Diabetes: America's Silent Killer
It's estimated that 80 million people in the United States have diabetes or are on the verge of developing this disease. Diabetes is particularly prevalent in the African-American community, where it claims nearly 100 lives every single day. "It's time to get out of denial," Oprah says.
Because so many people are affected, the United States is forced to spend $174 billion a year treating this disease—more than AIDS and all cancers combined. "If we don't fix the problem of diabetes in this country, we will bankrupt our future ability to pay for healthcare in the nation," Dr. Oz says.
As a heart surgeon, Dr. Oz says 25 percent of the patients he operates on have diabetes. Still, he says there's hope for anyone who's suffering or at risk. "Most diabetes is preventable," he says. "It is treatable, even reversible."
Type 1 diabetes, formerly known as juvenile diabetes, affects 10 percent of Americans diagnosed with diabetes. "[You're] not making enough insulin. That's generally from genetic reasons because your pancreas just doesn't work correctly," he says. "Type 1 has nothing to do to prevent it from happening. There's a lot we can do to treat you once it happens."
Type 2 develops from lifestyle issues. "[Patients] have a lot of belly fat and the like, and they have enough insulin," he says. "But it's not listening anymore because the belly fat has poisoned the ability of insulin to work, so the sugar is still floating around because it can't find a partner to get into your tissues."
Though type 2 affects most of the population, Dr. Oz says it's the most treatable. Patients just have to start making better lifestyle choices. "Ninety percent of type 2 diabetics can actually reverse their problem," he says.
Sugar often becomes an addiction, Dr. Oz says. "When you go to a store to buy food, when you go to a supermarket, to a restaurant, and you get a little bit of sugar, it stimulates the same part of your brain as crack cocaine," he says. "It just turns you on."
Even if you try to control your intake, Dr. Oz says sugar is often hidden in products you wouldn't expect. "It's hidden in our condiments," he says. "It's hidden in our salad dressing."
Watch Bob Greene's surprising expose on hidden sugars
Your body uses sugar (also called simple carbohydrates) to help the brain think and keep muscles moving. When you eat, your food goes through a digestive process that separates sugar and glucose from the rest. That sugar makes its way into your bloodstream. In a healthy body, the pancreas releases insulin, a hormone which helps funnel sugar from the bloodstream to tissues that need it.
Watch Dr. Oz's animation of what diabetes does to your body.
However, too much sugar can be a serious problem. "We store it in our belly," Dr. Oz says. "But that belly fat, the omentum, gets ponderously large. And as it does that, it poisons the insulin so it no longer can work and the sugar cannot get out of the bloodstream."
This causes issues for the heart. "The blood vessels are very delicate," he says. "The sugar is like pieces of glass shard scraping at it."
These shards leave small holes on the inside of the artery. "Our body scars in an attempt to heal it. It's a fragile repair," Dr. Oz says. "It breaks; it ruptures. Now you have an open surface that's sore."
As a scab forms over that sore, Dr. Oz says it gets larger and hardens the arteries—leading to a heart attack. "A diabetic will most likely die from a heart attack," he says.
See how diabetes can affect your heart
For that reason, Dr. Oz says diabetics are at high risk of kidney failure."Here's a picture of a normal kidney on the left. Beautiful. Plump. Robust," he says. "Look at the kidney on the right. It's shrunken. It's shriveled. It's been killed. That's a diabetic kidney."
As the blood accumulates, you aren't able to see as much as you did before. "Do you see those dark areas? That's a charley horse in the eye," he says. "That's your view of the world. ... It's not just a little bit of sugar."
In severe cases, a diabetic's blood vessels look like bent straws that cut off blood flow to the legs. "The diabetes causes scarring on the inside and basically kinks it off. It kinks it off in multiple places so we can't even get around them," he says. "You can't fix that if you're a doctor."
The condition can reduce your ability to fight infections in your lower extremities by shutting off the supply of white blood cells, Dr Oz says. "[In] a lot of diabetes [cases], the first time they know they've got a problem is they get an infection in their toe. They don't feel their toe so well because it affects their nerves, and so they end up losing their feet."
An amputee's plea to those with diabetes
Constant thirst and frequent urination: These are the first things doctors will ask you about. "You have [constant thirst] because you're urinating all the time," he says. "The sugar gets into your urine, and it actually drags it through your kidneys. It fools your kidneys."
Non-healing infections: "The white blood cells that protect the immune system can't get there," he says. "And by the way, your white cells don't function normally. Your whole immune system's depressed because you're waging a constant civil war against your body, which has the sugar scraping away on the inside."
Tingling toes: "Nerves have a cable around them," Dr. Oz says. "That cable gets broken with diabetes, so you end up with short circuits of your nerve system."
Blurred vision: "You're having little bleeds in the back of your eye," he says.
Belly fat: A big belly is the number one risk factor in America, and Dr. Oz has a simple test to see if you have too much: "If your waist size, measured at your belly button is more than half of your height, then you've got too much belly and you're at risk for diabetes."
Sedentary lifestyle: Physical activity is key to preventing or reversing diabetes. "When you exercise and do muscle-building work, the muscle actually becomes more sensitive to insulin," he says. "The insulin can work better. It can drive the sugar where it's supposed to go."
Family history: "If you've got relatives who have diabetes or if you had diabetes when you were pregnant, big warning signs."
Smoking: Cigarettes not only harm your lungs, "it kills your pancreas," Dr. Oz says.
Dr. Ian Smith, the medical and diet expert behind the 50 Million Pound Challenge, says the obesity epidemic has spiraled out of control. African Americans are twice as likely to have type 2 diabetes, develop end-stage kidney disease, have amputations and die from the disease. "African-Americans are facing an obesity crisis," he says. "It's literally killing us."
Dr. Smith says part of the problem lies with bad habits. "Habits are tough to break, especially for African-Americans when their habits are around food, which is like a culture for them," he says. "Food is love and comfort."
Another major battle is attitudes toward eating and exercising. "Transgenerationally, we've eaten this way, and African-Americans take this 'heels in the ground' approach," he says. "This is a disease often about attitude, and attitude has a lot to be desired right now. We have to improve our attitudes about it."
Diabetes is a disease close to Bob's heart. "Both of my parents have diabetes," he says. "Through lifestyle, you can change your risk and, in most cases, prevent this disease."
Incorporating exercise into your life doesn't have to be overwhelming. Bob says two simple activities can reduce your risk, weight and symptoms dramatically:
- Walk 30 minutes a day.
- Start strength training. "This can be done with bands or weights. My favorite is dumbbells," he says. "Maintaining the muscles and the joints is so important in combating diabetes because it raises your metabolism."
If you already have diabetes, make sure you are on top of your condition. "Diabetes is years and years and so you don't feel the immediate effect of it, and that's why people say, 'I'll make a change tomorrow,'" Dr. Smith says. "Why wait until it's a crisis situation? Wait until the doctor says that you have to take insulin or you're going to have an amputation? Do something about it now."
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