Diabetes: The Silent Killer

Millions of Americans don't realize they have diabetes, and that ignorance could cost them dearly

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HealthDay Reporter

SATURDAY, Nov. 17, 2001 (HealthDayNews) -- Millions of Americans have a potentially deadly disease and don't even know it.

The disease: Diabetes, which can cause blindness, kidney failure, heart attacks and strokes. More than 16 million Americans have diabetes, but more than five million of them aren't aware of their condition.

During November, the American Diabetes Association is hoping to reach some of those five million with the observance of American Diabetes Month.

"It is truly a huge national problem," says Dr. Francine Kaufman, the association's president-elect. "And it is an epidemic in the adolescent population."

Diabetes is increasing at a startling rate. In the last decade, there has been a 33 percent jump in people with Type II diabetes, often called "lifestyle diabetes."

Type II diabetes used to be known as "adult-onset diabetes," because it usually occurred in mature adults. But that term has been dropped as the disease increasingly strikes children in their teens or younger.

At the heart of the problem: Too much food and not enough exercise.

"We're getting heavier. We're not as active," says Dr. Frank Vinicor, head of diabetes programs for the federal Centers for Disease Control and Prevention.

"We're not only eating more calories, but maybe not the best foods, either," he adds.

Diabetes is caused by an imbalance of insulin, a substance that helps the body process sugar to produce energy.

Type I diabetes, usually first seen in children, is caused by the body's failure to produce insulin. People with Type I diabetes have to inject themselves with insulin daily.

But Type I diabetes accounts for only 5 to 10 percent of all diabetes cases. Type II diabetes is much more common -- and more preventable.

Drastic improvements in your risk for diabetes can be made with only modest changes in behavior.

Recent studies show that a brisk 30-minute walk five times a week and the loss of 10 pounds can cut the risk of Type II diabetes in half.

"That's hot stuff," says Vinicor. "You can cut the risk in half if you exercise and eat better.

"Those can be tough things to do," he acknowledges. "It's tough to exercise and to push away from the table. Food tastes good."

With more and more children developing diabetes, Vinicor and Kaufman say the schools are a good place to start changing habits.

"It's important that the schools are a healthy environment," says Kaufman. "It has deviated from that. You can eat junk food and sugary sodas whenever you want, and meanwhile, they've taken away physical education.

"That's not a good switch," she says.

Vinicor says school districts need to say "no" to lucrative contracts with soft-drink companies, which often pay schools millions of dollars for exclusive sales rights. Schools also need to reinstate physical-education requirements, he says.

"Somebody's got to step in and say, 'The risks are too great,' " Vinicor says. "We're not only harming the kids today, but also harming them later as adults."

While those with Type I diabetes have no choice but to inject insulin, an array of newly developed drugs is available to treat Type II diabetes. Some make the body more sensitive to its own insulin. Others slow down the body's absorption of sugar or reduce the addition of sugar from the liver.

Possible symptoms of Type II diabetes include excessive thirst, frequent urination, sudden weight loss, fatigue, blurred vision or tingling and numbness in the hands or feet.

Check with your doctor if you have any of these symptoms, particularly if you're overweight.

And also check with your local American Diabetes Association branch. Some may be offering free screenings during November.

Kaufman says progress against diabetes is possible, but will require both public and private efforts.

"We're in the era of a lot of innovations, a lot of new and important discoveries," says Kaufman. "We're looking at genetics, we're looking at treatment and preventive strategies.

"As a society, we're going to have to come up with some sensible policies. We need to encourage our schools and our public officials to get us safe and accessible places for physical activity, she says.

"But this is a disease pretty much like none other," Kaufman cautions, "where the burden of everyday management lies with the patient and their family."

What to Do: Learn more about Type II diabetes from the American Diabetes Association, or get answers to frequently asked questions about diabetes from the Centers for Disease Control and Prevention.

SOURCES: Interviews with Frank Vinicor, M.D., head of diabetes programs, Centers for Disease Control and Prevention; Francine Kaufman, M.D., president-elect, American Diabetes Association, and professor of pediatrics, University of Southern California School of Medicine, Los Angeles

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