The rate of increase in diabetes cases has been described as a worldwide epidemic. According to the Centers for Disease Control (CDC) diabetes in the U.S. has increased 136% between 1980 and 2007. Even more alarming than this rate of increase is that most of this increase has occurred between 1990 and 2007. The incidence of diabetes was 3.3 per 1,000 in 1980, 3.5 in 1989, 5.4 in 1999 and 7.8 in 2007. These rates translate into 24 million people with diabetes. Only 18 million of these are diagnosed; another 6 million do not know they have the disease. What is both frustrating and hopeful is that it is believed that diabetes is largely preventable.

The Diabetes Prevention Program (DPP) was a large multicenter clinical research study aimed at determining whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes medication metformin could delay or prevent the onset of type 2 diabetes. Participants from 27 clinics around the U.S. totally 3,234 who were overweight and pre-diabetic based on known risk factors were separated into 4 groups. One group received intensive training in diet, physical activity and behavior modification. Their aim was to lose 7% of their body weight by eating fewer calories, less fat, and exercising for 150 minutes per week. A second group took 850 mg of metformin per day. They also received information about diet and exercise but no motivational counseling. A third group received placebo tablets. A fourth group was started the drug troglitazone but this group was discontinued when the drug caused serious liver damage. The lifestyle modification group reduced their incidence of type 2 diabetes by 58% and the people taking metformin by 31%. Subsequent studies showed additional health improvement in the lifestyle modification group including lower blood pressure, lower triglyceride levels, increased HDL (good cholesterol) levels, and reduced C reactive protein. Women who lost weight had fewer problems with urinary incontinence than the other groups.

The direct medical costs of diabetes in 2007 were estimated at $116 billion with another $58 billion of indirect costs from disability, loss of work, and premature death for a total of $174 billion.

The implications of preventing a devastating and expensive disease such as diabetes simply by eating less and exercising more are huge. Billions of dollars in health care could be saved and redirected to treatment for other diseases. Though not researched here, it stands to reason that other chronic conditions such as heart disease and kidney disease could also be reduced through lifestyle modification. Consider the money that could be saved and the pain and suffering that could be avoided. Give yourself the best chance at a healthy life, eat less, eat healthy, and exercise.

References: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf, http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/.

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