Which of the following statements is true?
A) Eating hamburgers causes Mad Cow Disease, a fatal disease.
B) Eating fried chicken causes avian flu, a fatal disease.
C) Eating pork barbecue frequently causes trichinosis, a painful parasitic disease.
D) Eating hamburgers, fried chicken, and pork barbecue is safe.
None of the above.
Despite the media attention given to Mad Cow Disease, as of today there has never been a human case in the United States. The same is true of avian flu. Trichinosis, a non-fatal disease, occurs with about 88 cases reported annually. There is a less than one in three million chance of getting any of these diseases per year, yet these are the diseases that Americans fear.
In the United States, over one million people are newly diagnosed with diabetes each year. Eighteen million Americans currently have diabetes. Forty one million Americans have “impaired fasting glucose” or pre-diabetes (Box 1). If you were born in the year 2000, your lifetime risk of developing diabetes is one in three! These numbers are staggering. Shouldn’t diabetes deserve more hysteria than Mad Cow, avian flu, and other less common or less serious diseases?
Diabetes isn’t caused by hamburgers, fried chicken and pork barbecue; unless you eat them. Here in Cumberland County we have a higher per capita incidence of diabetes than the rest of the country! Part of this is due to the high rate of obesity here. Part of this is due to the other diabetes risk factors.
What are the risk factors for diabetes? Obesity is far and away number one. This is because over 95% of diabetes is diabetes Type 2, caused by too much fat. The risk of diabetes increases with age. Other risk factors include a family history of diabetes, race/ethnic background, exercise, diet and history of gestational diabetes. What race/ethnic background puts you at increased risk for diabetes? Compared with Caucasians, African Americans are twice as likely, Hispanic Americans are 2.5 to 3 times more likely and Native Americans are 5 times more likely to develop diabetes. How much does gestational diabetes increase your risk? Women who had diabetes while pregnant have an over 40% chance of developing diabetes within fifteen years. Until they develop diabetes they have no symptoms.
Many people have diabetes for about 5 years before they show symptoms. Many of us (me included) overindulge during the holiday season. This overindulgence may be enough to cause you to develop symptoms. The early symptoms of diabetes include: increased thirst (polydipsia), increased hunger (polyphagia) and increased frequency of urination (polyuria). Other early symptoms include: slow healing; unexplained weight loss; blurry vision; unusual tiredness or drowsiness; tingling or numbness in the hands or feet; and frequent yeast infections.
We care about Mad Cow disease because it is universally fatal. Why should we care about diabetes? In 2002, 9.4% of people living in Cumberland County between the ages 40 and 59 and 18.6% of people sixty and over had diabetes. If you are over sixty, live in Cumberland County and have five friends, chances are that you or one of your friends has diabetes; and you may not know it! Diabetes is the fifth leading cause of death in North Carolina. Diabetic retinopathy is the leading cause of blindness in the U.S., affecting more than 5.3 million Americans. Diabetes is the leading cause of chronic kidney disease in the United States. Diabetes is a major risk factor for heart disease and stroke. More than sixty percent of non-traumatic lower-limb amputations in America occur among people with diabetes. Diabetes is the leading cause of peripheral neuropathy (when you can’t feel your feet.) Like Mad Cow disease, diabetes left untreated is universally fatal.
How can you treat diabetes? As Benjamin Franklin put it, an ounce of prevention is worth a pound of cure. Medications help, but the most important thing to remember is to limit your intake of hamburgers, fried chicken and pork barbecue, among other unhealthy food choices. And be careful around the holidays!
Dr. Salzberg teaches and sees patients at the Southern Regional AHEC Family Medicine Center here in Fayetteville.