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diabetes1

Here’s a scary statistic.  Americans born in 2000 or later have a lifetime risk of more than one in three of developing type 2 diabetes (3).  The problem extends across the world with increasings cases of diabetes in developed and developing nations like the UK, China and the Arab Emirates (3).  Diabetes is a growing world public health concern for several reasons (1-6). Long-term consequences of type 2 diabetes include vision problems, kidney issues and nerve loss.  On a larger scale, diabetic complications contribute to stroke and myocardial infarction(2).  An estimated 65%–80% of people with diabetes will die of a cardiovascular event, many without prior signs or symptoms of cardiovascular disease (2).  Diabetes  also impacts quality of life in terms of fatigue, healing from injury and sexual complications.

Type 2 diabetes is a prevalent and costly chronic illness that demands lifestyle interventions, effective monitoring and sometimes pharmacologic management (2). The good news is that we have the power to control common risk factors including physical inactivity, blood pressure and blood lipid levels as well as blood glucose levels (2).

Over the last several years, many diabetes risk score models have been created (2-5).  These tools are easy to use questionnaires that increase awareness, helpdiabetes2 gauge risk of developing type 2 diabetes and/or requiring pharmacological intervention.  The higher the score the higher the risk.  Low scores are better.   Like all tools they do not provide the right answer all the time for all people.  These tools evaluate your risk and help answer the question, “should I seek further guidance from a medical professional?”

Furthermore, the research suggests that these tools help guide medical professionals in prioritizing further testing for type 2 diabetes.  30–60% of people with diabetes go undiagnosed and can have potentially life-limiting consequences.  On the flip side, over-testing leads to over-diagnosing, false positives and unintentionally creates problems that could have been avoided.  This is a sticky point and it is still unclear who should or should not be tested but the medical community is moving in the right direction by focusing on high risk individuals and using their judgment in questionable cases (2-5).

Take home point:  type 2 Diabetes is preventable (2-5). Pharmacological intervention is not always necessary early on provided people can control their risk factors.  I still haven’t met anyone that wants to live on meds.  Many studies show that lifestyle plays a critical role in developing disease even in people with a strong family history.  So don’t think you are doomed if diabetes runs in the family.  That said, nothing is new under the sun.  Eat right, exercise, watch your weight,  stop smoking, drink in moderation and all that jazz.  You have heard it all before.  Now you have a tool to grade your efforts.

BTW, in case you were wondering, the most important factors were age, BMI, waist circumference, high blood pressure and increased blood sugar.  So for all you wellness advocates, paleo promoters, supplement sellers and cross fitters, keep fighting the good fight!

Stay healthy.  Live better.  Pass it on.

Dr. Lopez signing out……..

FINDRISC– Finnish Diabetes Risk Score.

anaerobic-exerciseREFERENCES:

  1. Type 2 Diabetes Screening Guidelines Updated. Medscape. Oct 18, 2012.
  2. Canadian Task Force on Preventive Health Care. Recommendations on screening for type 2 diabetes in adults CMAJ October 16, 2012 184:1687-1696; doi:10.1503/cmaj.120732
  3. Noble D ,Mathur R ,Dent T ,Meads C ,Greenhalgh T. Risk models and scores for type 2 diabetes: systematic review. BMJ 2012;343:d7163.  http://dx.doi.org/10.1136/bmj.d7163
  4. Timo Saaristo, Markku Peltonen, Jaana Lindström, Liisa Saarikoski, Jouko Sundvall, Johan Gunnar Eriksson, and Jaakko Tuomilehto.  Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome.  Diabetes and Vascular Disease Research May 2005 2: 67-72, doi:10.3132/dvdr.2005.011
  5. Jaana Lindström and Jaakko Tuomilehto.  The Diabetes Risk Score: A practical tool to predict type 2 diabetes risk.  Diabetes Care March 2003 26:725-731; doi:10.2337/diacare.26.3.725
  6. http://spo.escardio.org/eslides/view.aspx?eevtid=40&fp=P5480