a year, those who were in the lifestyle intervention group reduced medication use by 10 percent whereas thosewho received no counseling increased use by 11 percent. Aggressive lifestyle changes doubled the percentage of participants whose diabetes was optimally controlled.

Weight loss and physical fitness can make diabetes either improve dramatically or disappear altogether. But in order to ensure a long-lasting effect, it must be a sincere commitment to lifelong healthy habits. Patients under close supervision by experts in the field are more likely to achieve success.

Anyone recently diagnosed with diabetes is best served by becoming involved in intensive diabetic education. Supervision by an expert dietitian and exercise physiologist or trainer is also highly recommended. Learn everything possible about the diabetic diet. Know how, when and what to eat to assure predictable blood sugar levels.

Under the supervision of a qualified dietitian it becomes readily apparent that being a diabetic is not a life sentence to dull and tasteless food. A diabetic diet can be nutritious, filling and deliciouswhile simultaneously reducing excessive calorie intake.

For adults with Type 2 diabetes, weight loss achieved by a combination of diet and exercise will dramatically reduce reliance on medications and prevent side effects. Exercise must include 30 minutes of aerobic activity daily and strength training with weights at least three times per week. This form of resistance training reduces fat and builds muscle that is far more metabolically active. This in turn improves the function of insulin and reduces the need for medications.

With rates of obesity and diabetes on the rise, a reaffirmation and commitment to improving lifestyle and maintaining healthy habits is the only solution to reverse a potentially disastrous future.

Dr. David Lipschitz is the director of The Longevity Center at St. Vincent Infirmary Medical Center. More information is available at:

drdavidhealth.com

High Profile, Pages 50 on 07/25/2010

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