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by Reg Block
By the year 2050, 50 million North Americans may have diabetes, primarily caused
by improper diet, lack of exercise and genetic pre-disposition. Today in Canada
and the US there are 19 million cases of diabetes, more than triple the number
reported in 1965.
Globe and Mail public health reporter Andre Picard wrote on Oct. 18, 2003 that
"More than 16.5 million Canadians - half the population - are considered at risk."
Dr. K.M. Venkat Narayan, a diabetes epidemiologist with the US Centers for Disease
Control (CDC) says that one in three children born in 2000 will develop the illness
and nearly 50 percent of black and Hispanic children will be affected. The harsh
reality is that diabetes leads to a plethora of conditions including heart disease,
kidney failure, blindness, chronic open wounds and amputation. The Canadian Diabetes
Association (CDA) maintains that healthy diet, weight control, exercise and stress
reduction can help prevent diabetes.
In areas where diets are high in whole foods like fresh fruit and vegetables and
unrefined grains, diabetes is barely a statistic in contrast to North America
where junk food rules supreme and diabetes is an epidemic. But diet is not the
only culprit, as numerous prescription drugs used to treat other medical conditions
are known to produce diabetic markers like hyperglycemia (high blood sugar). Additionally
it is common practice for physicians to prescribe diabetes drugs for those with
a pre-diabetic diagnosis, rather than insisting upon lifestyle changes.
Earl L. Mindell, RPh, PhD, in his book Prescription Alternatives, says, "Giving
a borderline diabetic drugs without recommending lifestyle change should be considered
malpractice. Any physician or health organization that doesn"t vigorously, consistently,
and insistently work with a diabetic patient to lose weight (without weight loss
drugs, preferably) and exercise is not in the business of healing, they are in
the business of pushing drugs. Diabetes drugs should never, ever be a substitute
for a healthy lifestyle."
In the same Globe and Mail article, Dr. Ehud Ur, head of endocrinology and metabolism
at Queen Elizabeth II Health Sciences Centre in Halifax, said that another major
development is the recognition that diabetes is preventable, largely by adopting
a healthy lifestyle and maintaining a healthy weight. Conversely, in the same
story it is stated, "While new guidelines place much emphasis on diabetes prevention,
they call for dramatic changes in how it is treated. In particular, physicians
should screen early and treat risk factors aggressively, (with drugs and a combination
of lifestyle changes) even when people have so-called pre-diabetes."
Statistics show that 61 percent of North Americans are overweight and therefore
at high risk of developing adult-onset Type 2 diabetes, leading to full-blown
Type 1 diabetes. More alarming is the fact that one in seven children aged six
to 11 is obese. Pediatric endocrinologist Naomi Neufeld says, "overweight children
are 20 to 30 percent heavier today than they were 10 years ago." Obesity related
conditions, primarily diabetes, cost North Americans more than $120 billion in
the year 2000.
Marcelo Dominguez, CDA marketing and communications officer, says the purpose
of the Canadian Diabetes Association is to promote diabetes prevention, cure and
management of the disease. This is done through literature, seminars, lectures
and research, funded primarily by pharmaceutical companies, various corporations
and donations from gaming organizations.
Both Dominguez and Dr. Mindell maintain it is ultimately the individual"s responsibility
to make the necessary lifestyle changes to reduce risk of developing diabetes.
Recently, the CDA awarded $5.3 million to 96 Canadian research teams for the study
of diabetes, various biological mechanics, its relationship to other diseases,
genetic links and patient care. Only one "complimentary therapies" study of Canadian
blueberry and Moroccan nigella will be conducted on animals to determine "how
safe and effective these treatments are.Õ The results of most of the 96
studies could be beneficial for future development of diabetes drugs, a logical
progression given the huge growth projections for diabetes in the next 50 years.
In many cases, Type 2 or adult onset diabetes can be successfully treated with
diet (may include supplementation) and exercise. However, this requires a great
deal of cooperation and perseverance between the patient and physician. Oftentimes
neither is able to affect appropriate lifestyle changes thereby resulting in the
use of prescription drugs to control the symptoms. This presents a financial strain
on the medical system due to frequent doctor visits, not to mention pharmacy costs
for the patient. Some diabetics spend as much as $2,500 more per year than the
average pharmacy customer. Type 2 is most common in people over the age of 40
but that is changing as more teens and children are being diagnosed each year.
