Diabetes
Precursor Rife Among Americans
You might live in blissful
ignorance of insulin resistance syndrome, but there is a decent
chance you have it.
The condition, which physicians
are also calling "dysmetabolic syndrome," involves not only impaired
sensitivity to insulin but blood fat anomalies, high blood pressure,
and obesity. The syndrome is linked to a constellation of severe
health problems, including diabetes, heart ailments, and strokes.
Experts suspect that between one in five and one in three Americans
have it.
There
Is Good News
But the good news, they
said, is that staying fit and shedding excess pounds can greatly
reduce the chances that insulin resistance will lead to illness.
"We have the capacity
to make an enormous, enormous impact," said Dr. Gerald Reaven, a
Stanford University diabetes expert acknowledged as the father of
insulin resistance syndrome, which he initially dubbed Syndrome
X. Even modest reductions in body weight, say 5 to 10 percent, and
regular physical activity can sharply improve the outlook for people
with abnormal insulin sensitivity.
New
Guidelines Are Published
New guidelines for the
condition have been put forth by a panel that included members of
the American Medical Association, The Endocrine
Society, the American Association of Diabetes Educators,
and the American College of Physicians-American
Society of Internal Medicine. The prevalence of the syndrome
in this country has soared by 61 percent over the last decade, thanks
to an equally stunning rise in obesity.
However, roughly 20 percent
of people with insulin resistance syndrome are not overweight at
all, Reaven said. So physicians who only look for the problem in
their heavier patients may be missing a large chunk of cases. That
is especially important for the detection of risk factors for heart
disease, which is a major complication of insulin trouble and its
most severe form, diabetes.
Dr. Daniel Einhorn, medical
director of the Scripps/Whittier Diabetes Institute in La Jolla,
Calif., and co-chairman of the panel, said the guidelines should
help physicians identify patients with the syndrome.
Potential
Signs of the Condition
A family history of diabetes
and heart disease, a high body mass index—a measure of obesity—and
elevated blood pressure are potential signs of the syndrome. So,
too, are high levels of blood fats called triglycerides, and low
concentrations of high-density lipoprotein (HDL), the so-called
"good" cholesterol. Many people with insulin resistance syndrome
may have normal levels of LDL, the "bad" form of cholesterol.
"If you are a person at
risk, you should know your values. If you have one or more of these
abnormalities, you most likely have the insulin resistance syndrome,"
Einhorn said.
Physicians should also
be alert to the condition in their patients over age 40, as well
as those whose body fat is distributed chiefly around their abdomen.
And women with a history of diabetes during pregnancy or a disorder
called polycystic ovary syndrome have a high risk of insulin insensitivity,
too.
Insulin resistance syndrome
cannot currently be identified directly. But physicians see its
shadow in the blood by testing people for how well they process
a large dose of blood sugar.
Dr. Omega Silva, past
president of the American Medical Women's Association,
called insulin resistance a "public health epidemic" that "needs
to be prevented rather than treated."
Einhorn noted that while
diet and exercise can keep insulin problems from flowering into
disease, physicians do not yet have medications approved specifically
to enhance sensitivity to the hormone in non-diabetic patients.
Reaven said weight and
physical activity each contribute about 25 percent to the variability
in insulin sensitivity between people. The rest appears to be genetic,
though researchers have not made much progress identifying the genes
involved.
Consult your physician
for more information.
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October 2002
There
Is Good News
New
Guidelines Are Published
Potential
Signs of the Condition
Glucowatch
Gets OK For Children With Diabetes
Online
Resources
In Other Diabetes News:
Glucowatch
Gets OK For Children With Diabetes
A wristwatch-like device
already used by adults with diabetes to monitor glucose levels has
been approved for use by children over the age of 7.
The Glucowatch, whose
electric currents can replace the constant finger-pricking needed
to ensure a proper blood sugar reading, can now be marketed to pediatricians
to sell to parents of children who have type 1 (insulin-dependent)
diabetes.
The US Food and
Drug Administration (FDA) has given its approval after
clinical trials on 66 persons with type 1 diabetes between the ages
of 7 and 17 showed that its results "were effective for detecting
trends and tracking patterns in glucose levels in children and adolescents."
But with the approval
comes an FDA warning. The Glucowatch should not
be used to replace the finger prick when an accurate glucose reading
is needed to confirm a sugar level.
However, it is a big improvement
over the way most persons with diabetes—children and adults
alike—have to check their blood sugar. Often, the only way
for persons with type 1 diabetes to get an accurate reading
is by pricking a finger and placing a drop of blood on reactive
strips. And this has to be done many times a day.
The Glucowatch, made by
Cygnus, Inc., sounds an alarm when it detects an abnormal reading.
It is available only through a physician.
Always consult your child's
physician for more information.
Online
Resources
American
Association of Diabetes Educators
American
College of Physicians-American Society of Internal Medicine
American
Diabetes Association
American
Medical Association
American
Medical Women's Association
Centers
for Disease Control and Prevention (CDC)
The
Endocrine Society
National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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