Thanks to Hanks, Diabetes Awareness is Up

Thanks to Hanks, Diabetes Awareness is Up

Getting the conversation started

GREENBRAE, CA — “Tom Hanks has done people a favor by speaking out about his diabetes diagnosis,” says Jyoti Bhat, MD, a specialist with Marin Endocrine Center. “It’s one of the most prevalent diseases in the world today and anything that raises awareness of the causes and consequences of diabetes is a good thing.”

Hanks, a popular movie and television actor and director, revealed his diagnosis on the David Letterman Show recently, joking that his doctor told him he had “graduated” from high blood sugar (prediabetes) to Type II Diabetes.  He also called his diagnosis “inevitable”.

Dr. Bhat says that while the rise in diabetes is “alarming—25 million people in the US alone, and it’s growing daily”—an even bigger concern is that “most of them don’t know it.  If Mr. Hanks’ revelation encourages more people to be tested—or encourages more people to follow their doctors’ recommendations--then something important has been accomplished.”

Like Hanks, people all too often believe that their diabetes is inevitable. 

“For many individuals with prediabetes, it’s simply not true that it’s inevitable,” she says.  “If the condition is caught early it is possible to delay or even prevent the onset of diabetes. That’s why it is so important to be screened early.”

Elevated blood sugar, which Hanks says he had been warned about since he was 34, is one of several conditions that might put someone in the “prediabetes” category, sometimes referred to as impaired glucose tolerance, according to Dr. Bhat.  Hypertension (high blood pressure), an increased waist circumference and high cholesterol are other conditions that independently constitute “prediabetes,” and three out of four of them together mean an individual has what is known as 'the metabolic syndrome.'

“Being prediabetic means that you have 10 to 40 times the average risk of developing diabetes,” says Dr. Bhat. “But some people can stay in a prediabetic range all their lives and not develop diabetes. They will still be at risk for complications such as neuropathy (nerve damage), kidney disease, cardiovascular disease, and vision impairment, however, so diet and exercise are still important to maintain health and avoid disability. “

While it may have seemed to some that Hanks was too flippant about the potential effect of his disease (he told Letterman, “Something’s got to kill us all,”) Dr. Bhat says that what can motivate many patients isn't just mortality. "Potential disability from diabetes can have a major impact on a person's quality of life," she says. Regardless of how long they live, people want a fulfilling life as they get older.”

In fact, age itself is a major risk factor for diabetes, “compounded by the fact that people tend to gain weight as they age,” says Dr. Bhat. “But exercise and a healthy diet will not only reduce your risk at any age but contribute to a better quality of life as we get older.”

For those who know they already have at least one of the risk factors for diabetes, Dr. Bhat points out that losing as little as 5% to 10% of your total body weight—just 10 to 20 lbs. for someone who currently weighs 200 lbs.—has proven benefits, reducing or even eliminating the need for insulin. “Surprisingly, it doesn’t matter how heavy you are to start—a relatively minor weight loss can have a major beneficial effect,” Dr. Bhat says. 

She also points out that lean people can get Type II diabetes. “It’s really about body fat distribution and body composition,” she says. “Fat around the middle (the classic “apple shape”) is much more metabolically active than subcutaneous fat and fat carried in your hips and thighs (the classic “pear shape). That’s why waist circumference is an important measure of risk.”

“Very often, we see patients who have diabetes—probably have had it quite some time—and simply had no idea.  Many have nonspecific symptoms—so if they’re not looking for it, they won’t find out.  Because the length of time you have diabetes or prediabetes before taking action will help determine your chances of preventing or reversing damage, the earlier you are screened and take preventive steps, the better,” says Dr. Bhat.

“Diabetes is controllable and it’s possible to live a normal life with it,” Dr. Bhat says. “Many people do.  But uncontrolled diabetes can result in a significant decline in quality of life and independence. If you’ve been avoiding getting screened, ask yourself if it’s worth the risk—do you want to live with a significant disability?”

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