To begin, Type II (also known as adult onset diabetes) accounts for 95 percent of diabetes cases in the United States. Now there’s solid evidence that patients themselves hold the key to improving their health, and that the improvements they experience are often dramatic.
In a groundbreaking study at the University of South Carolina ’s Norman J. Arnold School of Public Health in Columbia, researchers have found that lifestyle intervention focusing on exercise and modest weight loss worked nearly twice as well as medication did.
The study involved a cross section of the population that included 45 percent non-Whites. “Many of the non-White groups have much higher risk of Type II diabetes, so it was clearly important to include them,” says research Elizabeth Mayer-Davis, an associate professor of epidemiology at the university. “We had African-Americans, Hispanics, Native Americans, and Asian-Pacific Islanders included in the project. And the interventions worked just as well in the non-White groups as they did in the White groups.”
THREE IMPORTANT GOALS
There were three goals for the intervention group—to lose weight, to get dietary fat down to about 25 percent of calories, and to get the activity level up “to about 30 minutes a day of moderate activity like brisk walking on at least most days, five to seven days a week.” Some people did a bit more exercising than that, she adds; others did a bit less.
The results of the intervention were so favorable that even though the study was originally designed to last four years, it was stopped after three—an entire year early.
Jules Oaklander, a family physician, recommends that his patients exercise. “They just have to do a 30-minute walk every day. That’s it. They don’t have to join a gym or buy fancy equipment. They can just stand in front of their TV and watch the news and just jump up and down for thirty minutes. Really, that’ll do it.” And exercising indoors, he says, takes away the weather as an excuse not to do anything.
IS YOUR FAMILY TO BLAME?
But what about those patients who have a family history of diabetes?
Although Oaklander doesn’t unequivocally rule out such a history, he doesn’t have this observation: “I find out that the mother weighted 300 pounds, and the father was 280 pounds, and the sister was 200 pounds, and the strong family history of diabetes was not a genetic thing. It was just that they ate too much, and they were obese. Because they don’t know any different—if their mother had it and their sister had it, they all had it—they call it a family history. But in actuality, they’ve been eating things that are bad for them from the very beginning.”
SMALL GOALS = BIG BENEFITS
When a patient loses weight, the amount doesn’t have to be huge to be of benefit, says Mayer-Davis. For the intervention group in the University of South Carolina study, the average loss was from 10 to 15 pounds. As little as a loss of 5 to 10 percent of total body weight makes a difference. “If you’re 300 pounds, 5 percent is only 15 pounds,” she says.
“There’s one other point I’d like to make that I think is important,” she adds. “A lot of the burden of diabetes occurs in older age groups, over age 60. And sometimes there’s sort of a felling that if you are older, then don’t bother with weight loss—that type of thing. But in the diabetes prevention program the benefit for people over 60 was tremendous. There was a 71 percent risk reduction for people over 60 with this moderate lifestyle. It’s important, if you think about it, because if you have somebody who’s 65 years old, they easily could live another 20 years, and you want that time to be of good quality and of good health.”
Regular exercise is an important part of managing Type II diabetes, and it helps keep weight down, says W. Stuart Tucker, M.D., an endocrinologist at Eastover Internal Medicine in Charlotte , North Carolina . When patients don’t exercise, “it’s a vicious cycle. You don’t exercise; you gain weight. You get deconditioned. The weight and the deconditioning make it harder to exercise.”
Patients (especially sedentary ones) need to begin gradually with exercise and build up, he continues. And the type of exercise a patient does depends on any other health issues that may be present. Patients who are otherwise healthy, he advises, “should start off walking. The usual guideline there is that if you’re walking so fast that you can’t talk to somebody, you’re working to hard.”
But what about people who have difficulty walking? Dr. Tucker suggests, too, that a physical therapist can outline a plan for an individual’s particular needs and capabilities. For some people, “an exercise bike or an elliptical trainer or rowing machine, even stair master, may be more convenient.”
So what effect do a healthy diet, moderate weight loss if you’re overweight, and exercise have on Type II diabetes? Simply this: If you already have Type II diabetes, they can help you control it. If you’re on medication, they may help reduce the amount you need or eliminate it altogether. And if you don’t have Type II diabetes, they may just keep you from ever having it.
Reprinted from Vibrant Life Magazine . All rights reserved.