Prevent, Control, Eliminate: Diabetes and Your Weight

Strange but true - America has been getting fatter and fatter, but fat is not fueling the problem. "Fat gets a bad rap" but the fact is, fat is not fueling the problem - carbs are the culprit. Click on the picture for a great infographic that diagrams the science behind the 12 steps of getting fat, the role of carboyhydrates in that process, and what carbs are the worst offenders.

Type 2 Diabetes significantly increases a persons risk for vision loss due to eye disease. In a recent study by the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), 3.6% of type-1 diabetes and 1.6% type-2 diabetes were legally blind.

People with Type 2 diabetes are at higher risk for a number of eye diseases, including cataracts, glaucoma, and "diabetic retinopathy", or non-inflammatory damages to the retina of their eyes. Your retina is the part of your eye that is sensitive to light. Retinopathy is caused by problems with blood supply.

Retinopathy is caused when a Type 2 diabetes patient does not adequately control blood sugar; sugar crystals form in the capillaries, causing micro aneurysms that leads to macular edema (fluid leakage) into the part of the eye that is is responsible for precise vision.

During the late stages of retinopathy, fragile new capillary growth in the eye can severely reduce vision capacity, or bleeding can cause retinal detachment and blindness.

The main risk factor for developing diabetic retinopathy is the length of time the patient has been diagnosed with diabetes. Among patients in the WESDR study, 8% developed diabetic retinopathy 3 years after diagnosis; this number jumped to 25% at 5 years post diagnosis, and 80% at 15 years post-diagnosis.

The good news is, early stage retinopathy is treatable. Good blood sugar control through lifestyle modification (diet and exercise) and medication (such as metformin) can prevent the onset of, and slows down the progression of, early stage retinopathy.

If you have been diagnosed with diabetes, it is important to have an annual vision exam, especially if you experience any difficulty seeing clearly.

More than 350,000 people have had LAP-BAND surgery. Another ~200,000 have gastric bypass each year. Vertical sleeve gastrectomy is the fastest growing obesity surgery, and the new gastric plication, or "pleat" - an evolution of reflux surgery that accomplishes stomach restriction without device implantation or resection - is being hailed as the future gold standard king of the weight loss surgeries. Is this too many people having surgery instead of losing it by less drastic and invasive means (that are not without significant risk).

In Prevention Magazine (August 2011) Dr. Oz focused on weight loss, physical activity, and better sex and overall health. And while some might guess that a physician would be against surgical intervention for weight loss except in extreme cases, that is not the case with Dr. Oz, who says that "we are probably only performing about 1% of the gastric bypass surgeries that we should".

Dr. Oz calls himself an advocate for gastric bypass surgery in reducing the national BMI and stemming the devastating tide of maladies associated with "diabesity", saying he thinks that obesity surgeries will play a major role in people gaining control of their diets and lives.

He points out that a 50-year-old who is ~100lbs overweight has the same mortality rate "as if you have a solid cancer'" (that sounds pretty horrible, doesn' tit? I know, I paused when I read that too - ugh). Dr. Oz points out that in the case of the cancer patient, no one would hesitate to operate...so why hesitate on the obese patient, whose at just as much if not more risk of premature death.

In the world of Oz, if a person cannot lose the weigh on their own, that person should have a weight loss surgery. Do it with counseling and a complete clarity of understanding regarding the permanent changes in your eating and even lifestyle, but do it because "if you get people to start losing 5% of their excess body weight, you're really taking a big whack out of the two-thirds of Americans."

Type 2 Diabetes affects everyone - from kids to commercial drivers. The American Diabetes Association has created some resources for people to understand what their rights are. Did you know that your child's school has an obligation to meet the healthcare needs of its students who have diabetes? From correctional facilities to the workplace, if you have diabetes, you should know what you have the right to expect in terms of accommodations.

Many patients with Type 2 diabetes diligently diet and watch their blood sugar closely, and end up neglecting what Angeles Health International Medical Information Director Dr. Janis Gruska says is probably the most important factor in saving the lives of Type 2 diabetes - that is, controlling cholesterol and blood pressure.

Lowering cholesterol and blood pressure protects protects against heart disease and heart attack, the number one killer among people with Type 2 Diabetes. Though many Type 2 diabetes patients assume that that controlling blood sugar is the holy grail of controlling Type 2 Diabetes, that is not the case - both cholesterol and blood sugar levels are not impacted by blood sugar levels, and are equally if not more important than blood sugar for protecting long-term health.

