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Adult-onset diabetes risks and avoidance factors

by Wendy Smith

I know the nicest guy in the world. Seriously. It’s not just my opinion. A lot of other folks feel the same way about him. But I worry about him. He’s the nicest guy in the world, and he’s at risk for adult-onset diabetes, otherwise known as type 2 diabetes. Actually, one in 20 adults in the United States has type 2 diabetes and, unless eating and exercise trends change, one in four adults will have type 2 diabetes in the next decade. I should worry about all of us, but I don’t have enough time, so I’ll just worry about him.

It’s a severe, debilitating disease and one that is, in many cases, preventable. It is one of the most serious killers facing our nation today, because complications are numerous and deadly. They include weight gain, heart disease, nerve damage, circulation impairment, blindness, kidney failure. It’s like putting the aging process on fast forward. Unlike type 1 diabetes, in which the body does not produce insulin or enough insulin, type 2 is the opposite. The body produces too much insulin because the body is insensitive to it. Type 2 sufferers often start out with high insulin levels and end up with low insulin levels after many years.

I’m not exactly sure what risk indicators the nicest guy has except that he used to be overweight, and he has trouble with his blood sugar levels. There are several indicators, though, that are used to determine risk, such as: a family history of diabetes, obesity (20 plus percent above recommended weight), age (45 plus), race (African American and American Indian to name two at a higher risk), impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), hypertension, high triglyceride levels, low adiponectin levels or elevated fasting glucose levels.

Probably the simplest indicator, though, is how one feels after one eats. If intense mood swings can be attributed to food consumption, it’s time to re-evaluate diet and exercise programs. The highest level of risk goes to people who are obese (65 percent of the American population). Obese people have a near 100 percent chance of contracting this disease and around 85 percent of individuals with type 2 diabetes are obese. Why? One reason is that full fat cells (especially those in the abdominal region) secrete several hormones, cytokines and free fatty acids that reduce the effect of insulin, so the body overproduces to cope with the stressed blood sugar control system. The American diet readily sets people up for this disease too. It is very easy to overeat processed carbohydrates, and those cause blood sugar spikes. The blood sugar spikes cause insulin spikes, which can eventually throw off the blood sugar control system and cause the body to lose its sensitivity to insulin. Additionally, processed carbohydrates dole out calories without much nutritional value and can easily contribute to weight gain.

So we’re all at risk in some way. What can be done to lower our risk or control this disease in its early stages? The first obvious answer is exercise. Moderate exercise helps combat type 2 diabetes by increasing circulation and cardiovascular health. It lowers anxiety and can act as an appetite suppressant. It increases the basal metabolic rate. Most of all, it contributes to weight maintenance and the reduction of full fat cells. The second obvious answer is to eat well. Avoid large amounts of processed carbohydrates (white rice, pasta, white bread, white sugar). Avoid foods that list sugar (sucrose, glucose, maltose, corn syrup), fat or salt as one of the first three ingredients. Reduce the amount of red meat and grain-fed animal foods. (Although the nicest guy’s blood sugar levels have been much more stable since he’s been on the Atkins diet, meat lacks the antioxidants and phytochemicals that help ward off cancer and diabetes, and it contains a great deal of saturated fat which some studies say amplifies the risk of heart disease.)

Try to lower overall consumption of fats, especially saturated fats, trans fatty acids and partially hydrogenated oils, which have a dampening effect on insulin action. Increase the amounts of food with a low glycemic index. Foods with a low glycemic index get introduced slowly into the bloodstream thus avoiding severe blood sugar spikes. Eat as many whole foods as possible. A food worth mentioning here is nuts.

Studies have shown that the consumption of nuts is inversely associated with the risk of type 2 diabetes, independent of other known risk factors including obesity. Nuts have a low glycemic index and provide magnesium, fiber and beneficial monounsaturated fats and polyunsaturated fats that improve insulin sensitivity. And studies show that people who consume nuts are less likely to be obese.

To be continued. Part two of this article will focus on vitamins and supplements in regard to type 2 diabetes. Your homework over the next two weeks is to see Super Size Me. See the movie section for times and guru comments.

June 24, 2004 • Vol. 14, No. 26 © 2004 Metro Pulse