DIABETES PREVENTION - 12 VIDEOS

DIABETES PERVENTION



1. What are risk factors for developing diabetes?
2. Is it possible to prevent type 1 diabetes?
3. Is it possible to prevent type 2 diabetes?
4. Is it possible to prevent the complications of diabetes?
5. How do I know what an appropriate meal size is if I have diabetes?
6. How should I care for my skin if I have diabetes?
7. How should I care for my teeth and gums if I have diabetes?
8. Why is type 1 diabetes considered an autoimmune disease?
9. What is an "autoimmune disease"?
10. What environmental factors contribute to diabetes?
11. Why are people getting type 2 diabetes at a younger age?
12. Is diabetes just a problem in the USA and other "Western" nations?



Diabetes Prevention
What are risk factors for developing diabetes?

There are many risk factors for developing diabetes. First is age, so as people their risk for type 2 diabetes goes up and so being older than 45 years is considered a risk factor for diabetes. Being overweight is a very strong risk factor for diabetes particularly weight in the center. So people who gain weight in their center are those who are at highest risk. Having a family member with diabetes puts you at increased risk. There are certain ethnic groups such as native americans, african americans, latino americans, pacific islanders and asian individuals who are at higher risk for developing type 2 diabetes. People with high blood pressure are at higher risk for type 2 diabetes. People who have abnormal cholestorol levels are at higher risk for type 2 diabetes. Women who've had a big baby, meaning a baby that weighs more than 9lbs are at increased risk for having diabetes. Also, for women who've had gestational diabetes. Having polycystic ovarian syndrome, which is a syndrome people have infrequent or irregular menstrual cycles and developing facial hair and other findings are also associated with and increased risk for diabetes. So there's a whole list. Many things that many people have that put them at higher risk for getting type 2 diabetes. But, I would say the two most common findings that I see again and again are people who have a family history of diabetes and people who are gaining weight in there center. Now, in addition to a family history of diabetes, a family history of heart disease also puts you at much higher risk because before you actually get problems related to blood sugar levels, you may have problems related to high blood pressure and abnormal cholestorol. So, often people will have a heart attack first and then get their diabetes later. So I actually look at alot of heart disease as somewhere on the spectrum of getting diabetes.
Is it possible to prevent type 1 diabetes?

Type 1 diabetes, as far as we know, is not yet preventable. But there's a lot of research that's ongoing to try to find the genetics of type 1 diabetes, and also to try to find ways to prevent it. So it's something that's on the horizon, but unfortunately we have no way to prevent it at present.
Is it possible to prevent type 2 diabetes?

Type 2 diabetes is really preventable. The first thing you have to do is know you're at risk. And really try to figure out not only if you're at risk, but if the people in your family are at risk. The real way to prevent type 2 diabetes sounds simple but it isn't. It means you need to lose weight if you're overweight and exercise. Now, it doesn't mean that you need to become thin. If you need to lose a hundred pounds, you don't have to do that to prevent diabetes. You only really have to lose about fifteen pounds, about seven percent of your body weight. So for a lot of people, that's twelve to twenty pounds. If you lose that weight, and if you keep it off; it will prevent diabetes. Now, in addition you need to exercise, and I don't mean running marathons although that might not be bad. What you really want to do is to exercise for thirty minutes a day, five days a week and we think that walking, for instance, is a very good way of getting exercise. Also, just gently going out, just moving your body, increasing your exercise, and if you can over time increasing the intensity this is perfect. But getting exercise and losing weight prevents diabetes. For a lot of people, that's really hard to do. And everyone's busy and people don't have the time to do it and the really important part is that people don't have the time to maintain it. So a lot of people can lose twenty pounds but keeping that twenty pounds off is the hard part. So a lot of individuals will develop diabetes gradually and there's now ways we can try to use different medications that are actually meant for treating diabetes but if we use them earlier we can prevent diabetes. But my key message is lifestyle. So if you have an overweight fifteen year old and you or someone in your family has type 2 diabetes, the best thing you can do for that kid is to really work with them in terms of helping them choose healthy lunches, giving them breakfast, getting them to do physical activity, making habits young that will last for a lifetime and that's how you prevent diabetes.
Is it possible to prevent the complications of diabetes?

I think that the most of the complications of diabetes are preventable. Unfortunately they are not reversible so if somebody doesn't know that they have diabetes for 10 years they can come to me with the nuances of diabetes onset only they just found out and they already have damage to their eyes, their kidney and their nerves. So first and foremost people need to get diagnosed early. They need to find out what their blood sugars are, they need to see if they are at risk and then if you put people like that under good care and they keep coming back and getting good care, in my experience they really don't get diabetic complications. Now, there may be a little problem here and there, there may be a little damage to the eyes, little damage to the kidneys over 20 – 30 years but in general it's not something the person really notices and if it's treated then you can really deal with that.
How do I know what an appropriate meal size is if I have diabetes?

First of all, I think that everybody with diabetes should see a nutritionist, a dietician, or somebody that works at a program, or at least read books about nutrition – because people really need to eat in a way that's healthy. A very important way to eat, and a healthy way, is to reduce portion size. And, people need to get a sense of what normal portions are. And, I think that the best way to do that is to use your hand. So, everybody should take their hand and look at their palm. And, so – guys get a slightly bigger size than a woman does. But, if you look at the palm of your hand, and trace around it, that's about the amount of protein that you should eat a meal. And, in fact, it may be the amount of protein you need in a day. And, that's about the size of a deck of cards. And, you want to look at the width of the meat or protein as being about the width of your thumb. So, if you think about what you could eat if you went out for some gigantic steak, it's going to be twice as big and much thicker. That's way too much protein, and in fact, something you may want to split with someone else because when you eat that much protein, you generally get a lot of fat, and that, together, is not so good for you. Now, your hand is also useful for a variety of other things. You want to, for instance, figure out how much is a cup of something, or a half a cup of something, so a portion size of rice is a third of a cup – that's very little, that's only about half or a third of your palm. Your palm cupped is about a cup's worth of something. So, if you want to eat a portion of mashed potatoes or cereal, it's probably going to be about the amount that fits in your palm. So, again, it's not very big compared to what we're usually used to eating. And, then, if you're going to do a tablespoon, of, say, salad dressing, a tablespoon is about the amount of the tip of your thumb. So, you want to start getting a sense of your own portions and reducing portion size.
How should I care for my skin if I have diabetes?

