Experts stress lifestyle changes as prevention, treatment for diabetes #ahcj13

Diabetes is prevalent in the United States, and the numbers continue to balloon.

In a Health Journalism 2013 session focusing on type 2 diabetes, a panel of experts discussed the threats of the disease, its growth and possible treatment. The panel was moderated by Tennesseean reporter Tom Wilemon.

Rich Siegel, M.D., co-director of Tufts Medical Center’s Diabetes Clinic, said that the threats of diabetes and obesity – or “diabesity” – in adolescents and young adults is a 21st century time bomb. According to a 2012 study from the National Health and Nutrition Examination Survey, diabetes among adolescents rose 23 percent from 2000 to 2008.

Siegel said the keys to combating type 2 diabetes are diet, activity and education. Medication plays a role, with both injectable and oral medication available. He added that, after 90 years of use, insulin is still the most effective treatment. Surgery can even be an option, but not a first option.

“The idea of surgery is towards the bottom of the list,” Siegel said.

David M. Nathan, M.D., director of the MGH Diabetes Center and Clinical Research Center and professor of medicine at Harvard Medical School, cited a 2012 Centers for Disease control study showing that 26 million people in the United States have diabetes, a majority of them with type 2 diabetes. This is about 8 percent of the population. He added that nearly 2 million cases are diagnosed a year and 72 million American are pre-diabetic. According to an American Diabetes Association, $245 billion is spent every year on the disease.

In treating type 2 diabetes, Nathan stressed the importance of treating for the long haul, focusing on prevention and avoiding complications down the road. He cited a Diabetes Prevention Program Outcomes Study that showed that lifestyle changes reduced the development of type 2 diabetes by 58 percent, more than medication or a placebo.

Osama Hamdy, M.D., Ph.D., the medical director of Joslin’s Obesity Clinical Program and an instructor at Harvard Medical School, estimated that the cost to treat diabetes will reach half a trillion dollars in the next 12 years. He also suggested lifestyle intervention for diabetes prevention and treatment.

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