Thursday, July 10, 2014

Are We Losing the Battle with Diabetes?

By: Melanie Rubery MS RD

An alarming report was just released by the CDC citing 29.1 million Americans have diabetes. This is up from 26 million in 2010, roughly 1 million new cases each year. To add to this epidemic, around 86 million (1 in 3) have pre-diabetes. This means an individual’s blood sugar is higher than normal, but does not yet meet the criteria for a diabetes classification. Furthermore, many prediabetics are unaware they have it. This data resonated with Ann Albright, CDC’s director of Diabetes Translation, “These new numbers are alarming, and underscore the need for an increased focus on reducing the burden of diabetes in our country ” and “We simply can’t sustain this trajectory.”

If the current trends continue, federal health officials predict one in five Americans could have diabetes by 2025 - and one in three by 2050.

Diabetes exists in 2 categories-Type 1 and Type 2. Type 1 occurs as a result from an autoimmune illness and involves an inherited dysfunction of insulin-producing pancreas cells. However, according to the U.S. National Institutes of Health, 90-95% of diabetes cases fall in the Type 2 category. More importantly, type 2 diabetes is heavily influenced by weight. Americans continue to struggle with their weight as we now have 2 out of 3 adults overweight and 1 out of 3 classified as obese. The sooner people are aware they have prediabtes, the sooner they can take action and increase their chances of not developing type 2 diabetes.

Key sectors to address include children and minorities. Blacks, Hispanics, and American Indian/Alaska Native are about twice as likely to be diagnosed with diabetes as an adult. The surge in childhood obesity has also brought about an increase in pediatric diabetes. The CDC reported 208,000 children being diagnosed with either Type 1 or 2 from their 2012 health data.

The key to slowing down this progression involves lifestyle and behavioral change. Edward Gregg, chief of the CDC’s Epidemiology Division and Statistics Branch echoed this point “If we want to reduce the overall burden of diabetes in our nation, we have to focus on preventing diabetes in the first place.”

Americans are eating more processed and added sugars than ever before. Couple this with a less active lifestyle and waistlines expand. In my clinical practice, I see a combination of resistance to behavior change plus confusion with food labels and food choices. This makes it hard for lasting change as once someone gets to the point they are ready to make that change, they are limited in resources and education.

For diabetics and many other chronic diseases, counting calories is a small piece to the puzzle in health management. It’s the nutrition quality of those calories that makes the biggest impact. It’s very important for a diabetic and prediabetic to watch their carbohydrate intake, choose low glycemic foods, get adequate fiber, and stay within their daily added sugar recommendation. However, current food labels only mention total sugars and do not differentiate between natural and added sugars. One may think low-fat flavored Greek yogurt is okay, but if it is loaded with added sugars, a diabetic needs to take a second look. This is only one example with the confused consumer. The bottom line is that if making this lifestyle and behavior change is difficult, individuals will become frustrated and go back to their old eating habits.

Overall, the healthiest eating plan is to focus on fruits, vegetables, high-fiber/whole-grains, fish, lean meats, and anti-inflammatory foods. Having the support and expertise of a registered dietitian is key as we can individualize plans specific to a patients dietary and food preferences.

We also shouldn’t forget about physical activity. Multiple studies show you need a combination of both good nutrition and daily exercise to achieve a healthy lifestyle. A good rule of thumb is to aim for 30 minutes a day, 5 times each week.

What happens if diabetes is left untreated and why is intervention and prevention key? Diabetes boosts the risk of other complications such as heart disease, stroke, kidney disease, and premature death.

At the same time, the healthcare costs associated with treating diabetes is roughly $240 billion each year. This is up from $174 billion in 2010.

As diabetes rates continue to rise, so will the healthcare expenditure. Unless we can get a handle on early prevention and resources to better educate and support, we face a huge financial and human cost.

Melanie Rubery MS RD is a registered dietitian and CEO of a Birmingham mobile health app company, Nutripilot. Nutripilot aims to navigate individuals to healthier food choices based on specific medical conditions. To learn more, visit

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