People with diabetes when their sugars are high, often get dry skin and they may get even itchy skin which responds best, I think, to controlling the blood sugar levels. Otherwise, people with diabetes just deal with their skin the way that anybody would in terms of lotions and creams and trying to deal with the dryness externally. But, if you can control the blood sugars, I think that's the best way to treat it overall, and if you got a cut or sore, any kind of infection on your feet, that would mean you need to contact your doctor. That would not mean something you can treat yourself but rather to contact your health provider for and get some advice about what to do next.
How should I care for my teeth and gums if I have diabetes?

People with diabetes get more gum infections and more cavities than people without diabetes, but like everything in diabetes, it's all related to blood sugar levels, so the more normal the blood sugar levels, the more normal the teeth. So, people with diabetes need to make sure that they go regularly to the dentist, and they may often need to go more often because they're being treated for prior damage that happened when their sugars was higher. But once things get under control and the diabetes is treated, my expectation is that they should do just as well or as poorly as anybody else with their teeth.
Why is type 1 diabetes considered an autoimmune disease?

Type 1 diabetes is an autoimmune disease because it's a disease in which the body makes infection-fighting cells, what we call antibodies, that, by mistake, attack the islet cells, the insulin-producing cells on the pancreas. It is because of that that the body cannot make insulin any further and people get type 1 diabetes.
What is an "autoimmune disease"?

An autoimmune disease means the body makes a mistake. It looks at some normal tissue and says, "That's a foreign invader." So, in the case of diabetes, the body looks at all its cells and says, "There's something wrong here," and tries to kill off the eyelet cells by an autoimmune response, making antibodies. In the case of rheumatoid arthritis the body looks at joint tissue and says, "That's not normal," and the autoimmune response is that the body tries to kill it off. And so an autoimmune disease is really a mistake by the immune system, and that mistake creates a disease.
What environmental factors contribute to diabetes?

There probably are a lot of environmental factors that contribute to causing or triggering Type 1 diabetes but we don't really know what they are. We know that there are certain viruses. There are certain subtypes of Coxsckie viruses, for instance, which we know can cause Type 1 diabetes but most of the time we don't know what caused it. We know something in the environment triggered it, but we really don't have any idea of what that is. Eventually we will figure it out but we don't know yet.
Why are people getting type 2 diabetes at a younger age?

People are getting type 2 diabetes at younger ages because we are basically seeing an epidemic of obesity and inactivity in children. So if you think about it, when you see the classic guy in my clinic who is 45, 50 years old - he's got a central ponch. He has got a family history of type 2 and he comes to see me because he has diabetes. He'll tell me very proudly that he played something in college. That he was thinner than his wife when he got married, that he was fit and he is proud of that. And he will say, "I don't know what happened." But we know what happened, you know the kids, house, the mortgage. But we know that he was fit in high school and college. The problem is, is that his son is a couch potato. His son isn't going out and doing anything more than walking to school even if that. His son is spending hours and hours of time doing things that aren't physically active. So we are shifting. So instead of being 50 and becoming fat, people are becoming 10 and becoming fat and that means that this disease is now starting when they are ten, not fifty, which means this epidemic is going to be seen in fifteen year olds, twenty year olds, thirty year olds. And they're going to get heart disease. They are going to get strokes and they are going to get diabetes before they are forty.
Is diabetes just a problem in the USA and other "Western" nations?

Diabetes is an epidemic that's happening around the world. The two leading countries, in terms of developing diabetes, actually turn out to be India and China. The reason that is, because, they now have an influx of western dollars. Their societies are doing well, people aren't as poor as they once were. The way that I look at this is, maybe, all of those people who survive all of that poverty have these great genes for survival. Those same genes now, when they have food, are causing them to store food in their center and cause them to go on to get diabetes. In fact, in Asian individuals, the amount of fat they have to have, in their center is much, much less than in someone, say, from East Los Angeles where their guts are much bigger. So, very low levels of obesity or being over weight, Asian individuals develop diabetes. I think they are very good at surviving famine but, now their environment has changed. At least for many of them they are not as poor, they have more food, they have more fast food, they have fast food all over the world and people are getting diabetes.


1.

Diabetes: What are risk factors for developing diabetes?

2.

Diabetes: Is it possible to prevent type 1 diabetes?

3.

Diabetes: Is it possible to prevent type 2 diabetes?

4.

Diabetes: Is it possible to prevent the complications of diabetes?

Diabetes: Is it possible to prevent type 2 diabetes?

5.

Diabetes: How do I know what an appropriate meal size is if I have diabetes?

6.

Diabetes: How should I care for my skin if I have diabetes?

7.

Diabetes: How should I care for my teeth and gums if I have diabetes?

8.

Diabetes: Why is type 1 diabetes considered an autoimmune disease?

9.

Diabetes: What is an "autoimmune disease"?

10.


Diabetes: What environmental factors contribute to diabetes?

11.

Diabetes: Why are people getting type 2 diabetes at a younger age?

12.

Diabetes: Is diabetes just a problem in the USA and other "Western" nations?