Photo: Portrait. Caption: Peter J. Nebergall, PhD
Most people do not fix what they do not perceive to be broken. Although type
1 (insulin-dependent) diabetes is unambiguous in symptoms and treatment, perhaps
90% of all diabetes is of the non-insulin dependent type (type 2), with symptoms
that only become “obvious” once the disease has substantially progressed.
By the time many type 2 diabetics (and often their primary care physicians)
realize action is necessary: diet, exercise, lifestyle changes, oral medications,
perhaps insulin, the condition, and its destructive high blood sugars, has
been left to do its work for years. Damage has been done. Complications, like
retinopathy, neuropathy, and nephropathy, are likely well underway.
But we go to our doctors when we're ill, because we perceive ourselves to
be “ill.” We visit the physician because we feel bad, and we wish
to feel better. We react to the stimulus of perceived illness. This is understandable,
but does not allow much room for prevention.
Of course this idea, “Don't see the doctor 'til you need to,” comes
from our “crisis intervention” model of medicine; but to blame,
to point fingers at this stage is as pointless as is the parachutist's complaint
that his equipment has just failed. It's a little late to talk about why.
Some problems are better prevented. Sometimes it is better to be proactive.
What is a “proactive approach” to reducing diabetes? How do we carry
out such a multipronged attack? Step One is, of course, education. We need
to know what ails us, and what it is we can avoid, if we take the necessary
actions, and then we need to know what those actions are. Sounds simple, eh?
If you have type 2 diabetes, you know most of the time you don't feel very
bad. You might think that because you don't feel very bad, it isn't very serious,
and you don't have to do anything about it just now. I'll wait 'til it hurts
...You couldn't be more wrong.
Diabetes damages your body with high sugars. It doesn't care whether your
sugars are high from type 2, type 1, or some other cause — if they're
“up,” they're doing damage. Type 2 diabetics who let their sugars
run “because they don't feel bad” are doing serious damage to their
eyes, kidneys, hearts, and nervous systems.
I want to tell you a big secret: There IS no “diabetic diet.” There
is no specific “exercise plan for diabetics.” There's only something
called a ”healthy lifestyle“— and it's the SAME whether you
have diabetes or not!
The human body was meant to be slender, active, and not overly stressed. Do
you overeat? Are you carrying too many pounds? Do you work sitting down? When
you want an “adventure,” do you go watch one? Is your idea of “healthy
diet” a full plate, with seconds on everything? How 'bout a big T-bone
steak, and a plate of fries? How about a 40-ounce chocolate milkshake with
a “sidecar?”
And at your work, do you regularly get steamed up? Are you regularly ready
to scream and throw things —but you go have a few beers, and a cigarette,
instead? Isn't it time to talk about healthy lifestyle?
Hippocrates the Physician, the ancient Greek doctor who founded modern medicine,
advised his patients that a healthy diet, in moderate amounts (that means
what you need, not “how much you can hold!”), coupled with regular
physical exercise (and that really does mean more than “20 minutes, twice
a week”) would do a great deal to keep them healthy. He was right, of
course.
Suppose you have diabetes, and don't want the complications. Suppose you don't
have it, but you're from a high-risk group (and maybe someone has it in your
family), and you want to cut the risks. Or, suppose you just want to feel
better. It's all the same — a commitment to healthy lifestyle.
I remember the story of the 64-year old heart patient who, advised by his
doctor to get some regular exercise, joined an Aikido Dojo (Aikido is much
like Tai Chi), and died at age 96, Grand Master of the style. Its never too
late — there's something you can do, and the gyms are full of people
just like you. Or you could get a big puppy who needs lots of long walks.
Just talk to your doctor about it first.
Diet is a little more complicated (and there are professional dietitians to
advise you), but the biggest food problem most Americans have is too much
of it. Count your calories! Unless you're a steelworker, a cowboy, a furniture
mover, or a stonemason, I'll bet you eat more calories than you need. Losing
weight is a matter of retraining yourself. The Hollywood press is full of
stories of actors and actresses fighting the same battle, but the ones who
are winning do regular workouts (one called Pilates is much in fashion now)
and follow disciplined diets like The Zone.) Check it out with your dietitian.
Stress? Most of us would feel a lot less stressed if we went out and played
some sports. Even a good workout, a chance to strain against something heavy,
helps cut the stress level. So exercise provides a double benefit!
Everyone is a little different. Talk to your doctor about what you can do
with diet and exercise. It'll help. If you don't have diabetes, being proactive
can help you stay that way, and if you do, once you've been advised of the
precautions you need to take to keep yourself safe, being proactive can cut
your risk of complications, your need for expensive medications, and your
stress level. What are you waiting for?