Nearly half a billion people globally now have diabetes

[RAE]

As the article below says, diabetes has "exploded" everywhere, with the number of cases increasing by 4X or more since 1980. And a lot of diabetics don't even know they are diabetic, so they are walking around untreated. A lot of this undoubtedly has to do with poor lifestyle choices.........processed food consumption, obesity, lack of exercise. A couple of the main risk factors for COVID were/are diabetes and obesity, and of course diabetes leads to all sorts of other serious chronic diseases.


Meanwhile, the big food companies keep trying their best to get us all hooked on more processed junk foods, most of which are high profit margin items. So I am not optimistic that this trend is going to reverse anytime soon.



https://www.studyfinds.org/half-billion-people-have-diabetes/

 

[athena53]

This is a big concern of mine, too. I listened to a really informative Freakonomics podcast on dialysis last month- the cost of dialysis is 1% of our GDP. Much of the dialysis is done to treat people in kidney failure due to diabetes.

Think what we could do with 1% of GDP if it we could devote it to other healthcare purposes.

 

[Car-Guy]

You think maybe growing populations, aging demographics and better/more testing has anything to do with the 4x increase too?

 

[RAE]

Think what we could do with 1% of GDP if it we could devote it to other healthcare purposes.

Yep. And when you think about all the other chronic health conditions diabetes often leads to (cardiovascular disease, stroke, nerve damage/neuropathy, blood circulation problems/amputation, vision loss, gum/teeth issues, weakened immune system, and more)........I'm sure the percentage of GDP devoted to dealing with it is WAY higher than 1%.

 

[audreyh1]

If your metabolic health is not already seriously compromised, it’s not that hard to severely reduce carbs in the diet and get that hyperinsulinemia taken care of, and avoid metabolic disease entirely. Unfortunately our standard of care neither detects the problem soon enough nor takes the obvious approach to treating it.

A lot of countries in Asia including India have an explosion of normal weight diabetes.

 

[Chuckanut]

Metabolic Health....

Here's a timely interview with Dr. Robert Lustig in regards to metabolic health and our diet:

https://www.peoplespharmacy.com/articles/show-1257-the-metabolical-results-of-the-american-diet

Several points made by Dr. Lustig stood out for me:

1. It's possible to be TOFI or FOTI and that can fool people. TOFI - Thin on the Outside, Fat on the Inside. FOTI - Fat on the Outside, Thin on the Inside. It all depends on where the fat is. If it's on your behind, it's not nearly as dangerous as the fat that surrounds your internal organs.

2. Food is the key to fixing the markers of metabolic syndrom. There are no drugs that will cure this problem. Diet often can.

3. Avoid getting fatty liver disease.

4. Check your ALT results from your blood panel. It should be below 25 (not the high listed by the lab). Under 25 generally means the liver is in good shape. Values over 25 get worse as the number goes higher.

5. Public enemy #1 is sugar because of the fructose in it which can only be processed by the liver.

Note: Dr. Lustig has a new book out discussing metabolic syndrome - Metabolical.

He also talks a lot about diabetes, what it means to health, and how he believes we are mishandling the diagnosis and treatment of it.

 

[Sojourner]

A lot of countries in Asia including India have an explosion of normal weight diabetes.

Yes. I read an article about a year ago regarding the extremely worrying diabetes trends in India. I don't recall the exact numbers, but I think the incidence of type 2 diabetes was projected to grow by about 40% over the next decade in India.

 

[audreyh1]

Metabolic Health....

Here's a timely interview with Dr. Robert Lustig in regards to metabolic health and our diet:

https://www.peoplespharmacy.com/articles/show-1257-the-metabolical-results-of-the-american-diet

Several points made by Dr. Lustig stood out for me:

1. It's possible to be TOFI or FOTI and that can fool people. TOFI - Thin on the Outside, Fat on the Inside. FOTI - Fat on the Outside, Thin on the Inside. It all depends on where the fat is. If it's on your behind, it's not nearly as dangerous as the fat that surrounds your internal organs.

