Friday, February 8, 2008

Diabetes: Curing the Sweet Blood

The dinner table is always a good place to start lifelong habits of good food and nutrition. Occasionally in this blog, I will focus on a specific health problem that is associated with eating right and nutrition. Today, I'll highlight diabetes.
An estimated 21 million Americans have diabetes and 284,000 die from it each year. Sixty-five percent of the deaths are related to cardiovascular causes. Type 2 diabetes increases the risk for heart disease 2 to 4 times. NHLBI, ACCORD Study Press Release, 2.6.08
Diabetes is a serious chronic disease caused by an imbalance in the body's ability to produce insulin and regulate blood sugar. One of the major symptoms is high blood sugar, which prompts some to call the disease "sweet blood." It has often been thought that the lower the blood sugar, the better. It was a shock, then, that the National Heart, Lung, and Blood Institute abruptly ended a massive clinical trial (ACCORD), as covered in the New York Times yesterday. The startling report was that intensive blood sugar control was not effective in reducing the risk of cardiac events. The intensive regimen used in the trial was actually associated with increased risk of heart attack and stroke compared to more traditional control of blood sugar. The study centered on Type 2 Diabetes, which is sometimes called adult-onset diabetes, and is the disease type that is more associated with obesity.

Heart disease is not the only complication to diabetes and other complications may be more lethal. Still controlling blood sugar (by making dietary or exercise changes or by taking prescription drugs) has been the primary method of diabetes treatment for the past 10 years. A close read of the ACCORD study, and the reasons for stopping it, do not dispute that traditional control of blood sugar is still advised, as many in the Diabetes advocacy circles have pointed out. Many blame the media for sensationalizing and misrepresenting the results. The Times actually published a modified response today. To me, moderation may be what's signaled here, rather than pushing for lower and lower blood sugar levels with more and more drugs.**

I am particularly invested and interested in diabetes because I had gestational diabetes in my three pregnancies and am at risk of developing diabetes later in life. Also my stepfather has diabetes, and has just recently taken to testing his blood regularly. Normally, you test your blood several times a day. (You pinprick your finger and analyze a tiny drop of blood on a little machine that reads the sugar level.) It's not bad, but it's not fun either. In addition you track what you eat during the day, when you exercise, and when you take medication.

The blood sugar level tells you what you are doing "right," and it can be maddening to figure out and adjust your life to get the right levels. I found that eating whole wheat toast with jam was fine, but having just a little pasta or any fruit juice were both absolute "no-nos." Also, going from my first pregnancy in 1995 to my last in 2005, the standards for "low blood sugar" became draconian. I easily controlled my blood level with diet and exercise in my first pregnancy. By the time my third came around, not only did my body produce higher levels of sugar naturally, but the medical standards for "low" had changed. Now fasting levels were supposed to be at or below 70mg/dL whereas before it was under 100. Two hours after eating, I was supposed to be in the 110mg/dL range, and it was tough. No wonder I didn't gain any weight in my pregnancies! With my third child, I had to take medication as well as follow a strict diet to be in compliance.

This is an important topic for family dinner since diabetes affects so many Americans and because prevention is the best remedy for the disease. Well-balanced meals, including careful consumption of sweets as well as plain old carbohydrates, and regular exercise are the soundest ways to prevent diabetes for you and your family. More tips are below.

Wed MD: Healthy Diet Basics
American Diabetes Association: Diet and Exercise Tips to Prevent Diabetes
Harvard School of Public Health: Simple Steps to Preventing Diabetes

** If you have diabetes, obviously check with your medical provider and do not make changes in your treatment without medical advice.**

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