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Partners in crime: Diabetes & obesity

Last reviewed: December 2009
Marvin Lipman, M.D.
Marvin Lipman, M.D., clinical professor emeritus of medicine at New York Medical College, is Consumers Union’s chief medical adviser.

"I knew this was going to happen someday, and I guess I have only myself to blame." That was the response of a 52-year-old obese and sedentary woman when I discussed the results of a recent routine examination that added her to the swelling ranks of diabetics in the U.S. I lessened the blow somewhat by noting that her grandmother had type 2 diabetes and that the predisposition to the disease is, in large part, genetic. She had none of the usual symptoms of diabetes, such as increased urination, thirst, weight loss, blurry vision, or vaginal infections. Indeed, almost half of the diabetics we surveyed didn't know they had the disease until it was diagnosed during a routine exam.

In the past decade, the number of type 2 diabetics in the U.S. has almost doubled. Overall, there are an estimated 24 million people with diabetes in this country. That includes one in four who don't even know they have the disease. And some experts believe it won't be long before that number exceeds 30 million.

What's the reason for the explosion? It's probably not because of improved detection methods. The fasting blood-glucose test is still the major diagnostic tool. What has caught epidemiologists' notice has been the parallel rise in obesity: In some surveys, as many as one in three Americans is actually obese. And since obesity is present in an overwhelming majority of type 2 diabetics, it's no wonder those two disorders are often referred to as the twin epidemics.

The patients speak

Illustration depicting diabetes & obesity factors
Illustration by John Pirman

So it's not surprising that in Consumer Reports' 2009 Diabetes Patient Survey of 5,012 people with type 2 diabetes, obesity is a major partner. When asked to list risk factors that existed before diagnosis, being overweight was cited by almost three of every four respondents. Improving diet, losing weight, and increasing activity were the most important strategies among those who believed they were successfully managing their diabetes. Nurse educators and dietitians were rated as being more helpful than primary-care physicians and endocrinologists in educating patients about nutrition.

In addition, overweight respondents were more than twice as likely to say that they were unsuccessful at managing their diabetes than those of normal weight. The bottom line: Controlling obesity is critical to managing diabetes.

What can be done to halt the twin epidemics? A three-year study published in the New England Journal of Medicine in 2002 showed that for people at high risk for type 2 diabetes, a 7 percent weight loss through diet and 30 minutes of exercise, five days per week, resulted in a 58 percent drop in the expected incidence of the disease. The solution to tackling obesity and diabetes is simple. You can't choose your parents, but there are no barriers to losing weight and exercising.

Have your doctor check for diabetes if you:

  • Are overweight
  • Have a family history of diabetes
  • Have high triglycerides or low HDL-cholesterol
  • Are Hispanic or black
  • Took long-term corticosteroids
  • Had diabetes diagnosed during pregnancy
  • Are over age 50
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