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Weight Loss Matters
Weight Loss Matters -- Posted by Gumbo on 11-04-04 17:27
Weight Loss Matters
Source: American Diabetes Association
Publication date: 2003-09-23
Another Reason to Lose Weight: More Doctors Are Struggling To Convey Risks
of Diabetes
By TARA PARKER-POPE
The Wall Street Journal
September 23, 2003
The medical community wants you to be scared of diabetes -- but not too
scared.
An estimated 16 million people are on the verge of developing diabetes, a
serious condition that can lead to blindness, limb loss, kidney failure and
early death. Yet new research shows that more than half of new diabetes
cases can be prevented with some fairly simple lifestyle changes, such as
losing a few pounds.
After years of reassuring diabetics that the disease is one they can live
with and manage, doctors and health workers are struggling with how to also
send the message that diabetes is a deadly, terrible disease -- so that more
people will be motivated to take steps to prevent it.
This month, many patients may begin seeing pamphlets and brochures in their
doctor's office distributed by the American Diabetes Association as part of
its "Weight Loss Matters" campaign, which is trying to spread the word that
people have to lose only a little weight to dramatically lower their risk
for diabetes.
But "it's much harder to get people's attention who are just overweight,"
says Christopher D. Saudek, director of the Johns Hopkins University School
of Medicine Diabetes Center in Baltimore. "It's always been a problem of how
do you get people's attention without scaring the life out of them."
The medical community has learned it must walk a fine line when educating
people about a disease as ubiquitous as diabetes, which afflicts 17 million
people in the U.S. The trick is to warn people of the dangers of the disease
without making those who already have it feel hopeless. Several years ago, a
frightening public-awareness campaign featuring Uncle Sam as a diabetic
amputee prompted so many complaints it was quickly shelved, notes Dr.
Saudek.
Type 2 diabetes is the most common form of diabetes, and usually is
triggered by poor diet, obesity, lack of exercise and genetics. The body
becomes unable to process insulin effectively and can't make enough insulin
to keep blood-glucose levels normal. Insulin is important because it
promotes the storage and use of all nutrients, including sugar. Once
full-blown diabetes occurs, blood glucose is barricaded from the cell and
accumulates in the bloodstream. Type 1 diabetes, which isn't preventable,
occurs most often in children and young adults whose pancreas doesn't
produce enough insulin.
ARE YOU AT RISK?
Here's a look at risk factors that should prompt a conversation with your
doctor about Type 2 diabetes:
. Being 45 or older
. Family history of diabetes
. A body mass index greater than 25
. History of diabetes during pregnancy
. Giving birth to a nine-pound or bigger child
. Low HDL (good) cholesterol
. High blood pressure
. High triglycerides
How diabetes damages the body isn't entirely understood. One theory is that
all the excess sugar in the blood stream triggers a process similar to
rusting -- the sugar begins to stick to things and damage blood vessels,
kidneys and nerves.
But while it is true that diabetics can make diet and lifestyle changes to
manage their illness fairly well, complications from the disease can be
tragic. The leading cause of death from diabetes is heart attack and stroke,
and about 40% of all heart attacks are caused by diabetes. Diabetes is also
the leading cause of blindness, kidney failure, impotence and amputations,
and steals five to seven years from your life expectancy.
"In the short term, people don't pay much attention -- they think, 'it comes
on slowly, everybody gets it,' " says David M. Nathan, Harvard professor and
director of the diabetes center at Massachusetts General Hospital. "But if
you live with it for 10 to 15 years, you can end up being pretty sick. It's
not a nice way to die."
Dr. Nathan led a three-year clinical trial studying 3,000 people who weren't
diabetic, but were overweight with higher-than-normal blood-glucose levels.
The study found that participants who made lifestyle changes lowered their
risk for developing the disease by 58%. The changes were relatively small --
they walked about 30 minutes, five evenings a week and lost about 7% of
their body weight -- only about 15 pounds each. The impact of the lifestyle
changes was even greater among people over age 60, where the risk of
diabetes was reduced by 70%.
But since the results of the landmark 2001 Diabetes Prevention Program study
were released, diabetes experts have remained frustrated at how difficult it
has been to get the word out to both doctors and patients. "We know there is
this enormous gap between what we know to do and how it gets done," says Dr.
Nathan. "Forget about patients listening -- doctors don't even listen."
In addition to the new pamphlets going out from the ADA, a new Small Steps
Big Rewards campaign was launched earlier this year by the National Diabetes
Education Program. This spring 30-second public-service announcements with
the slogan "Get Real" began airing, urging people to get checked for
diabetes and promoting the simple lifestyle changes that can prevent the
disease. The ads are also being piped into 10,000 medical waiting rooms
around the country, and patients may also see pamphlets from the program in
thousands of doctors' offices.
The goal is to simply get more people to ask their family doctor about
diabetes. It isn't always obvious who is at risk. Being over 45 and just
slightly overweight -- by 15 or 20 pounds -- puts you at higher risk for the
disease. A simple blood test can help determine if your blood-sugar levels
are above normal, putting you at high risk for developing diabetes over the
next 10 years.
"It's long been a concern that people don't take Type 2 diabetes very
seriously," says Martha Funnell, past president of health care and education
for the American Diabetes Association. "It's been our attempt to soften the
message to not frighten people, and in so doing, we perhaps have not
conveyed the seriousness well enough."
For more information about diabetes and obesity, visit
www.diabetes.org/weightlossmatters.
Publication date: 2003-09-23
© 2003, YellowBrix, Inc.
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