I want to introduce you to a brave woman at the hospital where I work. Her name is Laureen. At 34 years old, she was an active nurse -- vibrant, full of life and a volunteer EMT. But now, 10 years later, she spends three days a week tethered to a dialysis machine to rid her blood of impurities that her failed kidneys can no longer process. She has lost parts of both her legs. Her body is slowly turning on itself and each and every day revolves around managing the disease that ravages and scrapes away at her insides: diabetes.
Laureen was on "The Oprah Winfrey Show" last Thursday, courageously sharing her story. Even though it's very personal, Laureen told her story because she doesn't want others to go through what she has gone through. And there are almost 60 million potential diabetics who can watch and benefit from her experience -- though it doesn't have to be this way. One of the most painful things about her situation is that it could have been prevented. That's right -- Laureen's disease trajectory could have been slowed, stopped or even reversed through lifestyle and diet choices.
As a surgeon I have operated on thousands of people whose hearts were destroyed by diabetes - about 25 percent of all the patients I see are diabetic. Most of them could have prevented their fate.
But as the tragedy of this news sinks in, the alarm bells are ringing. Here are the statistics: there are 24 million diabetics in this country and about six million of them don't even know it yet. These are people whose blood sugar is over 125. They will most likely find out when other complications arise such as impaired kidney function, vision problems and, of course, heart disease. Even scarier is that there are 57 million pre-diabetics who are at a crucial fork in the road. Their blood sugar is between 100 and 125 and they stand at a juncture where some simple lifestyle changes and mindful diet choices will lengthen their lives and save them a world of suffering. Nearly half of Hispanic and African American children born this decade are projected to get diabetes. The CDC estimates one third of all Americans will develop diabetes and live 15 years less while losing immeasurable quality of life.
No public health problem compares in scale.
Diabetes will bankrupt our healthcare budget if left unchecked. It costs us $175 billion now to treat this killer and its complications, and that's expected to double in 25 years. Despite the best devised policy plans to manage the economics of healthcare, all solutions will fail unless we address the root causes and engage in widespread awareness and prevention. It starts with education -- you must know what this disease is, who is at risk and how to prevent it.
There are two types of diabetes. Type 1 is also called juvenile diabetes and you are born with it. It can't be reversed but it can be managed. Only 10 percent of diabetics are Type 1.
Type 2 is the culprit in 90 percent of those 24 million cases and 57 million pre diabetics in danger of slipping into full blown disease.
Type 2 takes root when fat stored in the abdomen -- belly fat called omentum -- poisons the pancreas and causes it to stop producing insulin or the insulin in your blood cannot deliver glucose into your cells. Without insulin you cannot process sugar and without glucose your cells have no power supply. Belly fat is a huge problem in America, with 60 percent of our population overweight. Any casual stroll down the street will reveal the prevalence of omentum in our society. The reason for the drastic increase is a perfect storm of poor diet and sedentary lifestyle. Our ancestors usually had little food and had to work very hard to catch or kill what food they could. As a result our bodies are designed to survive scarcity and famine. Now with food available virtually unrestricted our biology is outpaced by this abundance, and overeating creates disease. It happened incredibly fast.
Why is diabetes so destructive? Quite simply in both Type 1 and 2 your body can't metabolize sugar, leaving it to float in your bloodstream. Sugar in your blood is like shards of glass scraping the inner lining of your arteries. The scrapes heal with scar tissue and cause blockages. Smaller blood vessels in your feet close completely and cut off circulation, resulting in amputation as the tissue dies and becomes infected. The coronary arteries scar and cause heart attacks and stroke. These sugar shards damage kidneys so severely they shrivel and die and patents often wind up on dialysis.
Here's the catch: The symptoms are reversible.
Right now the average American eats 140 pounds of sugar per year, which is 40 pounds more than when Oprah and I were born 50 years ago. Sugar is hidden all kinds of places that you least expect -- condiments such as salad dressing and ketchup, peanut butter, and of course juice and soda. To be competitive and make things taste better, food companies have added more and more sugar. The intention wasn't to hurt anyone, it was just to get you to like their food. We have slipped into a cultural acceptance of "a little sugar" - a little in our coffee, a little on our cereal, and it all adds up. The consequence of all that sweetness is obesity and rampant diabetes.
But back to the good news: 90 percent of diabetes is preventable and the symptoms are reversible. Let's go through a few risk factors and action steps:
First, the warning signs are constant thirst, frequency in urination, feeling tired, frequent infections, tingling in the toes, and vision problems. If you have any of these symptoms, see your doctor.
Risk factors are a big belly which blocks insulin, a sedentary lifestyle and a family history. When we refer to a "big belly" we mean one that measures more than half your height. If you are five foot 10 inches, (70 inches) your waist should measure no more than 35 inches at your belly button. Another rule of thumb is a woman of average height should weigh less than 150 pounds for optimum health.
Can we change our biology or our genes? No. But we can nudge it in the right direction. Avoid "white" foods -- those with enriched flours, pasta, obvious sugar and rich starches like potatoes. Avoid high fructose corn syrup, which is found in everything from condiments to bread. You can just read the label to see what's in a food item. Exercise - a lot! Start by walking and set a goal of 30 minutes three times a week of vigorous walking, then move gradually into an exercise program.
Also, know your numbers. Speak with your physician about your risk factors and a screening - just about anyone can get tested for free. This is one of the most important decisions you can make for your health and your children's health. You owe it to yourself and your loved ones. It's not just a little sugar!
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