The Insulin Resistance Epidemic: Type II Diabetes

TYPE II DIABETES:
The Epidemic of the New Millennium
PART I: A Spectre Haunts the Land

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Like the sword of Damocles, suspended by a single hair, calamity is poised to strike at the heart of our modern world. And likethe ancient courtier, whose fate was cast in the midst of plenty, the affluence of our times is the cause of our undoing.Throughout the ages, humankind has borne frequent witness to the global march of disease and pestilence. Stalking the landwith grim determination, the great plagues of the Middle Ages left a wake of human carnage as testimony to their ominous passage.

Today, new epidemics continue to lay waste millions of innocent lives. The unfolding tragedy of the Ebola virus in Africa andthe worldwide spread of AIDS are two contemporary examples of our enduring battle against the ravages of nature. While medical science has been vigilant in its engagement against infectious disease, it has been dilatory in its response to new enemies at our gates - the 'maladies of affluence', brought on by a confluence of longevity and lifestyle. One such enemy, a leading cause of death in the developed world, is diabetes mellitus. Insulin Resistance According to Dr. Bernard Zinman, Head of Endocrinology and Metabolism at Toronto's Mt. Sinai Hospital, diabetes is "the epidemic of the new millennium." The origin of the name is Greek, referring to sweetness or honey (mellitus) that passes through (diabetes). More than 15 million Americans and two million Canadians have contracted the disease and over 70 million Americans exhibit pre-clinical symptoms, most without any knowledge of the fact.

There are two types of diabetes. About one in ten diabetics have insulin-dependent diabetes (IDDM), also known as type I orjuvenile-onset diabetes. While IDDM can occur at any age, those typically affected are children and young adults. Type I diabetics lack the ability to produce sufficient insulin to control their blood sugar levels. Nine out of ten diabetics have type II diabetes, also known as non-insulin-dependent (NIDDM) or adult-onset diabetes.

Historically, type II diabetes was known as the disease of middle age; however, that is rapidly changing. Type II diabetes is quickly reaching epidemic proportions in children and adolescents.

Because expression of the disease is largely dependent on lifestyle issues, including diet,weight control and exercise, management of the disease is complex and challenging. Treatment of the diabetic is very different than simply administering an antibiotic or vaccine.

Impact

Diabetes is often underestimated as a simple sugar imbalance that can be readily corrected. In fact, it is a complex medical disorder where a confluence of social, behavioural, dietary and lifestyle factors unmask an underlying genetic susceptibility. The disease has serious long-term implications for cardiovascular health, kidney function and eyesight.

Diabetes in our Modern World: Canada

"Diabetes, which more than two million Canadians have, is going to have an impact on millions more in the years to come if there are no concerted society-wide efforts to stop the epidemic."

- The Canadian Diabetes Association
"Diabetes: Impact of Disease Staggering."
Globe and Mail, November 1, 2000

Virtually unknown in Canada's aboriginal community until recently, the disease is now undergoing exponential growth. Within the next two decades an alarming 27 percent of Canada's First Nations peoples are expected to develop the disease - a likely consequence of lifestyle change, decline in indigenous diet, and development of a more sedentary lifestyle with a consequent rise in obesity.

Diabetes in our Modern World: the U.S.A.

According to a consensus report issued jointly by the American Diabetic Association, the National Association of Diabetics andDigestive and Kidney Diseases, and the American Academy of Pediatrics,between 45 to 80 percent of diabetics demonstrate a family history of the disease. Over 74 percent have a grandparent or close relative with the disease.The panel report points out that, while the disease exhibits a strong hereditary component, its recent explosive increase hasoccurred far too quickly to be the consequence of increased gene frequency or biochemical alterations within the gene pool. Theevidence, instead, points directly to the prevailing dominance of environmental factors.

Obesity is a hallmark of type II diabetes. Most children and adults with the disease are overweight or obese at diagnosis.

The American Diabetes Association, in a recent study on diabetes in children, reports that 85 percent of children contractingthe disease are obese. Furthermore, where less than four percent of childhood diabetes in 1990 was type II, the frequency nowaverages 20 percent and varies from eight percent to 45 percent, depending on the age group.

Diabetes in our Modern World: the World

Obesity

While a direct cause-effect relationship between obesity and type II diabetes has not been established, the correlation is strong. People who are overweight and lead a sedentary lifestyle are showing up in diabetes clinics with increasing frequency. The trend is strong, accelerating, and not limited to the developed world.

The disease is also found to be increasing rapidly in Third World nations, such as India, as they adopt the lifestyles and dietary patterns peculiar to the western world. The verdict is in. We are on the cusp of a tragedy of global proportions.

Reprinted with permission from the author.

Disclaimer: This article was researched and compiled for educational purposes only. No person should use the information herein for selfdiagnosis,treatment or justification for declining medical treatment. Any individual with a specific health problem referenced in this article should seek advise from a qualified medical practitioner.© Copyright 2001 MacWilliam Communications Inc.

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