Aug. 24-30, 2001
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Preventing a slow, silent epidemic

By Matt Kelly

Americans are eating, drinking and sitting their way into an epidemic.

Paulette Kaplan, nurse practitioner and diabetes educator with the Health System’s Diabetes Community Network, said the country faces an epidemic of diabetes cases because of Americans’ obesity, inactivity and poor diet.

There has been an increase in Type 2 diabetes, in which people build up glucose in their blood, and it needs to be controlled through diet, medication and insulin.

Kaplan said insulin allows sugar in the blood to enter the muscles and fat tissues, nourishing the body.

Symptoms of diabetes, including increased thirst and urination as well as weight loss, may not be immediately evident with gradual increases in blood sugar levels.

Sugar buildup in the blood breaks down fatty acids, making the blood more acidic and creating complications which can include blindness, heart attack, stroke and kidney failure as well as lead to amputations from a loss of circulation. Acute complications can include coma and dehydration.

Usually occurring in adults, Type 2 diabetes has lately been found in children as young as 10, which was considered unthinkable 10 years ago. About 95 percent of the 16 million diabetics in the U.S. are Type 2 and one-third of these are not diagnosed, Kaplan said.

To reduce the risk of diabetes, Kaplan advised exercise, which may be as simple as walking at least 30 minutes a day, not even all at the same time, five times a week. However, she said people who limit walking to only 30 minutes a day should walk every day. People should consult their doctors before they expand their exercise regimen.

Another key is maintaining a healthy diet and controlling weight, since reducing weight reduces insulin resistance.

“People should have a well-balanced diet,” she said, including cutting consumption of fatty and deep-fried foods. “Fatty foods have more calories per gram than fruits and vegetables.”

She stressed that diabetics don’t need to avoid certain food groups but simply need to limit their consumption of some things.

“People should keep their portion sizes down,” she said. “Many people just don’t realize how much they eat.”

Diabetics can track weight as a health risk factor through their Body Mass Index, which calculates a person’s height/weight ratio.

Kaplan also recommends stopping smoking.

“Smoking and diabetes increases your chance of a heart attack four times,” she said. She said moderate alcohol drinking, about two drinks a day, is permitted.

She recommends everyone get tested for diabetes, especially those with a family history of the disease. Check-ups should be annual, she said, unless advised more frequently by a physician.

Type 1 diabetes, which afflicts about five percent of the population, is more prominent in young children. It is an absence of the ability to produce insulin, which is manufactured in the pancreas, and is controlled solely through injecting insulin.

For those who have already been diagnosed with the disease, there have been advancements in treatment, including new medications and new longer and faster acting insulins, as well as insulin pumps, which automatically provide doses of insulin.


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