Diabetes: The Gathering Storm

Diabetes: An Avoidable Storm
Philip J. Goscienski, M.D.

July 2005

Have you noticed the diabetes commercials on TV lately? There were none only a few years ago but they appear several times a day now. You'll see them hourly before long because their market - Americans with type 2 diabetes - is exploding and every major pharmaceutical company is trying to cash in.

Type 2 diabetes affects about 6 percent of the population; nearly half as many Americans with the disease have not yet been diagnosed. Already the fifth leading cause of death among women, it accounts for almost 20 percent of hospital admissions among persons over the age of 45. In Native Americans it is already the second leading cause of death. Are the rest of us far behind? A survey from the Centers for Disease Control and Prevention offers a bleak projection: the prevalence of type 2 diabetes will double by the year 2050.

Almost all type 2 diabetes is entirely preventable. Although type 1 diabetes, which is determined by a combination of genetics and a trigger mechanism such as a viral infection, has occurred throughout all human existence, type 2 has not. Individuals who never eat food products made from refined grains and who are physically very active almost never get this lifestyle disease. Very few type 2 diabetics are slender. The ones who are either have an abnormal amount of abdominal fat on an otherwise slender-appearing frame, have recently lost weight because of the disease or fall into a special but small group of unfortunate individuals with a genetic abnormality.

Until the beginning of the last century, Native Americans were the modern equivalent of Stone Age humans. They are descendants of the hunter-gatherers that crossed the Bering Sea some 20,000 years ago and some of them began to raise crops in fixed areas about a thousand years ago. Paleopathologists, scientists who study disease processes in ancient humans, have discovered that their general health declined within a few generations after taking up the agricultural lifestyle.

The health of Native Americans has recently taken another devastating downward turn. Their genetic susceptibility to type 2 diabetes in a world of refined carbohydrates and little physical activity is literally killing them. A disease that was totally absent in this population well into the 20th century has emerged in a fury. Two separate groups, the Pimas of the American Southwest and one group of Inuit in Canada now have appallingly similar rates of diabetes: among females over the age of 55, 80 percent have the disease.

In 35 years of clinical practice in pediatrics I never saw a child with type 2 diabetes. My retired colleagues had the same experience but in the pediatric diabetes clinic of any metropolitan medical center about half the children have type 2 diabetes, what we once called adult onset diabetes. Another observation worries the medical community. When the disease begins early in life the onset of complications such as blindness, amputations and kidney disease appear even sooner. It is no longer unusual to see these tragic outcomes before the age of 30.

The storm is clearly on the horizon and it is approaching quickly. It requires nothing less than a new national priority. We can't cure the diabetics among us but we can prevent this disease among those who will reach middle age in mid-century.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.