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Diabetes: Underrated, Insidious and Deadly

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  • Teresa Binstock
    Yet another article that mentions obesity but fails to mention the relationship between diabetes and intra-body POPs (persistent organic pollutants; comment
    Message 1 of 1 , Jul 1, 2008
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      Yet another article that mentions obesity but fails to mention the
      relationship between diabetes and intra-body POPs (persistent organic
      pollutants; comment with cites follows news article. -Teresa

      - - - -

      Diabetes: Underrated, Insidious and Deadly

      July 1, 2008

      *July 1, 2008*

      A Growing Menace


      <http://www.nytco.com/> Print This Image <javascript:window.print()>

      In a set of recent focus groups, participants were asked to rank the
      severity of various health problems, including cancer, heart disease and

      On a scale of 1 to 10, cancer and heart disease consistently ranked as
      9s and 10s. But diabetes scored only 4s and 5s.

      "The general consensus seems to be, 'There's medication,' 'Look how good
      people look with diabetes' or 'I've never heard of anybody dying of
      diabetes,' " said Larry Hausner, chief executive of the American
      Diabetes Association, which held the focus groups. "There was so little
      understanding about everything that dealt with diabetes."

      But diabetes is anything but minor. It wreaks havoc on the entire body,
      affecting everything from hearing and vision to sexual function, mental
      health and sleep. It is the leading cause of blindness, amputations and
      kidney failure, and it can triple the risk for heart attack and stroke.

      "It is a disease that does have the ability to eat you alive," said Dr.
      John B. Buse, a professor at the University of North Carolina School of
      Medicine who is the diabetes association's president for medicine and
      science. "It can be just awful --- it's almost unimaginable how bad it
      can be."

      Diabetes results when the body cannot use blood sugar as energy, either
      because it has too little insulin or because it cannot use insulin. Type
      2 diabetes, which accounts for 90 to 95 percent of cases, typically
      develops later in life and is associated with obesity and lack of
      exercise. Type 1 diabetes, which is often diagnosed in children, occurs
      when the immune system mistakenly destroys cells that make the insulin.

      The disconnect between perception and reality is particularly worrisome
      at a time when national diabetes rates are surging. Just last week, the
      Centers for Disease Control and Prevention announced that the number of
      Americans with diabetes had grown to about 24 million, or 8 percent of
      the population. Almost 25 percent of those aged 60 and older had
      diabetes in 2007. And the C.D.C. estimates that 57 million people have
      abnormal blood sugar levels that qualify as pre-diabetes.

      To be sure, diabetes is treatable, and an array of new medications and
      monitoring tools have dramatically improved the quality of care. But
      keeping the illness in check requires constant vigilance and expensive
      care, along with lifestyle changes like losing weight, exercising
      regularly and watching your carbohydrates.

      Dr. Buse says patients who are focused on their disease and who have
      access to regular medical care have a good chance of living out a normal
      life span without developing a diabetes-related disability.

      But some patients say they are too busy to take better care of
      themselves, and many low-income patients can't afford regular care. Even
      people with health insurance struggle to keep up with the co-payments
      for frequent doctor visits and multiple medications.

      And to make matters worse, diabetes is associated with numerous other
      health problems. Last week, for example, The Journal of the American
      Medical Association reported that people with depression were at higher
      risk for Type 2 diabetes, and vice versa.

      That is not surprising: according to data published last year in the
      journal Diabetes Care, depression tends to interfere with a patient's
      self-care, which requires glucose monitoring, medications, dietary
      changes and exercise.

      Ultimately, diabetes can take a toll from head to toe. In the brain, it
      raises the risk not only for depression but also for sleep problems and
      stroke. It endangers vision and dental health. This month, The Annals of
      Internal Medicine is reporting that the disease more than doubles the
      risk of hearing loss.

      Moving down the body, diabetes can lead to liver and kidney disease,
      along with serious gastrointestinal complications like paralysis of the
      stomach and loss of bowel control. Last year the journal Diabetes Care
      reported that in a sample of nearly 3,000 patients with diabetes, 70
      percent had nonalcohol fatty liver disease.

      Poor circulation and a loss of feeling in the extremities, called
      neuropathy, can lead to severe ulcers and infections; each year in the
      United States, there are about 86,000 diabetes-related amputations.

      Diabetes can also take a toll on relationships. By some estimates, 50
      percent to 80 percent of men with diabetes suffer from erectile
      dysfunction. Experts say women with diabetes often lose their libidos or
      suffer from vaginal dryness.

      The challenge for doctors is to convince patients that diabetes is a
      major health threat. For years, the message from the American Diabetes
      Association has been one of reassurance that the disease is treatable.
      Now, beginning in 2009, the association plans to reframe its message to
      better communicate the seriousness of the disease.

      "Our communication strategy is going to be that diabetes has deadly
      consequences, and that the A.D.A. is here to change the future of
      diabetes," said Mr. Hausner, a former executive with the Leukemia and
      Lymphoma Society who came to the association 10 months ago. "It's the
      word 'deadly' that was the potentially controversial word for the
      organization. In the past, people said, 'We don't want to get anybody
      scared.' "

      The new strategy is not a scare tactic, he added. Prevention and hope
      will still be part of the message.

      "It's not that we don't want people to have hope," he said. "We want
      people to understand this is serious."

      E-mail: well@...


      Comment by Teresa Binstock:

      A series of studies by DH Lee and colleagues uses CDC data from US
      populations. Findings describe associations among flame retardents,
      persistent organic pollutants (POPs), diabetes, insulin resistance, and
      metabolic syndrome. For instance, obese people with low blood-levels of
      POPs were less likely to develop diabetes than were slim people with
      elevated levels of POPs.

      1. Association of Brominated Flame Retardants with Diabetes and
      Metabolic syndrome in the United States Population: 2003-2004.
      Diabetes Care. 2008 Jun 16.
      2. Association between serum concentrations of persistent organic
      pollutants and insulin resistance among nondiabetic adults: results from
      the National Health and Nutrition Examination Survey 1999-2002.
      Diabetes Care. 2007 Mar;30(3):622-8.
      3. A strong dose-response relation between serum concentrations of
      persistent organic pollutants and diabetes: results from the National
      Health and Examination Survey 1999-2002.
      Diabetes Care. 2006 Jul;29(7):1638-44.


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