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Why We Need to Attack the Diabetes Problem with Lifestyle Changes — and Why We Need to Do It Now

By Sheri Colberg, Ph.D., FACSM

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The National Changing Diabetes (R) Program (NCDP), a program of Novo Nordisk (www.ncdp.com), recently published online the results of their new analysis that found that the cost of diabetes and pre-diabetes reached $218 billion in 2007, with the exploding number of cases of Type 2 diabetes responsible for the majority of the costs. According to the study, diagnosed Type 2 diabetes accounted for $174.4 billion of the spending on diabetes-related health care costs that year, while undiagnosed cases added another $18 billion in costs, more than that attributable to Type 1 diabetes ($14.9 billion). Moreover, pre-diabetes cost $25 billion. 

What I want to know is, why is this news not alarming to everyone? We should be shouting it from the roof tops, amassing our forces, and getting ready to launch a full-scale attack on the problem that is diabetes/pre-diabetes/insulin resistance. These diseases are threatening to shorten all our lives, lower our quality of living, and overburden and financially ruin our health care system, and in most cases, diabetes is preventable and pre-diabetes reversible.

We need to wake up and take action. Americans are already all paying for this through higher health insurance premiums, whether we know it or not. Spending on each case of Type 1 diabetes totaled about $15,000 in 2007 — but that is somewhat understandable with the need to take insulin, monitor blood glucose levels frequently, and consult with health care specialists. However, Type 2 diabetes cost nearly $10,000 per patient that same year, mostly due to costs associated with the treatment of diabetes-related health problems. By way of comparison, pre-diabetes averaged only $443 in extra medical costs per person. 

Research has definitively shown that high-risk people with pre-diabetes can cut their risk of developing diabetes with lifestyle modifications. The Diabetes Prevention Program (DPP) study found that lifestyle modifications — including doing 30 minutes of moderate exercise daily and aiming for weight loss of 5-7% with positive dietary changes — was able to lower diabetes risk by 58 percent in high-risk individuals. This is old news by now, but we can’t afford to forget it. A 10-year follow-up of DPP patients published last year found that the benefits from lifestyle improvements persisted for at least a decade, with individuals in the lifestyle intervention still maintaining a 34 percent lower risk of diabetes that many years later.  Moreover, the lifestyle intervention was shown to be most successful in preventing diabetes in older individuals, the group at the highest risk for developing it in the first place.

In my last column, I talked about the launch of the National Physical Activity Plan (www.physicalactivityplan.org), which is now scheduled for May 2010 in Washington, D.C.. I am not alone in believing that the only way to get a handle on diabetes before it overtakes us and to make lifestyle interventions work on a large scale is through thoughtful, nationally funded programs that can arise from the launch of this effort and other large-scale attempts to improve the health of Americans through exercise and dietary changes. 

Honestly, how many of your patients really would want to go on another medication if they can avoid it? Exercise truly is the best medicine (and a relatively inexpensive one), and the only side effect is usually better health, more energy, enhanced longevity, and an improved mental state. Who can argue with results like that?   

If you’re not a regular exerciser already, take a long, hard look at all the obstacles keeping you from choosing a healthier — even a diabetes-free — life and choose to overcome them. If you’re active, but others around you are not, help them also figure out how to make increased physical activity possible in their daily lives. We all have to work together to make these changes happen, and the time to start doing something is now. 

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.

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