• Diabetes is The New Heart Disease

    by Christoper Ko, MD
    on Sep 19th, 2016

Diabetes is the new heart disease.  Coronary heart disease used to be the primary health concern on most people’s minds, but from the 1960s to the present, fatal heart disease in the United States has steadily declined.  However, over that same time period, the prevalence of diabetes has more than tripled. Approximately six percent of Americans have coronary heart disease, while nearly one in ten Americans suffer from diabetes. 

The sad truth is that many Americans needlessly suffer from diabetes.  Adult onset diabetes is often a preventable illness, but many people ignore easily identifiable warning signs.  For instance, simple blood tests can help determine if you already have diabetes or are at-risk for diabetes—a condition known as prediabetes.  

Diabetes and prediabetes are also commonly associated with weight gain and being overweight.  One-third of Americans are overweight and another one-third is obese.  Part of the problem is some of the very medications used to control blood sugar in diabetics also promote weight gain!  For instance, commonly prescribed medications for diabetes such as sulfonylurea and insulin are associated with weight gain.  This might explain the somewhat surprising results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial in 2008, which showed that strict control of blood sugar was harmful.  Not only did aggressive blood sugar targets result in more medication, they were associated with twice as much risk of substantial weight gain and an increased risk of death.  

To create true wellness and improved health, diabetics and prediabetics should focus on measures that both lower blood sugar and improve weight status.  In 2012, the Food and Drug Administration approved two new appetite suppressants, Qsymia and Belviq.  In clinical trials, both medications not only resulted in weight loss, but an improvement in average blood sugar levels as well.  Weight loss not only makes diabetics feel better, it also actually makes their diabetes better.   

Adopting healthy lifestyle measures is another critical way to improve blood sugar and even prevent the progression of prediabetes to diabetes.  In the Diabetes Prevention Program, individuals with prediabetes who participated in an intensive lifestyle modification program reduced their risk of developing diabetes by 58%.  In this study, the intensive lifestyle intervention consisted of a healthy low-calorie diet, brisk walking for at least 150 minutes per week, and a curriculum covering diet, exercise, and behavior modification. 

One of the most important lifestyle changes you can make to reduce your risk of diabetes or improve blood sugar control is to eat a diet that has a low glycemic index.  Eating foods that are low on the glycemic index will help control blood sugar and prevent weight gain. Consider incorporating nuts, beans, protein and vegetables into your diet for low glycemic indexed foods.

Taken together, pharmacotherapy, lifestyle changes, and multidisciplinary behavioral programs can effectively treat or prevent diabetes and create truly long-lasting health and wellness. 

Author Christoper Ko, MD

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