A global diabetes epidemic is underway with devastating human,
social and economic effects. Every 10 seconds a person dies
from diabetes, every 10 seconds two new people get diabetes.
Diabetes is the 5th largest cause of death from disease in
the world and is the No.1 killer among non-communicable diseases.
It is expected to cause 3.8 million deaths worldwide in 2007,
about 6% of global mortality (about the same as HIV/AIDS).
Diabetes currently affects 246 million people worldwide and
this number is expected to rise to 380 million by 2025. Each
year a further 7 million people develop the disease.
The WHO say this translates into 25 million years of life
lost every year with an additional 23 million years of life
lost to disability. Bad as they are, these figures are almost
certainly a lot, lot worse than they appear. 50% to 80% of
people are unaware they even have the disease and a further
3.8 million deaths annually are attributable to diabetes as
cause of death from heart attack, stroke and kidney failure.
The medical bill for all this is horrendous, currently estimated
at US$232 billion.
A Democratic Disease
If you think diabetes is a disease of developing countries
and old folk, think again. Diabetes has been called “affluenza”
(that’s cute, but diabetes is NOT cute), traditionally
being a disease of the rich countries. And, while the highest
incidence is experienced in the demographic group 65+, the
disease is growing fastest in the 49 - 65 year old group.
No comfort for us there.
In the US some 27 million or 9% of the population have diabetes.
Over 20% of all Americans over 60 have diabetes. It affects
women only slightly less than men. In 2007 over 80,000 Americans
died from diabetes and for nearly 300,000 diabetes was cited
as a contributing factor. Deaths from the disease are massively
under-reported.
The effects of the disease are horrible. Heart disease and
stroke account for 65% of death in people with diabetes. Adults
with diabetes have heart disease deaths up to 4 times higher
than adults without the disease. High blood pressure: about
73% of Americans with diabetes have blood pressure greater
than 130/80 mm Hg or use prescription medication. Blindness:
diabetes is the leading cause of new cases of blindness in
America. Kidney disease: diabetes is the leading cause of
renal failure in the US, accounting for 44% of all new cases.
Neural disease: 60 to 70% of diabetics suffer mild to severe
forms of nervous system damage. Amputations: more than 60%
of all non traumatic amputations occur among diabetics. Pregnancy
complications: diabetes causes major birth defects in 5 -10%
of pregnancies and spontaneous abortions in 15 to 20%. To
complete the picture, your breath will probably be foul as
diabetics often develop gum and periodontal disease.
It’s Elective.....
In about 20% of cases the cause of diabetes is hereditary.
Other than that, to put it baldly, in rich countries it is
an elective lifestyle disease. You don’t have to get
it. The causes are bad diet and lack of exercise. 80% of Type
2 diabetes is preventable by adopting a healthy diet and increasing
physical exercise. In the developing world the cause is bad
diet arising out of poverty and ignorance.
The short life span of the Australian aborigine for example,
is directly attributable to the introduction by white Australians
of sugar, bread, jam and tea as wages, just as much as it
was to alcohol. Standard treatment of diabetes concentrates
on controlling blood sugar levels. Quite rightly, as the consequences
of not doing so can be dire, ending up with blindness, loss
of a leg, or kidney failure.
Successfully controlling blood sugar levels is great, so far
as it goes. It is, alas, only 40% of the preventative way.
The disease that kills nearly everyone with diabetes is heart
disease. This means attention to cholesterol & blood pressure
is the other 60% of staying alive for diabetes sufferers.
Effective overall treament means sufferers can live a normal
life for almost their entire natural span.
Most people, even doctors, behave as if obesity or being overweight
is the cause of diabetes, that losing weight will help cure
the disease. YES, it will. BUT only that 40%. Losing weight
does produce dramatic improvements and quickly. Blood sugar
levels drop and the disease seems under control as patients
stabilise at a lower weight.
HURRAH! I’M CURED!
Hang on a bit: the diabetes and the risk however still remain,
albeit with a substantially reduced risk factor for amputation,
blindness and kidney failure. The patient is NOT cured.
The Killer Factor
The grim missed statistic is the fact that almost a third
of all fatal heart attack patients in the US have diabetes,
even though diabetes patients constitute only 9.3% of the
population. Added to which, a FURTHER 25% of heart attack
patients are verging on diabetes with abnormally high blood
sugar levels.
The remaining two thirds of the preventative answer is treat
aggressively for heart disease prevention and watch blood
pressure like a hawk.
Specifically LDL cholesterol levels should be well below 100
(mg p/dcL), ideally it should be 80. The lower level is mandatory
if there is any indication of existing heart disease. Too
often diabetic patients with LDL levels of 100 to 140 (which
may be acceptable for a person without diabetes) are told
it’s OK. It is NOT OK. It is potentially lethal.
LDL reduction can be quick and simple, achieved most easily
with a statin drug to reduce LDL and as a preventative for
a number of risk factors. Lipitor is most effective of these.
If you are one of those people who don’t like taking
drugs, join the club - but don’t be a sap. When you’ve
got a big problem, you need Big Medicine. Diabetes and heart
disease kills people by the million. I’ve yet to hear
Lipitor has actually killed anyone.
How is it that so many doctors mostly miss the major cause
of complications and death from diabetes?
There are two reasons. First, it’s understandable when
you consider that public health campaigns give the impression
that out-of-control diet and sedentary lifestyle are the major
causes of diabetes. Losing weight (exercise & diet) is
the answer. That’s absolutely correct, but unfortunately
it’s only 40% of the answer.
Secondly, doctors: most people with diabetes are treated by
primary care physicians with just a few hours at medical school
on diabetes. They follow the book. The book is one third right,
the patient responds positively, ergo the patient is doing
great. NOT necessarily so. It ignores 60% of the fatality
risk factor.
If you are diabetic, ensure specialist treatment and ensure
ALL the major risk factors are addressed. Lose weight, exercise,
eat a good diet and use natural nutritional support. Seriously
consider use of a preventative statin.
It’s not the diabetes that kills you, it’s the
diabetes that causes cardiovascular disease that kills you.
Now That’s A Deal.....!
And lastly, don’t kid yourself. about any of this health
stuff, whether it’s diabetes or any other of the major
degenerative diseases which kill us. For the most part they
are elective and our lifestyle catches up with us, unless
we clean up the act as we grow older. Unfortunately the clean
up required is often unacceptable and/or uninformed. We kid
ourselves that tinkering will do it. Many of us say we’d
rather live our lives as we wish and accept/damn the consequences.
Well Good for You!
If you really mean it. I suspect however, much of this is
ignorant bravado or lack of imagination. Or even a declining
appetite for life itself. In which case don’t beat yourself
up but do at least be clear about it and not let the disease
your murderer be. The nasty underlying truth is that we do
not, most of us, shuffle this mortal coil snuffed out like
a light. No, we linger on for decades in pain and progressive
decrepitude, while the medical support system we have devised
for ourselves strips us of our wealth, before we finally quit
this world as naked of earthly asset as we came into it.
No, the real question is this: is it worth informing yourself
and radically changing the habits of a lifetime in exchange
for a decent shot at ten to fifteen extra years of active
life with marbles and mobility intact, followed by a short
final illness in your mid-80’s or 90’s, whenever
your organs finally give out, with a half decent inheritance
to leave to your children?
That, AND a misspent youth’s gotta be a good deal.
