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The Honolulu Advertiser
Posted on: Thursday, February 4, 2010

Diabetes: What you know may not be the truth


By Charles Stuart Platkin

Diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations and nerve damage. The National Institute of Diabetes and Digestive and Kidney Disease reports that more than 23 million people, or nearly 8 percent of the U.S. population, have type 1 or type 2 diabetes, and both types are on the rise. Diabetes is a metabolic disorder affecting the way the body uses and digests food. The food you eat is broken down into glucose and circulated in the blood as sugar — the body's source of fuel. Insulin (produced by the pancreas) moves the glucose/sugar from the blood into the cells. If you have diabetes, however, your pancreas produces less or no insulin. As a result, excess glucose builds up in the blood creating major issues for the body.

In his new book, "Diabetes Rising," medical journalist Dan Hurley sheds some light on this mysterious disease. The author recently answered some questions:

Q. Why focus on diabetes?

A. I have had type 1, or "juvenile," diabetes, since 1975, and I simply got sick and tired of reading and seeing so much information that is outdated and/or dead wrong. The main message we hear over and over again is that diabetes is totally manageable if you just take care of yourself, so any problems that develop are your own fault. And that's a terrible lie.

Q. What are the two types of diabetes?

A. Cars run on gas; bodies run on glucose — the sugar in your blood that supplies every cell with energy. But glucose can't get into those cells without insulin, the hormonal key that unlocks the cell walls. With type 1 diabetes, your body stops producing insulin because of an autoimmune attack causing your white blood cells to target and destroy the insulin-producing cells in the pancreas. Type 1 diabetics must take insulin for the rest of their lives. With type 2, as your weight and age increase, your body develops resistance to normal insulin levels, and your insulin-producing cells slowly grow weaker. Many people can prevent or reverse the early stages of type 2 through diet or exercise. When that doesn't work, pills are often necessary, and sometimes insulin.

Q. If diet, insulin or pills can treat diabetes, what's the problem?

A. The treatments hold diabetes at bay, but they don't "cure" it. Most diabetics still have higher blood-sugar levels on average than people without the disease. The result is serious damage to your eyes, the nerve endings in your feet, your kidneys and your heart. In fact, diabetes triples your risk of heart disease. Keeping your blood-sugar levels as near to normal as possible lowers these risks.

Q. Does eating sweets cause diabetes?

A. That is a terrible myth. Neither kind of diabetes is caused by sugar. It's true that eating something sweet can raise your blood-glucose level quickly, but then so can eating a plate of french fries or even a banana. People get obsessed with the idea that if they just avoid sugar, everything will be fine. It's far more important to watch your total calories, and in particular your total intake of carbohydrates.

Q. So why does type 2 diabetes occur?

A. The older and heavier you are, the greater your chances for developing type 2 diabetes. But type 2 also has a strong genetic link, so if your brother or mother has it, you are more likely to get it. And studies have shown that exposure to common pollutants also strongly raises your risk.

Q. Can a person cure type 2 diabetes by following a good diet?

A. It's possible but difficult. We're living in what I call a "diabetic nation," where it's easy to eat junk food and hard to find the time to be active. And let's get real: People who were couch potatoes for the first 40 years of their lives are going to find it hard to change their ways. It's true that you can usually hold type 2 diabetes at bay for a while by going on a modest diet and getting more active. But long term, it will just keep getting tougher and tougher. That doesn't mean you shouldn't try.

Q. So are you saying that many people do not take their diabetes seriously enough?

A. On the contrary, most people get consumed with worry and guilt. They try and try and feel like failures. We need to stop putting the blame on individuals and start working together as a society. To prevent type 2- and improve our overall health we need to change our communities, make sure sidewalks and bike lanes are available, put well-lit, inviting stairways in malls, offices and airports so that exercise becomes part of our normal lives. If healthy food were as cheap and convenient as fast food, more people would eat it. Throwing pills at type 2 diabetes is not going to fix it. We need a lifestyle revolution.

Q. Meanwhile, is there a diabetes cure coming?

A. If you have ever heard the sports term "winning ugly" you'll understand what I mean when I say that, right now, there are some "ugly" cures for both kinds of diabetes. As drastic as it sounds, bariatric surgery on the intestines has been shown to "cure" type 2 diabetes in a matter of days or weeks, even before the person loses weight. It's not for everyone, but for some it beats a lifetime of pills and struggling. And for type 1, researchers have now developed an electronic "artificial pancreas," an external device the size of an iPod that senses your blood-sugar level and automatically gives you only as much insulin as you need. I participated in a clinical trial of this device last year, and it's totally amazing. FDA approval of at least a preliminary version is expected in the next two years.