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Diabetes: One In Four


Last week, a high school student shadowed me in clinic and we saw several patients with diabetes and so we chatted about the epidemic that affects One in Four Adults in the U.S. and is a leading cause of death in the United States.

What is Diabetes?
Diabetes is a disease in which blood glucose levels are above normal. The food that we eat is turned into glucose, or sugar, which enters our blood stream, flooding the blood vessels and rushing through our body. The brain signals the pancreas to release insulin and the insulin unlocks the doors allowing sugar into the cells. If the insulin is not produced by the pancreas or the insulin produced doesn't work properly to allow the sugar into the cells, the sugar cause havoc in the body. Medical doctors define diabetes as a fasting sugar over 125 (at least twice) or a three month sugar test called a hemoglobin a1c greater than 6.5.

How Sugar Damages Your Body
When the insulin is lacking or it doesn't work effectively to drive the sugar into the cells, the sugar acts like shards of glass coursing through your blood stream, injuring and inflaming the lining of the arteries as it flows to the eyes, kidneys, heart, brain, feet causing damage to the small and big blood vessels. Diabetes is a major cause of blindness, kidney failure and lower limb amputation. This sugar when not driven into cells can cause progressive damage to the arteries, leading to plaque accumulation, inflammation and blockage, becoming the leading cause of heart attacks and strokes. Other bad influences like cigarette smoking, fried foods, processed meats, artificial sweeteners, preservatives, salt add cumulative effects to the destruction of the body. Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes. Diabetes is also a major cause of memory loss and Alzheimer's disease.

Causes of Diabetes
There are genetic factors that can predispose one's risk for diabetes. African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders and Asian Americans have a higher risk for diabetes. Also diabetes risk increases with age, family history, other conditions like pancreatic injury through trauma, infection or surgery and autoimmune diseases can cause diabetes. But by far in our Western society, rising rates of obesity contribute greatly to this epidemic. Our current food sources, desire for prepared convenient foods and sugary drinks, larger food portions, hidden sugars in our food, weight gain, sedentary Western lifestyles are major contributors to diabetes, especially in children. Americans consumes an average of 66 pounds of sugar a year, that is equal to the weight of an average 7 year old child. Most children in the U.S. consume their weight in sugar annually and have rising rates of diabetes and pre-diabetes.


Sugar Addiction
Sugar is an addiction. Research also shows that, for some people, eating sugar causes chemical changes in the pleasure centers of the brain leading to of craving and withdrawal, just like a drug.
 
There is scientific evidence, using brain-scanning technology by the U.S. National Institute on Drug Abuse to show that sugar causes changes in peoples' brains similar to those in people addicted to drugs such as cocaine and alcohol. These changes are linked to a heightened craving for more sugar. This increased sugar consumption causes insulin levels to rise.  Unfortunately, high insulin levels cause the body to store more calories as fat leading to weight gain.
Another hormone besides insulin leads to weight gain, Leptin. Leptin's main role is to curb appetite, it tells the brain to stop eating.  But with increased sugar intake, high fructose consumption and elevated insulin levels, we shut down the effects of Leptin and the brain comes "Leptin-Resistant" and no longer hears the message to stop eating leading to weight gain.

How to Treat Diabetes?
Healthy diet, regular physical activity, lowering stress levels, proper sleep, reading labels, logging food, maintaining a normal body weight, cutting back alcohol and avoiding tobacco use are ways to prevent or delay the onset of non-insulin dependent diabetes and complications. Healthy lifestyle habits are a drug-free, cost-saving option to control or prevent diabetes. To effectively treat diabetes, the patient has to take 100% ownership of their daily decisions and take back the power to drive their own healing.  They can enlist the support of their family and friends, diabetic educator, exercise instructor/trainer, counselor, primary care physician and/or endocrinologist. Often, there are diabetes education classes offered at local libraries (free) and hospitals that are a valuable resource. Pharmaceutical companies have online and phone support with a diabetic educator or nutritionist that can help motivate the patient.

Arm Yourself With Technology 
There are several smart phone Apps that help track sugar, diet, exercise, allow you to sync stats like blood sugar levels, hba1c, lipids, offer data sharing with your doctor, provide motivational feedback, recipes, restaurant diabetic information and goal setting. My favorite diabetic apps are:
  1. Diabetes In Check
  2. Diabetes Companion
  3. icookbook diabetic
  4. healthyout
  5. mySugr (and mySugrkids)
Finding your Own Path
There are so many mixed messages with diet plans, documentaries, online gurus, latest fads and supplements promising the one path to health and wellness. They latch on to one food group whether it is carbs, fats or proteins and demonize the rest. False promises of one savior or one villain is based on anecdotal testimonials and opinions based on biased and selective studies.
Keep it simple and find your balance based on your system. Incorporate whole foods, vegetables, fruits, beans, lentils, nuts, seeds, whole grains, water and if desired meat. Work towards cutting out processed meats and grains, high sugar foods, preservatives, dyes, artificial ingredients, pesticides, antibiotics and chemicals in your food. Keep moving in your day, laugh, breathe, sleep restfully. Its not one good thing, its all good, natural things in balance that should make up most of your daily routine. Variety is the spice of life.

References:sugarscience.ucsf.edu, diabetes.org, cdc.gov/diabetes
 
The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine. 
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women's health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

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