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We have an epidemic of diabetes in the United States and worldwide.
Take a look at some of these staggering statistics from just this year:
By 2050, without significant change in our lifestyle, one third of all Americans will have diabetes.
The situation varies to some extent in other countries, but diabetes is clearly a worldwide epidemic.
This epidemic of diabetes and prediabetes is really an epidemic of insulin resistance. If we understand what insulin resistance is, and how it is prevented, we have a fighting chance to combat this epidemic.
Insulin is the hormone made by the pancreas to metabolize the food we eat. Without insulin, we can’t absorb calories and sugar into our bloodstream, so it’s crucial to life. In type 1 diabetes, individuals stop making insulin and hence need to be given insulin in order to live.
We are not talking about those patients here, who represent a very small percentage of diabetics. Instead, we are discussing type 2 diabetes, which is caused by insulin resistance.
The epidemic of insulin resistance is due to multiple factors. Many people have a genetic predisposition. Hispanics and Native Americans are particularly susceptible.
In order to survive during periods of famine hundreds and thousands of years ago, our bodies developed the capacity to become insulin resistant so that we didn’t burn all our calories and die when we couldn’t find food.
Obviously, this isn’t a problem in modern society, but the genes that cause insulin resistance are still present in many of us. When you combine that with obesity, overeating, the intake of calorie-dense foods (ex: junk food), and a significant decrease in physical activity in recent times, an epidemic of insulin resistance is created.
Insulin resistance develops long before diabetes is diagnosed.
When a person becomes insulin resistant, their pancreas produces more and more insulin in order to overcome the resistance and metabolize what we eat. For a while, because of increasing levels of insulin, the blood sugar remains stable.
At some point, the pancreas reaches the point where it can’t make enough insulin to metabolize what we eat, and blood sugar rises. This is when diabetes is diagnosed.
Typically, a person can be insulin resistant for 10 years or more before they have any symptoms or signs of diabetes.
There are no great tests to diagnose insulin resistance until the blood sugar starts to rise. And here’s the kicker: insulin resistance itself significantly increases the risk of heart attack and stroke. So people who have this insulin resistance, who are generally unaware they have it, already have a very elevated risk of a cardiovascular catastrophe.
Hopefully soon, we will have tests to determine who is insulin resistant. Before that happens, insulin resistance can be treated. But it will require a concerted effort from all of us to change our lifestyles to live healthier. The treatment of insulin resistance in 2017 does not include any specific medication. It simply comes down to good, old-fashioned diet and exercise.
If a person who is prediabetic loses just 6% of their body weight, their risk of developing diabetes drops by 75%!
Every fat cell that we get rid of decreases our insulin resistance and makes us more insulin sensitive. Every bit of exercise makes us more insulin sensitive. Every time we avoid high carbohydrate, calorie dense food (ex: desserts, sugar, bread, baked goods, potatoes, rice), we become more insulin sensitive.
When we combine a better diet with fewer calories, more exercise and increased weight loss, we can prevent and reverse insulin resistance.
Much information exists online about better diet. At WakeMed our nutritionists can help you understand how to improve your diet. A good rule of thumb is to aim for 150 minutes of aerobic exercise weekly. This includes activities such as: walking, running, biking, swimming aerobics, yoga, etc.
This sounds like a lot of exercise time but it’s crucial, especially since most of us have relatively sedentary jobs, at least compared to occupations one or two generations ago.
With understanding and lifestyle change, insulin resistance can be treated and prevented.
Diabetes, heart attacks, strokes, blindness and amputations can be prevented. But it will take both individual and societal change. If all of us don’t improve in this regard, we face an ongoing epidemic of diabetes and illness so gigantic that it will swamp our health care system and our economy.
Dr. Michael Soboeiro is a primary care physician at WakeMed Physician Practices – Primary Care – Garner. He is board-certified in internal medicine and has clinical interests in diabetes management and the care of patients with multiple medical issues.
Schedule an appointment with Dr. Soboeiro today.
3000 New Bern Ave.
Raleigh, NC 27610