2. Food is the key to fixing the markers of metabolic syndrom. There are no drugs that will cure this problem. Diet often can.

3. Avoid getting fatty liver disease.

4. Check your ALT results from your blood panel. It should be below 25 (not the high listed by the lab). Under 25 generally means the liver is in good shape. Values over 25 get worse as the number goes higher.

5. Public enemy #1 is sugar because of the fructose in it which can only be processed by the liver.

Note: Dr. Lustig has a new book out discussing metabolic syndrome - Metabolical.

He also talks a lot about diabetes, what it means to health, and how he believes we are mishandling the diagnosis and treatment of it.

I enjoy his presentations.

For 3. if you have good metabolic health, you won’t develop NAFLD (non-alcoholic fatty liver disease). Moreover, fatty liver quickly reverses as the liver is able to dump accumulated fat after dropping carbs (especially junk carbs) in the diet.

 

[audreyh1]

Yes. I read an article about a year ago regarding the extremely worrying diabetes trends in India. I don't recall the exact numbers, but I think the incidence of type 2 diabetes was projected to grow by about 40% over the next decade in India.

What’s also shocking is that now China has a higher incidence of type 2 diabetes than the US! These are traditionally populations that have very low instances of diabetes.

 

[RAE]

If your metabolic health is not already seriously compromised, it’s not that hard to severely reduce carbs in the diet and get that hyperinsulinemia taken care of, and avoid metabolic disease entirely. Unfortunately our standard of care neither detects the problem soon enough nor takes the obvious approach to treating it.

Yep, that is very true. But I would also argue that people have some responsibility to monitor and take care of their own health also, independent of care by a doctor. Anyone who has an annual medical exam, including bloodwork, can easily monitor things like fasting glucose, HbA1C, fasting insulin. And you can easily monitor your blood pressure at home, along with weight. If you notice any of these things getting outside of the normal parameters (even slightly), that is telling you that you probably need to make some diet/lifestyle changes, or you may be headed for trouble down the road.


Making those diet and lifestyle changes is not always that easy, because the grocery store aisles are mostly filled with processed foods these days (especially refined carbs), many of which are designed to be addictive. Every time I go to the store, I see people with their carts full of that stuff. It is obvious to me why diabetes is so rampant.



I am speaking here mainly about the U.S. population, not other less developed countries around the world. I understand that many of those people may have a more difficult time both monitoring some of the things I've mentioned above, and also getting adequate medical care.



You can see why reversing this trend of more and more diabetes is going to be so hard to do.

 

[audreyh1]

Fasting glucose is a standard part of annual blood work. But once that is elevated it’s already way late and you could have had hyperinsulinemia and ravages to your major organs and your vascular system for 10 years! A doctor will not normally order HbA1C unless a patient is already diagnosed as pre-diabetic by fasting glucose, which is already very late in the progression of metabolic disease. Fasting insulin is even more rare but a much earlier warning. Fasting insulin is pretty important, because even an elevated HbA1C is pretty late in the game.

So you have to know to either insist that your doctor includes HbA1C and fasting insulin, or order these tests yourself.

There are some who think elevated fasting insulin is late, but I don’t remember what test they did instead.

 

[athena53]

Yep, that is very true. But I would also argue that people have some responsibility to monitor and take care of their own health also, independent of care by a doctor. Anyone who has an annual medical exam, including bloodwork, can easily monitor things like fasting glucose, HbA1C, fasting insulin. And you can easily monitor your blood pressure at home, along with weight. If you notice any of these things getting outside of the normal parameters (even slightly), that is telling you that you probably need to make some diet/lifestyle changes, or you may be headed for trouble down the road.


Making those diet and lifestyle changes is not always that easy, because the grocery store aisles are mostly filled with processed foods these days (especially refined carbs), many of which are designed to be addictive. Every time I go to the store, I see people with their carts full of that stuff. It is obvious to me why diabetes is so rampant.

