Why is Everyone Getting Diabetes and Prediabetes?
New book proposed five causes of diabetes.
The latest statistics about diabetes released by the Centers for Disease Control and Prevention are staggering: 25.8 million Americans have diabetes, and another 79 million with prediabetes are waiting in the wings to develop it. This rise in cases is exponentially greater than what was predicted even a decade ago, and the increase in diabetes is a worldwide trend, not just a North American one. At current rates, everyone around the globe will have diabetes or prediabetes before the end of this century.
People are quick to point their fingers at weight gain, fast-food gluttony, and slothful lifestyles as being the main culprits, but what if it's more than that? Is there anything that can be done to abate this looming health crisis? In his recent book, Diabetes Rising, author and journalist Dan Hurley examines five potential reasons behind what has become a modern pandemic. At this point, his five hypotheses about the causes of diabetes — revolving around weight gain, cow's milk, persistent organic pollutants (POP), vitamin D, and hygiene — warrant further discussion.
The first is the Accelerator Hypothesis, which revolves around body weight and insulin resistance. Some researchers are actually beginning to believe that type 1 and type 2 diabetes — heretofore considered to be caused by autoimmune destruction or insulin-producing beta cells and a high level of insulin resistance, respectively — may actually be the same disease. He postulates that the recent rise in cases of both types of diabetes has been accelerated by weight gain (an environmental factor), but are modulated by genetic factors, including the tendency to have a highly reactive immune system and the tendency to develop insulin resistance in response to weight gain. The jury is still out on whether weight gain is a direct causal factor, but we do know that type 2 diabetes risk can be lowered greatly by even a small (5-7%) decrease in body weight.
The Cow's Milk Hypothesis relates more directly to the development of type 1 diabetes and could more accurately be called the Foreign Protein one. In essence, early exposure in infancy to any proteins other than the ones found in human breast milk appear to make the body's immune system more permissive toward autoimmunity and the ultimate destruction of the insulin-producing beta cells in the pancreas. An easy (and economical) approach is to promote the breast feeding of all infants as long as possible during the first year of life.
Hurley's discussion of the risks associated with organic pollutants in the POP Hypothesis is quite compelling and is picking up steam. POPs originate from pesticides, but also from solvents, pharmaceuticals, paints, pollution, and even plastic. These compounds accumulate in body fat, so levels are higher farther up the food chain. One study actually showed a 38-fold increase in diabetes incidence when comparing the lowest and highest quartiles of POP exposure, and a follow-up study suggested that obesity is one of the causes of diabetes only when a person has POPs above a certain level — which are stored in body fat. In that case, keeping body fat lower may actually be quite effective in lowering diabetes risk by decreasing the amount of POPs stored in the body.
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Like many of us who live near major cities, I've been to a few ADA Diabetes Expos — my first in November, 2003, just over a year after diagnosis. The Expo took up a large part of New York City's Javits Center; most of the major meter, insulin, pump, and pill manufacturers were there; there were enough food vendors (with free samples!)...