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Diabetes is caused by excessive increase of blood glucose, or sugar, levels in the body. In Type 1 diabetes, insulin, a hormone that helps the glucose get into your cells to give them energy, is not created. With the more common Type 2 diabetes, the body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.


[edit] Symptoms

[edit] Causes

[edit] Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women

In a large survey of middle-aged women, a combination of several lifestyle factors, including maintaining a body-mass index of 25 or lower, eating a diet high in cereal fiber and polyunsaturated fat and low in saturated and trans fats and glycemic load, exercising regularly, abstaining from smoking, and consuming alcohol moderately, was associated with an incidence of type 2 diabetes that was approximately 90 percent lower than that found among women without these factors. These results suggest that in this population the majority of cases of type 2 diabetes could be avoided by behavior modification.

Excess body fat is the single most important determinant of type 2 diabetes. Weight control would be the most effective way to reduce the risk of type 2 diabetes, but current strategies have not been very successful on a population basis, and the prevalence of obesity continues to increase. The public generally does not recognize the connection between overweight or obesity and diabetes. Thus, greater efforts at education are needed.

Our data suggest that the percentage of cases of diabetes that are preventable by diet and exercise independently of body weight is greater among women of normal weight than among obese women. However, even among overweight and obese persons, the combination of an appropriate diet, a moderate amount of exercise, and abstinence from smoking could substantially lower the risk of type 2 diabetes. Although the percentage of cases that could be avoided by means of these lifestyle changes is lower among obese persons, the absolute number of cases avoided among such persons would be greater because of their higher risk. Moreover, diet and exercise are the primary factors in determining weight loss.

Our present results are in agreement with our previous study of coronary disease,21 which found that adherence to similar guidelines was associated with an 83 percent reduction in risk. These analyses underscore the common lifestyle-related origins of diabetes and coronary disease and provide further evidence that modifications of diet and lifestyle have large and multiple benefits.

Clinical trials in China and Finland have demonstrated the feasibility and efficacy of lifestyle-intervention programs in the prevention of diabetes in high-risk populations. Among 577 patients with impaired glucose tolerance in Da Qing, China,38 exercise interventions, dietary interventions, or both resulted in a decrease of 42 to 46 percent in the rate of progression from impaired glucose tolerance to diabetes during six years of follow-up. Recently, the Finnish Diabetes Prevention Program reported that the modification of lifestyle reduced the incidence of type 2 diabetes by 58 percent during 3.2 years of follow-up among 522 middle-aged, overweight participants with impaired glucose tolerance.39 The program included a relatively small reduction in weight (less than 4.5 kg [10 lb]), combined with a diet low in saturated and trans fat and high in fiber and regular moderate exercise. Results from the first three years of the Diabetes Prevention Program in the United States also show that regular exercise and the modification of diet reduced the incidence of type 2 diabetes by 58 percent among patients with impaired glucose tolerance.40 Our results suggest that closer adherence to behavioral guidelines could reduce the risk further in both low-risk and high-risk populations.

Because all the women in our study were health care professionals, our findings may not apply directly to the general population. However, since risk factors for diabetes tend to be more prevalent in the general population, the magnitude of the reduction in risk that would be achievable with adherence to the behavioral guidelines we outline would probably be even greater than the magnitude of the reduction we found. Although some factors we considered — for example, alcohol use and smoking — have not been (and will probably never be) tested in randomized trials with clinical end points, ample observational data support their associations with diabetes. Nevertheless, physicians must exercise caution in recommending alcohol use, since it may lead to overuse. Finally, we did not consider pharmacologic means of preventing diabetes, some of which are being tested in ongoing clinical trials in high-risk populations.

Diagnoses of diabetes in our study were reported by the women but were confirmed by a supplementary questionnaire regarding symptoms, diagnostic tests, and treatment. Our previous study found this confirmation to be highly accurate as compared with a review of the medical records.5 Because the women in our cohort who did not have diabetes were not uniformly screened for glucose intolerance, some cases of diabetes may not have been diagnosed. However, when the analyses were restricted to symptomatic cases of diabetes, the findings were not altered substantially, suggesting that surveillance bias is unlikely.

In conclusion, our findings suggest that the majority of cases of type 2 diabetes could be prevented by weight loss, regular exercise, modification of diet, abstinence from smoking, and the consumption of limited amounts of alcohol. Weight control would appear to offer the greatest benefit.

The New England Journal of Medicine

[edit] Did You Know?

  • The average chance of developing diabetes is about one in 48 for ages 18 to 44, but after that it jumps to one in nine!
  • Chances of developing diabetes double the moment a parent, or a sibling is diagnosed with it before the age of 45. If two immediate blood relatives are diagnosed, the chances of getting the dreaded disorder quadruple.
  • Being overweight and leading a sedentary life are two biggest predictors of diabetes.
  • Also at increased risk are women who have had gestational diabetes, a supersize baby (more than nine pounds) or polycystic ovarian syndrome.

[edit] Conventional Treatment

[edit] Alternate Therapies

[edit] How to Cut your Chances of Diabetes

  • Get moving. Regular exercise increases the body's sensitivity to insulin, lowers blood sugar levels and cuts the risk of developing diabetes by half.
  • Eat less. Overweight people with a prediabetic condition who lose less than five to seven per cent of their body weight are almost half as likely to get diabetes than those who take the diabetes prevention drug Metformin.

[edit] References

  • Diabetes

[edit] See Also