Yep- Little Debbies and cartons of 7-Up are in way too many of the grocery carts around me. I get tired of Big Food arguing that it's a personal CHOICE and that their products should be enjoyed in moderation. Then they use gigantic packaging sizes and unrealistic portion sizes for nutritional information (half a cup of ice cream? really?). I fill out marketing surveys and the food companies want to know which foods I CRAVE. None, thank you, although I may quit donating blood if they stop giving out Nutter Butters afterwards.

I'm a big fan of Lustig- his book "Fat Chance" is a good (and scary) read. He's treated 6-year old kids who weigh 100 lbs.

On a1C- my fasting glucose has sometimes run between 100 and 110 although recently it's been in the high 90s, so I watch my a1C like a hawk. Thanks to braumeister's recommendation here I order my own bloodwork quarterly through RequestaTest.com and then forward it to my doc's office. For about $130 I get a lipids panel, fasting glucose, a1C and other things i forget because they're OK.

 

[audreyh1]

India has an estimated 77 million people with diabetes, which makes it the second most affected in the world, after China. One in six people (17%) in the world with diabetes is from India. (India's population as calculated in October 2018 was about 17.5% of the global total.)

From Wikipedia https://en.m.wikipedia.org/wiki/Diabetes_in_India

 

[audreyh1]

On a1C- my fasting glucose has sometimes run between 100 and 110 although recently it's been in the high 90s, so I watch my a1C like a hawk. Thanks to braumeister's recommendation here I order my own bloodwork quarterly through RequestaTest.com and then forward it to my doc's office. For about $130 I get a lipids panel, fasting glucose, a1C and other things i forget because they're OK.

Even folks on very low carb diets may have fasting glucose > 100 due to the dawn effect where the liver does gluconeogenesis getting the body ready for activity for the start of the day. For a person well established on a low carb diet this is often the highest blood sugar reading of the day rather than the lowest. Vista Health had some good presentations on the topic.

A1C, which is an average measure of blood sugar over the recent 3 months, will quickly dispel any concerns.

 

[Mr._Graybeard]

Quote:
India has an estimated 77 million people with diabetes, which makes it the second most affected in the world, after China. One in six people (17%) in the world with diabetes is from India. (India's population as calculated in October 2018 was about 17.5% of the global total.)
From Wikipedia.

This makes me think of the Southwestern Native American population, where food resources formerly scarce suddenly became abundant due to industrial agriculture. https://www.ncbi.nlm.nih.gov/books/NBK233089/

Some people in the Arctic literally live on fat, but their metabolisms learned to accommodate that over generations. I'm not letting the carb-pushers off the hook, but I wonder if rapid dietary changes may play a part in sudden health onsets like this.

 

[RAE]

Fasting glucose is a standard part of annual blood work. But once that is elevated it’s already way late and you could have had hyperinsulinemia and ravages to your major organs and your vascular system for 10 years! A doctor will not normally order HbA1C unless a patient is already diagnosed as pre-diabetic by fasting glucose, which is already very late in the progression of metabolic disease. Fasting insulin is even more rare but a much earlier warning. Fasting insulin is pretty important, because even an elevated HbA1C is pretty late in the game.

So you have to know to either insist that your doctor includes HbA1C and fasting insulin, or order these tests yourself.

I told my doctor several years ago that I want both the HbA1C and fasting insulin tests included every year when my bloodwork is done, and he didn't have a problem including them (and insurance covers them). You are correct in that these are not usually standard tests done for those not already diagnosed as pre-diabetic, but once again, the medical community is WAY behind the curve on this. It is absolutely critical to detect the start of metabolic disease early, when you can halt it (or even reverse it) through diet and lifestyle changes. With such an epidemic of diabetes in the country (and world), it's really insane that these tests are not performed routinely these days, on most of us. They are not expensive tests, and could save a lot of misery (and lives) down the road for millions of people.