Today, Type 2 represents about 90 percent of diabetic cases.
Type 1 is an autoimmune disease most often found in children and people under
age 30. Because insulin-producing beta cells in the pancreas have been destroyed
by the body's immune system, Type 1s must compensate by injecting insulin daily
to stay alive. Types 1 and 2 are both about insulin production (or the lack thereof)
and the body's use of that hormone to help transfer glucose from the blood to
the cells. In the case of a Type 1, the body needs help producing insulin and
for a Type 2, help is required to process insulin. Unlike Types 1 and 2, gestational
diabetes is usually temporary and associated with pregnancy as the body's hormones
change causing a greater demand for insulin.
Diabetes associations, MDs, NDs, nutritionists and dietitians all agree that diabetics
need to become well informed about prevention, treatment and management of diabetes.
The first line of defence is exercise and proper diet. Ronald Kahn, RHN, RNCP,
CBCT, LBA and founder and director of Ubiquity Wellness Centers, says everyone,
including diabetics, should avoid eating white sugar, white flour, white rice,
commercial cereals, pastries and refined foods, as these are major contributors
to pre-diabetic and diabetic conditions. Rather, whole foods like unrefined grains,
vegetables, legumes, fruit and non-hydrogenated oils are preferable dietary choices.
Kahn says, "Depending on the depth of symptoms, most diabetics who decide to alter
their lifestyle and diet show significant improvement within months. Those on
insulin can gradually, with qualified medical supervision, reduce their dosage."
Keith Dawson, professor emeritus at UBC, also quoted in the Globe and Mail Oct.
18, said that exercise and diet can prevent diabetes in about 60 percent of the
population but once a person is diabetic, we are unable to manage with just lifestyle
changes; medication is needed.
Many long-term diabetics suffer with neuropathy, chronic ulcers and non-healing
wounds that cannot be easily or quickly reversed with diet alone. Klaus Kallesoe
PhD, of the BaroMedical Clinic, maintains that compromised microcirculation can
be reversed by delivering more oxygen to the affected area, thereby facilitating
angiogenesis (growth of blood vessels), osseogenesis (bone growth) and nerve regeneration.
Increased blood supply and oxygen to damaged tissue help reduce infection and
promote healing. As part of early detection, prevention and disease management,
Dr. Kallesoe stresses the importance of micro-vascular assessment to determine
the amount of blood flow through capillaries and to measure levels of tissue oxygenation.
This type of diagnostic plays a vital role in planning suitable treatment at any
stage of the disease and may help identify markers that can lead to major organ
failure and gangrenous infections that typically result in amputation. Dr. Kallesoe
says that 70 to 90 percent of diabetes-related amputations can be prevented.
Any way you slice the CDC numbers, our future looks grim, unless massive improvements
in diet, exercise and education start now. In Canada alone, if the experts are
right, at least one-half the population should be on medication, particularly
those over 40 who are considered high risk. Measures like this would not stop
the rise of diabetes but rather would perpetuate the diabetes industry and according
to some it could cause the financial ruin of our health-care system. Although
diabetes drugs are vital to the survival of many, the development and use of more
drugs should be considered only a stopgap measure and not the answer. Diabetes,
the disease of affluence, is largely a symptom of a how we live and the choices
we make. Among experts, doctors and laity, it is generally agreed that pharmaceutical
companies, diabetic associations and governments do not have the power to stop
the spread of diabetes. The responsibility lies with each and every person to
get informed and to make appropriate adjustments in diet and lifestyle.
Resources: Internet; www.diabetes.ca,
www.baromedical.ca, www.diabetes.org,
www.hc-sc.gc.ca.
Books: Hormonal Health, Dr. Michael Colgon; Prescription Alternatives, Earl L.
Mindell, RPh, PhD; Betty Crocker's Diabetes Cookbook, Richard M. Bergenstal, MD;
Diane Reader, RD, LD; Maureen Doran, RD, LD.
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