Diabetes prevention starts with education

“Can I catch diabetes?” is a question a patient of mine asked, apparently alarmed by reports in the news that America is in the midst of a diabetes epidemic. The diabetes epidemic is a fact. The national Centers for Disease Control estimates that 24 million Americans, about 8 percent of the population, have diabetes. More than a third are unaware they have the disease. Another 41 million are estimated to have pre-diabetes, a condition that increases the risk of developing type 2 diabetes, with the consequent danger of heart attack or stroke. Health experts predict that 25 percent of pre-diabetics will develop full-blown diabetes.

The American Diabetes Association defines diabetes as an excess of sugar in the bloodstream, a fasting glucose (sugar) level of 126 mg/dl (milligrams per deciliter). It is usually measured in a routine blood test. The results will be interpreted by the physician and a diagnosis determined based on his/her clinical experience with the patient. Pre-diabetes is a glucose level in the 90s. There are several tests for diagnosing diabetes. Your doctor may use one or more to confirm a diagnosis.

The nature of the disease varies. With type 1 juvenile diabetes the pancreas produces no insulin, the hormone necessary for processing glucose into energy (metabolism), at all. With type 2, or adult or late-onset diabetes, the pancreas produces some insulin but the cells resist processing it due to a slowing down of the metabolism as we age, resulting in the buildup of glucose in the blood. The importance of the diagnostic numbers with reference to type 2 and pre-diabetes is that we know the damage to the body’s organs that occurs with diabetes begins early on, with the pancreas gradually losing more and more of its ability to deliver insulin as the disease progresses.

Diabetes is found at a higher incidence among persons over 50 because their metabolism is slowing down. In a residential nursing facility, it’s estimated that 25 percent of the residents are diabetics. While this is a cause for concern for health care providers like me, it is also a public health issue that should be addressed through public health information and health care education. There are ways to prevent diabetes that can be learned.

Back to the question, Is diabetes contagious? No … yes … well, sort of. The causes of type 2 diabetes — sedentary lifestyle, poor diet and lack of exercise, and genetic predisposition — are within our control. You can “catch” diabetes like you can catch a cold, by the behaviors that will bring it on — an unhealthy lifestyle, poor eating habits and lack of exercise that lead to overweight. And your chances are even greater if there has been diabetes in your family.

There is no cure for diabetes. It can be managed with various medications that either supply insulin or that cut back the glucose. Often your doctor will prescribe more than one drug. But you can prevent getting diabetes; that is, pre-diabetes can be stopped through proper diet and a regular exercise program that helps control your weight.

A first step is learning about the disease. It’s a good idea to ask your family doctor to check you out to make sure you’re not at risk. Tell your doctor if you have blood relatives who have had diabetes, because you may have a genetic predisposition to diabetes. Keep in mind that diabetes is a life-threatening disease that gradually compromises all the organs of your body. Diabetics have a 50 percent greater risk for heart attack and increased problems with eyesight, kidneys and skin and, in severe cases, body extremities have to be amputated. While strictly speaking diabetes is not contagious, you want to defend yourself against it as if it were. It is, after all, an epidemic you should do everything in your power to avoid.

Dr. Slotkin is the medical director of San Simeon by the Sound Center for Nursing and Rehabilitation.