What's New in Diabetes Prevention

There are an estimated 16 million people with diabetes in this country, and there are some new strategies to prevent diabetes deaths by focusing on preventing its complications. Health correspondent Dr. Emily Senay explains.

What's the latest information we have about diabetes?

When we talk about diabetes prevention, we are talking primarily about type 2 diabetes, or adult-onset diabetes, which develops later in life. Unlike inherited childhood diabetes, with adult-onset diabetes, the body gradually loses its ability to process insulin, which is necessary for processing sugar. What we're finding is that in addition to the millions who already have diabetes, there are another 20 to 30 million more who are at high risk of developing the disease. The idea is to identify those people with risk factors and change their course before they actually get the disease.

Why is diabetes a dangerous disease?

Diabetes is a leading cause of heart disease, kidney failure, blindness, and amputation. Although we don't know exactly how diabetes develops, we do know that obese people are at much higher risk of diabetes, and more likely to die of a heart attack or stroke. And because all of these problems are intertwined, it's important to keep a close eye on them if you're diabetic.

Doesn't your doctor take care of that when you get checked up?

It's likely that your doctor is pretty good at diagnosing and treating diabetes, and diabetics normally get a good prescription for controlling blood sugar with good diet, exercise, insulin, or drugs. But new studies show that doctors have not been very good at monitoring some closely related risk factors like high blood pressure and high cholesterol.

Researchers found that among people with high blood pressure only about 40% had it under control, and among those with high blood pressure and diabetes too, only 20% had it under control.

How does high blood pressure affect diabetes?

It's a huge problem for diabetics along with high cholesterol because the risk factors for heart disease become much more dangerous for diabetics, who are two to four times more likely to get heart disease.

The latest numbers for high cholesterol are just as bad. In the 1980s, there was no cholesterol control at all in the group of patients studied. That percentage was only up to around 7% of patients controlling their cholesterol in the 1990s.

What other factors contribute to the development of diabetes?

Researchers have also discovered that sleep may be an important factor, because sleep disruption can affect the endocrine system and may lead to insulin resistance. A study showed that so-called "short sleepers" who get less than about 5_ hours a night were much less sensitive to insulin than those who got about 8 hours.

Is there any good news for diabetics these days?

It's never too late to make an effort to prevent or control diabetesThere is new data showing that even a short period of maintaining good blood sugar levels results in less risk of heart disease. Even in older patients who are at higher risk because of their age.

What other areas of research are being explored?

Obesity is still a major focus for research. While we already know that short-term weight loss can have beneficial effects, there is currently a large study gearing up to measure the effect of long-term weight loss on diabetics, in the hope of finding more clues to diabetes prevention.
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