Preventing Diabetes (Continued)
How much weight should you lose? All of the studies aimed at preventing diabetes looked at moderate weight loss. Why? Well, because it's achievable for most people. Baby steps and all of that. Don't get me wrong. I'm a big fan of baby steps. But it left me wondering about that six-in-ten success rate out of the gate, and the three-in-ten left standing at a decade. What would have happened if instead of moderate weight loss, we had done a diabetes moon-shot and gone for radical weight loss? Or even middle-of-the-road weight loss? Would the success rate have been higher?
I don't know. Nobody does. But I believe it would. And here's why. I know how diabetes works. Being fat doesn't give you diabetes. If it did, we'd be at a 50% diabetes rate to match our obesity rate, instead of the 12% diabetes rate we see today. But in people whose genes are predisposed to diabetes, weight and age are the known triggers.
It works like this: the heavier you are, the more insulin your body needs. If you're genetically predisposed to have diabetes (due to family history or ethnicity, for example), then your body probably doesn't use insulin as wisely as it should. If you don't use it well, and need a lot of it, you'll eventually run out. It's really biological economics. Supply and demand. When the demand outstrips the supply, prediabetes sets in. When the demand really outstrips the supply, diabetes arrives.
You will (hopefully) get older. There's not a damn thing you can do about that. Age is not yours to control. But weight — that you can change. It's the only ace up your sleeve, and I urge you to play it.
The lower, within reason, that you can get your weight, the more you tip the scales in your favor. Both literally and figuratively. When you lose extra weight, you are removing one of the two triggers from your personal diabetes time bomb.
Does time matter?
But what if, in the long run, it turns out that the prescription is only a delay, not a cure? If it's your genetic destiny to get diabetes, does it matter when it happens? In a word: Yes. Here's why. In theory, well controlled diabetes is the leading cause of absolutely nothing.
Diabetes itself is harmless; it's high blood sugar that's toxic. Keep the diabetes well controlled and you don't have much to worry about, so why should time matter? Because in reality, controlling diabetes is very, very difficult. It's been compared to walking a tightrope over shark-infested waters while having your eyes pecked out my seagulls. Simply put: It's easier said than done.
So if we admit that we will all fail some of the time, then it benefits us to put off diabetes as long as humanly possible. The effects of high blood sugar are corrosive. Our mistakes, missteps, and indiscretions will pile up on us over time. Like rust. If you give yourself 20 extra years before you start the fight, that's 20 years of rust you can avoid. Because when the hull rusts through, the water comes in and the ship sinks. End of story.
I'm not saying it will be easy. But it won't be that hard and you can do it. One bite less at a time. But if you don't think you can do that, why put it off? Eat more. Don't exercise. Put on some weight.
It's job security for me.
Wil Dubois is the author of four multi-award-winning books about diabetes. He is a PWD type 1, and is the diabetes coordinator for a rural non-profit clinic. Visit his blog, LifeAfterDX.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...