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According to the CDC, 29 million people in the United States today have diabetes. Worse, one out of every three children born here can expect to be diagnosed with the disease, at younger ages than ever before.
Yet the cause of this alarming trend often lies within our own hands.
“The rise in diabetes mirrors the rise in obesity,” says Michelle Magee, MD, a practicing endocrinologist at MedStar Washington Hospital Center and an associate professor of medicine at the Georgetown University School of Medicine. “Over the last 25 years or so, we as a nation started walking less and eating out more. As a result, many incidences of diabetes today are related to lifestyle.”
Many, but not all. Type 2 diabetes – the most common type - does run strongly in families. This means that your family genetics definitely play a role in whether you will get it or not. But Dr. Magee—who is also director of the MedStar Diabetes Institute’s clinical, education and research programs—concentrates on the risk factors that patients at risk for diabetes, known as pre-diabetes, or with diabetes can change and control.
The first step you can take is to know the numbers that tell you if you have pre-diabetes or diabetes.
There are two major blood tests that physicians use to help determine the presence or absence of diabetes…or the risk of developing it. The first is the fasting blood glucose (sugar) test. This provides a snapshot of how well your body is balancing what you eat and your physical activity at the point in time that your blood is tested. The second, called the A1C test, measures the average amount of sugar in your blood stream over a two- to three-month period. In both tests, numeric results are broken down into ranges classified as normal, pre-diabetes or diabetes.
The good news is that risks and complications—as well as those tell-tale numbers—can often be driven downward by eating right and exercising regularly. Large national studies have proven that intensive lifestyle changes can reduce risk for going from pre-diabetes to diabetes by up to 60 percent…and help prevent complications of diabetes itself. This includes preventing blindness, kidney disease, nerve damage and limb amputation. Lifestyle changes also help prevent cardiovascular disease, heart attack and stroke which are more common in people with pre-diabetes or diabetes than those without these conditions.
For those living with pre-diabetes, “As little as a 7 percent weight loss can make a big difference,” Dr. Magee says. “For a 200- pound person, that’s only 14 pounds. Exercising 30 minutes a day at least five times a week is also key.”
Once you have diabetes, because it is a progressive disease, most patients will eventually need some form of medication. But this isn’t your grandfather’s treatment. Advances in research and technology have produced 12 different classes of pills and two classes of shots, with delivery systems ranging from needles to pens to patches to pumps. And even more drugs, approaches and management techniques are on the horizon. As a result of advances in diabetes treatments in the past 20 years, people living with diabetes are living well and with less problems from complications than used to be the case.
Even the best of modern medicine can get a boost from a patient’s personal efforts. Toward that end, education is key, so patients understand their readings, how to correct low or high blood sugar levels, what to eat and when, how to recognize side-effects from medication and more. Unfortunately, studies show that nearly 50 percent of patients with diabetes never get the grounding they need to understand their condition and what they can do.
Ever the educator and advocate, Dr. Magee urges people with diabetes to do their own “due diligence” into the disease, and take advantage of management and support programs offered by the MedStar Diabetes Institute and others within the community.
“My biggest message to patients is this: Learn about diabetes. Then you can take control of it, versus it taking control of you.”