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PRE-DIABETES – ARE YOU AT RISK?

From a Series on Insulin Resistance and its
Links to Serious Health Conditions
 

By

Dr. Mary Shackelton, MPH, ND
Medical Director - Insulite Laboratories


Do you know what your chances are of developing Diabetes? Can you identify the leading risk factors? Do you have a clear idea of what Pre-Diabetes is?

And are you aware that, even if you’ve been diagnosed with Pre-Diabetes, it doesn’t automatically mean you are going to develop Type 2 Diabetes?

A recent survey conducted by the American Diabetes Association suggested that many Americans are either unaware or in total denial of their own risk factors for developing this deadly disease(1). More than half of the respondents to the survey knew that obesity is a leading risk factor in developing Type 2 Diabetes and acknowledged that they were personally overweight. But they also maintained that they weren’t at risk of developing the disease.

Type 2 Diabetes is the most common form of the disease, affecting over 15 million people in the United States alone. Diabetes occurs when the body either doesn’t produce enough insulin or the body’s cells cannot correctly process the insulin that is produced.

In the normal healthy cell, insulin allows food or glucose to pass through the surface via receptor sites so it can be converted into energy. But a condition called Insulin Resistance prevents the efficient conversion of food into energy because it vastly reduces the number of insulin receptor sites on your cells. Too few receptor sites cause glucose and insulin levels in the blood stream to become elevated.

It's been estimated that a typical healthy person has 20,000 insulin receptors per cell, while the average overweight person can have as few as 5,000. Insulin acts as a "key in a lock",  allowing glucose to pass through the cell wall and be converted to energy. If you have too few receptor sites, glucose bounces off the cell wall instead of passing thought the insulin "door". Free-floating glucose is sent to the liver, converted to body fat and stored throughout the body, which can lead to weight gain and obesity.

Insulin Resistance causes cells to become starved for energy while free-floating glucose and insulin rise to dangerously high levels. Long term effects can include damage to the heart, kidneys, nerves and eyes(2).

In addition, the imbalance of glucose and insulin leads to an increase in triglyceride levels, a rise in LDL “bad” cholesterol and a lowering of HDL “good” cholesterol, resulting in a greater risk of developing cardiovascular disease.

Before someone develops Type 2 Diabetes, they almost always have Pre-Diabetes. This is a condition characterized by blood glucose levels that are higher than normal, though not high enough to trigger a diagnosis of Diabetes. The American Diabetes Association estimates that, today, there are 41 million people in the United States with Pre-Diabetes. There is a growing body of scientific research that suggests long term damage to the cardiovascular system may be occurring among Pre-Diabetes sufferers(3).

In my clinical practice, a substantial number of the patients I’ve helped with weight loss issues are either Diabetics or in the Pre-Diabetic stage. Since obesity is not only a growing epidemic in this country but also one of the causal factors in Diabetes, my research logically expanded into the field of Insulin Resistance. This condition is increasingly considered to be an underlying cause of obesity.

It’s important to understand the distinction between Diabetes and Insulin Resistance. When you have Diabetes, the body either doesn’t produce sufficient insulin or the body can’t absorb the insulin that does get produced.

Insulin Resistance occurs when the body produces enough insulin but the cells can’t absorb the correct amount of glucose (blood sugar), which remains in the blood stream. This causes elevated blood sugar, which is sent to the liver. Once there, it is converted to fat and stored throughout the body which can lead to obesity.

The effects of Insulin Resistance are worsened by obesity in a fairly straightforward link between the two conditions. And the more Insulin Resistant you are, the more insulin your body manufactures as it tries to overcompensate for the inability to use insulin.

A vicious cycle has begun because the higher your insulin levels, the more you are likely to develop Pre-Diabetes or Diabetes and thereby increase your risk of a heart attack.

Are you at risk of developing Pre-Diabetes? You are if you’re overweight and don’t get enough exercise. And you are if you have a family history of Diabetes. While there is no single test that can determine if you have Pre-Diabetes, your doctor can run a series of blood tests which will evaluate whether you have this condition.

