Ask Dr. Scott
Pre-diabetes and weight gain
What is pre-diabetes and what do I do about this condition?
Q: Dr. Scott, what can I do to improve my chances of not developing diabetes?
A: I think you should know that nearly everyone who is overweight (that’s nearly 75 percent of all Americans today) have “pre-diabetes”, and therefore have a significantly increased risk of death and disease. People who are overweight also have a much greater chance for ending their final 30 years of life fatigued, over medicated, depressed, suffering from arthritis and back pain, and risk carrying heart disease with them into the grave.
Yet in the United States today there are no national screening recommendations, no treatment guidelines, no approved medications, and no reimbursement to health care providers for diagnosing and treating anything other than full-blown diabetes. How is this possible? Doctors in the US are not trained, paid, nor even expected to diagnose and treat the single biggest chronic disease in America, which along with smoking, causes nearly all the major health care burdens of the 21st century — that’s heart disease, stroke, dementia, and even cancer.
One-third of all diabetics have documented heart disease. (Centers for Disease Control and Prevention, 2015) People with diabetes are 4 times more likely to die from heart disease, and the rate of stroke is 3 to 4 times higher too. You are also more than 4 times as likely to develop dementia if you become diabetic, and pre-diabetes is a leading cause of pre-dementia or cognitive decline in everyone. 75 percent of those with diabetes have high blood pressure. Finally, just so all of this sinks in fully: A remarkable study in the New England Journal of Medicine (2011) examining 123,205 deaths found that diabetics died an average of 6 years earlier than non-diabetics. As you can imagine, the final decades of these diabetics’ lives did not see them full of energy, enthusiasm, creative achievement and fulfillment.
This condition has been called “Diabesity” by Dr. Mark Hyman, an expert on this subject, and is the single biggest global health epidemic of our time. Pre-diabetes is a continuum of health problems ranging from mild insulin resistance and overweight to obesity and diabetes. It now affects nearly 2 billion people worldwide. Scientists conservatively estimate it will affect 1 in 2 Americans by 2020, and 90 percent of these people will be undiagnosed as having this disastrous condition. In Pueblo County, 7.4 percent of adults have been told by a doctor that they have diabetes, which is higher than the Colorado average at 5.4 percent, which is probably under reported. (Pueblo County Health Department)
You should know that gaining just 11 to 16 pounds doubles the risk of Type 2 Diabetes, while gaining 17 to 24 pounds triples the risk. Despite these terrible, undeniable biological risks, there are no national recommendations from our government or key health care organizations advising screening or treatment for pre-diabetes.
You should also know that there are 27 million Americans with diabetes (and 25 percent of them were not diagnosed), and 67 million with pre-diabetes (90 percent of whom were not diagnosed). Some 2.3 billion people worldwide are overweight and 700 million are obese. For the first time in human history, there are now more overweight people in the world than there are starving people.
By 2020 it’s estimated that fewer than 20 million deaths worldwide will be from infectious disease, but more than 50 million deaths from chronic and preventable lifestyle diseases — heart disease, diabetes, and cancer. These are all fueled by the same preventable risk factors: pre-diabetes, high blood pressure, being overweight, physical inactivity, and smoking. (Diabetes Care, 2009) But strikingly, 95 percent of private and public efforts and funding focus almost exclusively on combating communicable or infectious disease.
Medically managed patients with diabetes and hypertension (while ignoring the pre-diabetes that is the cause of both of these conditions for the majority of people) generally take two or more antihypertensive drugs from the time of diagnosis until the end of their lives; these drugs commonly cause adverse effects, are relatively devoid of collateral benefits, and do not address the underlying causative physiological imbalances.
However, patients managed with nutritional and lifestyle modifications must likewise remain compliant with the prescribed health promoting treatment (diet and lifestyle improvements). They generally experience clinically and statistically meaningful collateral benefits. For example, correction of dietary and nutritional imbalances in these patients can vastly improve blood sugars, obesity, and hypertension while also improving musculoskeletal pain, cognitive performance, energy, and mood.
I recommend giving patients special nutrients to improve insulin sensitivity, including chromium, alpha lipoic acid, vitamin D3, fish oil, and exercise.
Robust health and vitality are definitely possible with nutritional guidance and proactive health care. You do not have much longer to wait before irreversible damage is done.
Every patient living with a lifestyle-generated disease should be coached in the reversal of the patterns that have caused their disease rather than being enabled to pursue their disease-promoting lifestyle, while surrogate markers of metabolic-physiologic dysfunction are pharmacologically suppressed. Remember, diabetes and pre-diabetes can be reversed. (Fuhrman, 2012; Hyman, 2012)
Dr. Scott Cuthbert is the chief clinician at the Chiropractic Health Center in Pueblo, Colorado, as well as the author of two new textbooks and over 50 peer-reviewed research articles. PuebloChiropracticCenter.com.
