The 7 Step Diabetes Fitness Plan
by Sheri R. Colberg, PhD.
Copyright © 2005 by Da Capo Press
Provided with permission by Da Capo Press.
For more information or to order this book, please visit www.shericolberg.com.
NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.
Ignorance Is Not Bliss
Americans are undeniably getting heavier by the minute. Maybe you also find yourself lamenting about your ever-increasing body weight, but wonder if all that extra fat means that your health will invariably suffer. The answer is that it depends. Many people who put on too much fat also suffer from other health problems, including diabetes. In fact, a diabetes epidemic is currently sweeping the nation – and the world.
More than 90 percent of people developing diabetes are developing type 2 diabetes, characterized primarily by insulin resistance, or an inability of the hormone called insulin to work effectively to keep blood sugars (referred to throughout this book as blood glucose, or BG) in check. Although a minority, the people with type 1 diabetes which is caused by their bodies' own destruction of insulin-producing beta cells in the pancreas (essentially autoimmunity triggered by an environmental cause), can also develop an insulin-resistant state that makes their diabetes harder to control. Of late, a new type of diabetes – unofficially known as type 1.5 diabetes, or "double diabetes" – has been emerging; it has characteristics of both type 1 (autoimmunity) and type 2 (insulin resistance) diabetes, making it difficult to make an accurate initial diagnosis is all cases.
If you are reading this book, that means either diabetes or a pre-diabetic condition (characterized primarily by insulin resistance, with a closer-to-normal BG level) has already happened to you or someone you know or care about. Perhaps your doctor recently told you that you have type 2 diabetes, which is frequently diagnosed by a fasting BG level of 126 milligrams per deciliter (mg/dl) or 7.00 mmol/l) or above first thing in the morning, or perhaps your sugars have been hovering in the prediabetic range (100 to 125 mg/dl, or 5.56 to 6.94 mmol/l, prebreakfast) as your body weight has been creeping up. You may want to blame the half-dozen glazed doughnuts or that triple-fudge sundae you just ate, instead of diabetes or prediabetes for a passing BG reading of 200 mg/dl (11.11 mmol/l), but you can't. The reality is that regardless of what you eat, your BG level will never spike above 140 mg/dl (7.78 mmol/l) if you don't already have one of these health conditions.
A doctor may have already advised you to lose some weight to better control your BG, but is losing weight the only solution? If it is, then most people are out of luck. The reality is that only a fraction of the millions of dieters – with or without diabetes – succeed in losing weight and keeping it off permanently. Obesity and diabetes are currently overtaking our nation. Two-thirds of American adults are considered overweight or obese, and that number is rising fast, particularly among younger adults and youth, based on their body mass index (BMI).
Even more alarming is the fact that children born nowadays have a one-in-three chance of developing diabetes in their lifetime, and for many minority groups, the risk is close to a whopping 50 percent. More than 20.8 million people in the United States already have diabetes, and the projected number of Americans with diabetes by 2030 is over 30 million. That's an overwhelming number of Americans with diabetes, and that doesn't even include the more than 40 million insulin-resistant, prediabetic people who have a strong potential for developing it. Moreover, among the nearly 370 million cases of diabetes projected worldwide by 2030 (up from 170 million in 2000), the United States lags behind only India and China, two countries with much larger populations.
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This past weekend was a whole lot of diabetes weird. I've finally gotten into a good rhythm with my Lantus rate - settling in with a 70-30 nighttime-morning split of the total dose. My bolus dosing seems to be pretty much on the money too. I'm avoiding huge swings... Though lows are creeping up more often, I think because summer traditionally is a lower basal rate time, owing to warmer weather, increased activity and sweat, as we get closer to the warmer days I just need less insulin in the...