Diabetes Prevention Should be a Major Priority

Author: Dr. Linda Gaudiani, a diabetes specialist and medical director of the Braden Diabetes Center

Marin County has among the lowest prevalence of diabetes in the state and that’s reason for cautious optimism. But with 5,000 residents diagnosed and the incidence of diabetes rapidly rising here as it is across the nation, prevention and treatment still need to be major priorities.  

It’s a huge challenge. In the U.S., the CDC estimates that 86 million are “pre-diabetic”, a term for early impaired glucose metabolism that puts individuals at higher risk of developing diabetes later. In Marin that translates to hundreds of people. Despite the relatively low prevalence of diabetes in Marin, it is accelerating rapidly. Marin attracts a diverse group of people drawn to a healthier environment and lifestyle. The county’s growing ethnic diversity includes many who are at genetic risk for diabetes. People are living longer, and obesity rates are increasing, which are additional risk factors. So it’s imperative that we also accelerate prevention efforts to insure that the diabetes epidemic doesn’t increase here.

In addition to pre-diabetes, undiagnosed active diabetes is another concern. Although the level of undiagnosed diabetes has declined by about a third in the last 15 years, about 10 to 20% of diabetes still goes undiagnosed. Without a diagnosis, individuals aren’t getting the early treatment and support necessary to avoid complications that can be devastating. In fact, the first time many patients learn they have diabetes is when they’re being seen for one of its complications.

Everyone over 40 should be screened

To take charge of their health, patients need to find out where they stand. Risk factors for developing diabetes include having a relative with diabetes, obesity and sedentary lifestyle, gestational diabetes (diabetes during pregnancy), age and ethnic background. Symptoms such as excessive thirst, increased urination, weight fluctuations, blurred vision, and fatigue could be indicators that an individual has active diabetes. But the disease doesn’t always present with these typical symptoms. It sometimes can be silent for many years while causing complications to nerve, heart, kidney and eye tissues. Everyone over 40 should be screened, as well as those with clear risk factors.

Don’t let worry prevent you from getting screened. Overall, there’s encouraging news for diabetes patients. According to an April, 2014 article in the New England Journal of Medicine that looked at hospital discharge data for 11,000 diabetes patients between 1990 and 2010, rates of diabetes-related complications have been significantly reduced in the past 20 years, sparing millions of people the problems they once faced from the disease. Especially striking was the decrease in heart attacks, which declined by nearly 68%. Stroke and amputations declined by about half. The key is prevention, early diagnosis, improved control of high blood pressure, cholesterol and associated factors and smoking cessation—all of which are being addressed more actively now.

The good news is that we live in one of the best places in the world to have diabetes, because of access to good care. Marin General Hospital has recently spearheaded a diverse Diabetes Care Program specifically oriented to improve the lives of patients with diabetes both in the community and in the hospital.  Marin residents with diabetes also have access to unprecedented educational tools at the hospital’s Braden Diabetes Center (BDC) to help them understand diabetes, support healthy choices, self-manage blood sugar and learn about new technologies and treatments.  They also have the opportunity to participate in clinical research studies using the state-of-the-art oral agents and the newer and generic insulins through Marin Endocrine Care and Research.  It adds up to cutting edge care on the green side of the Bridge.

Fortunately, most people can take effective actions to avoid developing the disease in themselves or their families. Those who are diagnosed with Type II diabetes can reduce complications, and in some cases, even reverse the course of the disease.  It’s almost never too late to achieve improvement, and in many cases it’s not complicated. 

Simple steps that reduce risk

The top things that will help you prevent diabetes will also improve your overall health and enjoyment. 

  • Eat better—more fruits and vegetables, less processed, fatty and high sugar foods, and smaller portions in general.
  • Exercise 30 minutes a day—it will lower your blood sugar, rev your metabolism, may help reduce your body fat, and can even recondition your heart.
  • Lose weight—just a few pounds can lower your diabetes risk by half. Scientific data suggests that losing only 5% of your body weight has positive effects on your blood pressure and cholesterol. This is a prescription to minimize diabetes and maximize quality of life.

The really compelling fact about diabetes is that now more than ever, its impact can be dramatically reduced. Here in Marin we have access to all the care needed to accomplish that. Get screened and get going to reduce your risk.