Ask yourself how many of these risk factors you have for developing Pre-Diabetes:
  • Do you have a relative with either Type 2 Diabetes or heart disease?
  • Are you overweight or obese?
  • Are you 45 or older?
  • Do you have hypertension (high blood pressure)?
  • Do you belong to a high-risk ethnic group, which includes African-American, Latino, Asian American or Pacific Islander?
  • Are you “apple-shaped” rather than “pear-shaped”? (Meaning excess weight gathers around your waist, rather than your hips.)
  • If you’re a woman, did you develop Gestational Diabetes or have a baby that weighed more than 9 pounds at birth?
The more “yes” answers to those questions, the higher your risk. But just because you’ve been diagnosed with Pre-Diabetes, that doesn’t mean you’re automatically going to develop Type 2 Diabetes.

The Diabetes Prevention Program study found that even modest changes in diet and exercise can prevent the onset of Type 2 Diabetes(4). Simply losing 5-7% of your body fat (typically 10-15 pounds) and increasing your physical activity by taking a brisk walk 4-5 times a week can reduce your risk of developing Type 2 Diabetes by almost 60%.

Obesity is an underlying factor in developing Pre-Diabetes and Diabetes and a growing body of evidence suggests Insulin Resistance is a root cause of obesity. So it follows that addressing Insulin Resistance would also address the issues of Pre-Diabetes and Diabetes.

The rate of Diabetes has tripled in the past 30 years, fueled largely by the accompanying epidemic in obesity(5). A 2002 study by the Diabetes epidemiology section at the Centers for Disease Control and Prevention estimated that, if the trend continues, approximately 30% of the children born in 2000 will develop Diabetes in their lifetime. Clearly, since Diabetes can lead to heart disease, stroke, blindness, kidney failure, amputations and early death, lowering your risk factors for developing this disease is not only highly desirable but life-transforming as well.

It has long been known that a rapid weight loss program, whether brought about by strenuous dieting or excessive exercise programs or drugs, will simply not work as a long-term solution. Almost invariably, people who lose weight under these regimes will eventually gain back everything they’ve lost, plus additional weight, thus compounding the problem rather than solving it.

From my work in the Public Health sector, I saw first-hand the spiraling problem of obesity, recently re-defined as a medical condition by the U.S. Government. In my clinical practice, I became increasingly involved in addressing my patients’ weight loss concerns, which led directly to my research in the fields of Insulin Resistance and Diabetes. I realized that a systematic approach would be needed to address all the components of these disorders. Simply put, taking a pill every day won’t begin to effect the changes that are necessary if you hope to correct these conditions.

I wanted to develop a system for my patients that included all of those components while providing support and outreach, which research has shown are the most effective methods for achieving lifestyle transitions. My own research revealed that no one had yet developed and offered a complete system to patients suffering from Insulin Resistance. It was this omission which led directly to my creation of the Insulite System.

I use nutraceuticals (disease-specific vitamins, minerals and herbs) that can effect substantial metabolic change. The Exercise and Nutritional plans are not only necessary components of the system but also realistic and easy-to-follow. The underlying theories are based on well-recognized and accepted science that reprograms neural networks and replaces old, sedentary habits with gradual and permanent lifestyle changes.

Please, begin today to address these conditions. Your fitness matters. Put yourself back on the path to optimum well being.


Dr. Shackelton received her Masters in Public Health (MPH) from San Diego State University and her Naturopathic Doctorate (ND) from the Southwest College of Naturopathic Medicine in Tempe, Arizona. She additionally completed a program from the Institute of Women’s Health and Integrative Medicine in Portland, Oregon. Her work in the field of public health laid a foundation for thinking in terms of improving the health of large sections of the population. Her practice as a Naturopathic Doctor has allowed her to focus one-on-one in a clinical setting on women's and children's health where she has successfully worked with many of her patients' Insulin Resistance and weight conditions. In 1998, Dr. Shackelton was a team doctor for the First Disabled Ascent of Mt. Everest. She conducted research at Everest Base Camp on the effects of herbs and homeopathic medicines on high altitude acute mountain sickness and published the study results in The Journal of Complementary Therapies.



References:
(1) Survey conducted by the American Diabetes Association in August of 2003.

(2,3) American Diabetes Association, Type 2 Diabetes: Conditions, Treatments, Resources

(4) Diabetes Prevention Program study, 2001, study funded by the National Institute of Child Health and Human Development, et al.

(5) National Institute of Diabetes & Digestive & Kidney Diseases

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