 

[audreyh1]

Well in India and China this does seem to be something that happened in recent decades. Many folks believe it has to do with Western-style processed food habits becoming more prevalent. Originally these countries seemed “immune” in spite of traditional high carb diets.

There may also have been some misdirection for a while because these countries don’t exhibit nearly the amount of obesity seen in the US and some other Western countries. But as it turned out low obesity didn’t mean low diabetes rate.

 

[braumeister]

Some people in the Arctic literally live on fat, but their metabolisms learned to accommodate that over generations.

It doesn't take generations -- anyone can do it.

Google articles about Vilhjalmur Stefansson and you'll see how he proved that it works for anyone.

For more modern expertise, look up YouTube videos from Eric Westman, Jay Wortman, and Steve Phinney.

 

[audreyh1]

I told my doctor several years ago that I want both the HbA1C and fasting insulin tests included every year when my bloodwork is done, and he didn't have a problem including them (and insurance covers them). You are correct in that these are not usually standard tests done for those not already diagnosed as pre-diabetic, but once again, the medical community is WAY behind the curve on this. It is absolutely critical to detect the start of metabolic disease early, when you can halt it (or even reverse it) through diet and lifestyle changes. With such an epidemic of diabetes in the country (and world), it's really insane that these tests are not performed routinely these days, on most of us. They are not expensive tests, and could save a lot of misery (and lives) down the road for millions of people.

This is the great tragedy today. Diabetes is caught way too late after considerable damage is already done even before reaching that advanced state, and there doesn’t seem to be any movement to change this and use much earlier detection. Meanwhile this expensive preventable problem keeps mushrooming and eating more and more healthcare dollars.

 

[youbet]

4. Check your ALT results from your blood panel. It should be below 25 (not the high listed by the lab). Under 25 generally means the liver is in good shape. Values over 25 get worse as the number goes higher.

Your comment made me go find my last test results and take a look. ALT hasn't been something I've paid attention to. My reading was 16. I'll have to see if Mr. Google can help me understand that........

 

[youbet]

Is this "fasting glucose" thing folks keep mentioning the same test as when DW pokes my finger one morning a week and confirms my reading is still below 100? I think the little meter she uses is called an Accu-Chek and is provided free by the nice folks at Medicare. I also found "fasting glucose" on my latest blood work report from doc where it came in at 95. At home, it usually reads between 85 and 95.

So, in home test about the same as the lab test?

 

[audreyh1]

ALT of 16 mg/uL is within normal range. Same here.

 

[audreyh1]

Is this "fasting glucose" thing folks keep mentioning the same test as when DW pokes my finger one morning a week and confirms my reading is still below 100? I think the little meter she uses is called an Accu-Chek and is provided free by the nice folks at Medicare. I also found "fasting glucose" on my latest blood work report from doc where it came it at 95. At home, it usually reads between 85 and 95.

So, in home test about the same as the lab test?

Yes, as long as you have fasted overnight before the morning blood spot test.

As you see you are getting the same readings.

Otherwise there are “post prandial” blood readings some diabetics take to monitor their blood sugar response to a meal. Usually about 2 hours after the start of a meal.

 

[tmm99]

Well in India and China this does seem to be something that happened in recent decades. Many folks believe it has to do with Western-style processed food habits becoming more prevalent. Originally these countries seemed “immune” in spite of traditional high carb diets.

This is what's so puzzling to me. Their diets have always been very high in carbs (mainly very fast-acting carbs like white rice), yet diabetes wasn't prevalent until Western-style processed foods became readily available. What kind of western-style processed foods is the cause, do you think? A lot of high fructose corn syrup products?

 

[tmm99]

So, in home test about the same as the lab test?

I found them to be quite similar in results, although my home tests seem to always give slightly lower readings than the lab test results - I do trust the lab test results more though.

If I play volleyball intensively for a couple of hours the night before, my reading the next morning is much lower regardless of what I eat the night before. It's as if my body is still burning sugar after I go to sleep...