As a diabetes researcher and exercise expert, I appreciated the overall message of the episode of "The Oprah Winfrey Show" about the diabetes problem that aired on February 4, 2010, titled "America’s Silent Killer: Oprah and Dr. Oz Want to Save Your Life." Americans need to know about the diabetes epidemic, and they need to realize that this disease is neither going away anytime soon nor is it one that anyone can afford to ignore. The show focused mainly on how poor lifestyle choices contribute to the onset of Type 2 diabetes. Unfortunately, it was very misleading on several important points, and a lot of misinformation was disseminated to the viewing public.
For example, Dr. Oz talked about how diabetes is going to bankrupt the healthcare system, stating how expensive diabetes is to treat. Actually, treating diabetes itself is not nearly as expensive as paying for the health complications of uncontrolled blood sugars. Kidney disease, blindness, amputations, nerve damage, heart disease — these are some of the possible complications of diabetes, but not inevitable ones, especially with preventative care, which is what the show failed to focus on.
Our own research has also shown that many diabetic complications — simple ones like foot ulcers, amputations, and falls related to unstable gait — can be prevented with physical activity and exercise training. Even the 57 million Americans with pre-diabetes can cut their risk of developing diabetes in the first place with lifestyle changes. The Diabetes Prevention Program (DPP) study found that doing 30 minutes of moderate exercise daily and aiming for weight loss of 5-7% with positive dietary changes can lower diabetes risk by 58% in high-risk individuals, especially the older ones. This is old news by now, but we can’t afford to forget it. A recent 10-year follow-up of DPP patients found that the benefits from lifestyle improvements persisted for at least a decade, keeping diabetes risk 34% lower.
At one point, Dr. Oz misleadingly stated that the more insulin you take, the worse your diabetes is. While I believe he was trying to make the point that if your insulin resistance is higher, you will need more insulin to keep your blood sugars in check, his was an outdated statement that the medical community abandoned at least a decade ago. It scares people into thinking that if they are required to go on insulin they have a "bad case of diabetes," that they have failed somehow, and that they are to blame. Recent research has shown that many people with Type 2 diabetes can benefit immensely from early use of insulin injections.
Moreover, everyone with Type 1 diabetes is required to take insulin to replace this hormone that their bodies are no longer able to produce — just to stay alive and manage their blood sugars, not because their diabetes is worse. Millions of people with both Type 1 and Type 2 diabetes who take insulin are well-controlled, complication-free, and living long and well. Why didn’t Oprah choose to showcase any of these individuals? I personally interviewed over 55 people with both types of diabetes and shared their secrets to living well in 50 Secrets of the Longest Living People with Diabetes in 2007. Scare tactics like Oprah used seldom work well in getting people to change their lifestyle habits long term.
Finally, why didn’t Oprah invite a single diabetes expert — an endocrinologist, a certified diabetes educator, or even a dietitian — on her show to talk about how to best manage diabetes? Dr. Oz is not a diabetes expert, and he and fitness guru Bob Greene focused obsessively on sugar and other "white" foods, but failed to mention that French fries and other carbs that Americans consume by the ton raise blood sugars and contribute to weight gain as much as or more so than sugar consumption. At least Bob Greene did tell the patients he was making walk on treadmills that their 30 minutes of exercise of a day was "non-negotiable." Unfortunately, Dr. Ian Smith just kept telling older African-American ladies from the same church in Ohio that they were "ticking time bombs."
Oprah even showcased her former chef who apparently lost 85 pounds in less than a year after his diabetes diagnosis like the contestants on "The Biggest Loser" and reversed his diabetes symptoms — commendable, but hardly the best way to go about achieving lasting weight loss and not realistic for most people with diabetes who can expect about a 20 pound weight loss in six months. People really needed to hear how it’s important to focus on the lifestyle changes that naturally result in weight loss instead of on weight loss itself, which is seldom maintained without that focus. Her viewers walked away with the impression that it was time to go on yet another diet to lose inches from their waistline.
Oprah may have raised diabetes awareness some, for which we all are grateful, but she missed a wonderful educational opportunity and instead propagated many myths about diabetes (too numerous to list here) that were outdated or abandoned as incorrect by diabetes health care professionals years ago. Perhaps we can convince her to do a follow-up show that will increase awareness, but not set back diabetes care at the same time?
If you have further comments on the "Oprah" diabetes show, please send them to Steve and Dave at firstname.lastname@example.org. Thank you.
If you need tips for getting started on an exercise program, check out my book entitled The 7 Step Diabetes Fitness Plan. For people with any type of diabetes who are already more active, you will benefit more from Diabetic Athlete’s Handbook. For other tips on exercise, fitness, diabetes, nutrition, and more, please visit my website and exercise blog at www.shericolberg.com.