Letters to the Editor

Viewpoint: Taking on the diabetes challenge

It is estimated that there are more than 25.8 million children and adults with diabetes in the United States and more than 79 million more with “pre-diabetes.” U.S. data from the 2011 National Diabetes fact sheet of the American Diabetes Association spells out a grim future: 1.9 million new cases of diabetes are diagnosed in people aged 20 years or older each year and another American is diagnosed with diabetes every 20 seconds.

One in three children born in the year 2000 face a future with diabetes. Diabetes kills more Americans every year than breast cancer and AIDS combined. The total yearly costs of diagnosed diabetes is $174 billion. The cost for “pre-diabetes” is $25 billion. Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2007.

The really bad news is that about 6 million people who have diabetes are undiagnosed and only 5.5 million of the 79 million with “pre-diabetes” know it. Why does this matter? Adults with diabetes have heart disease death risks, and their risk for stroke is about two to four times higher than adults without diabetes. While ostensibly a metabolic disorder of glucose dysregulation, diabetes is a killer cardiovascular disease.

However, the really good news is that, genetics notwithstanding, diabetes is preventable! Furthermore, “pre-diabetes,” a condition signaling future risk for diabetes, can be reversed and the onset of diabetes can be delayed or entirely prevented. Obviously, prevention of diabetes is far preferable than treatment and far less costly in human lives and expense.

Ninety-five percent of all diabetes is defined as Type 2 and is directly caused by obesity and intra-abdominal fat accumulation that cannot be seen nor felt (like the “spare tire” around the waist). This type of hidden fat surrounding the internal organs acts like an endocrine gland, releasing more than 100 hormones into circulation.

These hormones wreak havoc within the body on the normal metabolic pathways and are responsible for the risk factors for pre-diabetes and diabetes, including insulin resistance, hyperinsulinemia and cardiovascular disease (heart attacks and strokes), including dyslipidemia (like high cholesterol) and hypertension. A clustering of these abdominal obesity-related risk factors for diabetes and cardiovascular disease is described as the “metabolic syndrome.”

To combat the twin epidemics of obesity and diabetes seen in the adult population, as well as in childhood and adolescence, medical researchers have long sought to prove the most effective way to reverse this trend.In 2002, the Diabetes Prevention Program research group showed conclusively that a program of diet and exercise, with a behavioral component, was more effective than using medication in delaying or preventing the onset of diabetes in pre-diabetics.

This approach is the model for the Jim Green Trail Challenge!, a free, 16 week family diabetes prevention, fitness and weight loss program being organized in Atascadero.

For more information about the Challenge!, call 610-0367 or e-mail me at tcomar@ccnppa.org.

Find out more

An overview of the Challenge! program will be given on Feb. 17 at 7:30 p.m. in the AARP building at Atascadero Lake. Sign–ups and orientation for Challenge! will be held Feb. 26 at 8 a.m. at the Martin Polin Community Room in the Atascadero Library.

Tom Comar is the president of the Central Coast Nurse Practitioners and Physician Assistants group.