The causes of diabetes (continued)
Last week’s article discussed the causes of Type 1 and Type 2 diabetes. Type 1 diabetes is believed to be caused by a viral infection such as mumps, measles, whooping cough, or the flu that causes an auto-immune disorder in which the immune system destroys the insulin-producing cells of the pancreas. Another theory is that an allergic reaction to foods introduced early in life, such as cow’s milk, may play a role. But Type 2 diabetes is thought to be due to a combination of heredity and environmental influences such as diet. However, the genetic predisposition will not manifest unless there is an environmental trigger or triggers. These environmental triggers are diet and lack of exercise. Obesity is the chief risk factor for developing Type 2 diabetes: 80 to 90 percent of Type 2 diabetics are obese, and obesity is directly related to diet. But what about the 10 to 20 percent of Type 2 diabetics who are not obese?
According to one authority, Dr. Richard Bernstein in his book, Dr. Bernstein’s Diabetes Solution, “It is quite possible that the 20 percent of the so-called Type 2 diabetics who do not have visceral obesity actually suffer from a mild form of Type 1 diabetes that causes only partial loss of the pancreatic beta cells that produce insulin.” A textbook on diabetes mellitus makes a similar statement, “Some studies suggest that as many as 20 percent of subjects who present initially with Type2 diabetes mellitus may have slowly progressive Type 1 diabetes mellitus.”
The increase in obesity matches increase in Type 2
The obesity rate and the diabetes rate have been consistently increasing: in 1991 the obesity rate in the United States was 12 percent; in 1998 it was 18 percent; in 2000 it was 20 percent; in 2001 it was 21 percent; and it is now thought nearly one-third of the American population is obese. The rate of diabetes in 1990 was 4.9 percent, in 1998 it was 6.5 percent; in 2000 it was 7.3 percent; in 2001 it was 7.9 percent; and now it is believed to be 8.7 percent in people over the age of 20. The actual number is almost surely higher, since many cases go undiagnosed for years. What has changed in this decade and a half? Certainly not genetics. Genetic evolution does not occur in a decade or two. The cause is simple – too many calories and too little exercise. This explains why children are now being diagnosed with Type 2 diabetes, something that was unheard of a generation ago. In America, getting fat is no longer a prerogative of adults, and diabetes, which is so strongly linked to obesity, is spreading down the age ladder.
In the cause the cure is found
Since diet and lack of exercise trigger Type 2 diabetes, then the remedy can be found in changing eating habits and increasing exercise. A genetic predisposition does not make diabetes inevitable. Although Type 1 diabetes does not seem to be caused by diet (except perhaps for allergic reaction to foods), diet is just as important in normalizing blood sugar levels in Type 1 diabetics as it is in Type 2 diabetics. By relying only on insulin to control blood sugar levels, Type 1 diabetics will oscillate between very high blood sugar after a meal to very low blood sugar after injecting insulin to bring it down. These extreme swings wreak havoc on the body’s systems and precipitate the complications of diabetes.
Diet should be the first line of defense against diabetes, both Type 1 and Type 2. There is no dispute about this. But a war is being waged about what that diet should be. It is the diabetes diet war. Next month’s article will discuss the diabetes diet controversy.
Mary Lou Williams, M. Ed., is a writer and lecturer in the field of nutrition. She welcomes inquiries. She can be reached at 267-6480.