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Diabetes:  Fighting the good fight, one pound at a time

Size matters when it comes to managing diabetes.

Obesity goes hand-in-hand with the disease, physicians and experts say.  A healthy diet and regular exercise can go a long way toward fighting it.

Incidences of diabetes are climbing to epidemic proportions across the nation.  New Jersey is no exception.  The NJ Diabetes Council estimates that the percent of persons with diagnosed diabetes has increased by 48 percent in the last decade.  According to the American Diabetes Association, approximately 90 to 95 percent of U.S. adults who are diagnosed with the disease suffer from type 2, which is linked to obesity.

"This is extremely frightening because it did not usually occur until middle age," said Dorothy Caputo, director of special initiatives at UMDNJ's Continuing and Outreach Education Center.  "Half of the people with diabetes don't know they have it.  The disease just continues to progress and complications continue to thrive."

The Centers for Disease Control, estimates that the number of U.S. adults with diagnosed diabetes, including women with gestational diabetes, has increased 61 percent since 1991 and is projected to more than double by 2050.

Diabetes inhibits the body's ability to use or produce insulin, a hormone needed to convert sugar, starches and other foods into energy.  It can lead to heart disease, stroke, blindness, pregnancy complications and amputations.

Numbers seem to be rising most quickly among minority groups and younger minority patients, especially African Americans in their 20's and 30's, said Dr. David Kountz, associate dean for postgraduate education, associate professor of medicine, and chief of the Division of Primary Care at UMDNJ-Robert Wood Johnson Medical School.

He attributes this rise to various factors, including lowered criteria for diagnosing diabetes and more sedentary lifestyles.

"Unless they can make significant lifestyle changes they will need to be put on pills or insulin at some point," he said.

Consulting with a certified nutritionist is often necessary since controlling one's diet can present a challenge in minority communities.

"There are preferences for (certain) foods and cooking styles.  It's not easy to have a one-size-fits-all diabetes diet," Kountz said.  "But nothing is better than healthy nutrition and a healthy lifestyle.  No pill is better than the right lifestyle."

Self-control and education also help.  Many people are unaware of risk factors or genetic traits that might make them susceptible to the disease, he said.

Kountz said many of his patients don't make their health a priority because of demanding jobs and family obligations.

Weight gains go unchecked and they ignore a family history of the disease, he said.

"That is really the time when we can prevent or delay diabetes," he said, "Otherwise, I'm telling you a year later that you are diabetic."

Some patients believe that only people who have had diabetes since childhood are at risk for its complications.

"No one is immune from the potential problems that are associated with it," Kountz said.  "If you develop diabetes at 30, if you haven't done a good job of managing it, then you are at risk."

Several celebrities and entertainers have signed on to projects to spread awareness in the African American community.

Actress-singer Della Reese serves as the national spokesperson for an educational campaign that details her personal experiences with type 2 diabetes.

Singer-Luther Vandross is still recuperating from a stroke suffered last year as a result of the disease.  His mother, Mary Ida Vandross, has become a spokesperson for the Charles Ray III Diabetes Association, encouraging diabetes testing, treatment and prevention.

Diabetes at a glance

• 18.2 million people in the U.S. have diabetes, 616,700 in New Jersey have the disease.

• 5.2 million people have not been diagnosed.  About half of New Jersey residents with diabetes are not aware that they have it.

• Diabetes is the sixth leading cause of death in America.

Major types of diabetes

• Type 1 diabetes results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them.  It is estimated that 5 to 10 percent of Americans diagnosed with diabetes have this form.

• Type 2 diabetes results from insulin resistance, combined with relative insulin deficiency.  Approximately 90 to 95 percent of Americans who are diagnosed with diabetes have type 2 diabetes.

• Gestational diabetes affects about 4 percent of all pregnant women - about 135,000 cases in the United States each year.

• Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher that normal but not high enough for a diagnosis of type 2 diabetes.  It is estimated that at least 20.1 million Americans have pre-diabetes, in addition to the 18.2 million with diabetes.

SOURCES:  American Diabetes Association, NJ Diabetes Council, By Raven Hill - Staff Writer - Home News Tribune, Thursday, March 18, 2004

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