"There's no doubt that blood sugar control is very important in diabetes," says Dr. Gruska. "It is essential for preventing some of the more fearsome complications, such as blindness, kidney failure and amputation. Faced with the spectre of such complications it's no wonder patients put most if not all of their preventive focus on blood sugar. But focusing on the blood sugar is like trying to avoid the flames in a burning house - and forgetting that smoke inhalation is what actually kills most people. Cholesterol in this case is the smoke."

Important advice, considering that according to the American Diabetes Association, nearly 75,000 Americans die each year from Type 2 diabetes - that's more deaths than any other disease except cancer, stroke and heart disease.

Unfortunately, most diabetic patients, through a lack of what Dr. Gruska calls a well-rounded, education about their disease are not doing what is needed to protect themselves from the damaging effects of uncontrolled cholesterol and blood pressure. The Centers for Disease Control and Prevention reports that just 7% of Type 2 Diabetes patients get all the treatments they need.

Other prominent members of the medical community agree with her. "I can only conclude that people are not aware of their risks and what could be done about them." said Dr. Michael Brownlee, director of the JDRF International Center for Diabetic Complications Research at the Albert Einstein College of Medicine in New York, as quoted in a New York Times story on Type 2 Diabetes.

So who do the other 93% of undertreated diabetes blame? Start with the medical system. Most people diagnosed with Type 2 diabetes go to a primary care doctor, most of who have had only a few hours of instruction, if that, regarding the disease - and most of THAT (decades ago, in med school) is devoted to detection, not long-term management and prevention. Add to that the fact that most GPs spend only 10 minutes or less with each diabetes patient, and it's no wonder that patients have defaulted to a dangerously simplistic strategy - managing blood sugar - for a complex disease.

Drug companies share some of the blame - most ads for diabetes drugs focus on blood sugar control, emphasizing the subliminal message that this is the main culprit of diabetes mortality, when in fact that is not at all the case.

And in part it is the fault of public health campaigns that give the impression that diabetes is a matter of an out-of-control diet and sedentary lifestyle and the most important way to deal with it is to lose weight.

It's Not the Diabetes, It's the Heart Disease

Most diabetics think the biggest risks they face from their disease is blindness or amputations and do not even think about heart disease. Neither are their doctors prescribing cholesterol-lowering or blood pressure drugs, something few patients think to ask for on their own: the American Diabetes Association reported results from a recent survey that showed only 18% of people with diabetes believed that they were at increased risk for cardiovascular disease.

Dr. Gruska thinks a drastic change in messaging is needed, and that Dr. David Nathan, director of the Diabetes Center at Massachusetts General Hospital, has made the point that could saves most succinctly with this recent comment:

"It's not the diabetes that kills you, it's the diabetes causing cardiovascular disease that kills you. Watch your cholesterol."

The gastric pleat is an evolution of reflux surgery and offers patients greater, faster weight loss than band. Health Travel Guides offers Squidoo readers free medical travel & complications insurance when they decide to have the gastric plication - featuring no medical device implantation (like LAP BAND) and no stomach resection (like Gastric Bypass) at state-of-the-art private luxe Hospital Angeles, the world's leading weight loss surgery center for gastric plication, and the home of the ongoing CE Surgical Training Courses for the proctoring of the gastric plication (also known as gastric imbrication and total vertical curvature plication) procedure. Get more info @ 866.978.2573 x 129 or chat online for details: http://dld.bz/free-insurance-offer.

Click on the picture to read the story of E.Magill who posted today over on Open Salon. The 32-year-old is, fittingly, celebrating Diabetes Awareness Month by sharing his story of getting a Type 2 Diabetes diagnosis at the age of 27. In his article he describes living with Type 2 Diabetes for the past 5 years.

Do you recognize any of these attitudes or symptoms? If so, it might be time to get your blood sugar checked!

- Are you more than 20lbs overweight, and have you carried this much excess weight for more than ten years?
- Does your diet regularly consist of the following: pizza, pasta, fast food, soft drinks?
- Do you exercise (in which your heart rate is elevated) less than two 30 minute sessions per week?
- Do you often feel thirsty?
- Do you urinate frequently?
- Do you have parents or grandparents diagnosed with Type 2 Diabetes?
- do you ever experience: hands shaking, teeth clenching, irritability, 'brain fog'

One thing E. Magill points out that many overlook when considering the risk Type 2 Diabetes poses to one's health, are long-term consequences, including the following I've excerpted from his list:

- getting your eyes checked annually (Type 2 Diabetes damages capillaries which can cause irreversible blindness)
- medication for high blood pressure
- cholesterol checked every six months
- annual sonograms on my pancreas