Letter to the Editor

America's growing waistline and diabetes

Wednesday, June 15, 2011

By Michael Carter

Medical Student

University of Nebraska Medical Center

Diabetes Prevention

It seems like everyone's waistline is growing these days. Although that increased girth might help a person hold down a lawn chair, it's not doing any good when it comes to their health. That increase in weight comes with an increased risk for hypertension, high cholesterol, heart attack, stroke, and of course, diabetes. Diabetes is a disease that causes the body to poorly regulate the amount of sugar in the blood, and it is diagnosed by measuring blood sugar alone. There are two major types: type I, which is often referred to as juvenile diabetes or insulin-dependent diabetes, and type II, which initially does not require insulin injections (though it may be required later).

How is insulin involved? Insulin is the hormone released by your body to regulate the concentration of sugar in the blood. Every time you eat a meal, sugar absorbed by the gut is transported into the bloodstream, increasing blood sugar. The pancreas senses this increase in blood sugar, and releases insulin in response. Insulin acts on many different organs and tissues, and stimulates muscle cells to transport sugar from the blood into muscle to be used for energy. Type I diabetes is a complete lack of insulin production by the pancreas, and insulin must be injected to survive. Type II is very different; in this version, peripheral tissues like muscle become resistant to insulin. Early on in the disease, insulin production is increased by the pancreas to compensate for this resistance. However, over time, the pancreas is overworked and eventually fails, leading to dependence on injected insulin.

Obesity greatly increases the risk for type II diabetes. Increased abdominal fat and lack of activity cause insulin resistance, leading to diabetes. The obesity epidemic is causing diabetes to become a public health issue. 1 in 3 Americans have pre-diabetes, which means their body's ability to regulate sugar is abnormal but not yet in the diabetic range. Without changes, many of these people will become diabetic. In the U.S., diabetes is the most common cause of blindness, kidney failure, and amputation. People with diabetes are also at a higher risk of heart attack than people who have suffered a prior heart attack, a sobering realization.

It's not as difficult as you think to improve health and prevent diabetes. You don't have to look like a model to be healthy. For many people at risk, losing 7-10% of their body weight will considerably improve their blood sugar regulation. The best results will be achieved by modifying both diet and exercise. The U.S. Department of Agriculture has assembled recommendations for both, which can be found at HYPERLINK "" . These recommendations include 30 minutes of moderate intensity exercise every day, which has been shown to improve health outcomes and prevent many chronic diseases. Combined with good food choices, which above all should emphasize a limited calorie intake, exercise and diet control will greatly improve health for all types of people.

Michael J. Carter is a third year medical student at the University of Nebraska Medical Center, and will graduate in May 2012. He hopes to specialize in radiology and practice in the state of Nebraska. Michael is the son of Robin L. Carter, of Stratton, and Peg A. Andrews, of McCook, and the grandson of Joe and Beth Augustyn and Lee and Marjorie Carter, all of McCook.

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