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Spring 2004

Diabetes on the Rise in Adults and Children

The sharp rise in obesity and sedentary lifestyles has resulted in an increased incidence of diabetes in the United States, where as many as 20 million people have the disease—a number expected to double by 2025. Type 2 diabetes, characterized by the body’s inability to make enough, or properly use, insulin, was once called “adult-onset”; but, with the alarming number of children being diagnosed, that has become a misnomer. These children and their adult counterparts face potential complications over their lifetimes that include heart disease and stroke, nerve disease and amputations, kidney disease, and blindness.

“Today’s foods and soft drinks contain much more concentrated levels of calories than they did in the past,” says Vikram Kamdar, M.D., an endocrinologist at Santa Monica-UCLA Medical Center. “Meanwhile, physical activity in the schools and at home has declined. When added up, you can see why we are facing this epidemic.

” Not all of the news is bad, Dr. Kamdar notes. Experts now have a much better idea about the risk factors for developing diabetes. The most definitive study to date shows that a healthy diet and moderate exercise can prevent or delay diabetes among those at risk, and can reduce the likelihood of complications for people who are already living with the disease.

An estimated 20 million Americans have so-called pre-diabetes or metabolic syndrome, with symptoms that can include a fasting blood sugar measurement of 110-125, waist measurement of more than 40 inches for men or more than 36 inches for women, blood pressure higher than 130/80, triglyceride levels higher than 150, and HDL cholesterol lower than 40 for a man or 50 for a woman. Studies suggest that making lifestyle changes including a healthy diet and moderate physical activity of 30 minutes a day, five days a week, reduces the risk of Type 2 diabetes by 58 percent.

Type 2 diabetes is often “silent” in its early phase, but anyone with warning signs such as tingling and numbness of the toes and fingers, increased frequency of urination, unexplained weight loss, blurred vision, fatigue and unusual thirst or hunger should be checked by a physician. The complications of diabetes are almost entirely preventable with not only lifestyle changes, but also close monitoring and medication.

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