The devastating facts on diabetes are about as awful as they come. Diabetes is a chronic disease that often leads to blindness, nerve damage, kidney failure and even death. It plagues our state and causes more deaths each year in the United States than breast cancer and AIDS combined.
By the time we reach age 65, statistics from the Centers for Disease Control and Prevention statistics indicate half of us will have diabetes or pre-diabetes. And yet, all too often, we overlook the most important fact — overwhelmingly, the vast majority of cases are entirely preventable.
Many Americans believe that diabetes is strictly genetic, and we have little control over whether the condition will develop. This is likely true for genetically influenced Type I diabetes in which a faulty immune system affects insulin production. Insulin is critical in regulating blood glucose levels. While the exact cause that triggers Type I diabetes is unclear, we do know that Type I diabetes accounts for only 5 percent of diabetes cases in the United States. Enter Type II.
An astonishing 95 percent of all diabetes cases are Type II. Millions of Americans are living with this chronic disease, and the most important causative factors are poor diet and a lack of physical activity. If you think this is familiar to another issue we in Georgia struggle with, you’re absolutely right. Obesity is a major physical indicator that someone might have pre-diabetes or diabetes. We must focus on our future.
With one in five of our precious children classified as obese — earning Georgia the second highest childhood obesity rate in the U.S. — we must focus first on combating childhood obesity. We’re starting with SHAPE — the Student Health and Physical Education Act — which requires all students enrolled in physical education classes to participate in a fitness assessment with individual results privately sent to parents and guardians.
When combined with other sources of information, including hospital data and community characteristics, SHAPE will help provide our state with unprecedented information to ensure that the most effective interventions and policy changes are proposed and implemented in Georgia.
That is the true importance of our work with childhood obesity. Not every overweight child has diabetes, but extra body fat makes insulin’s regulation of blood glucose more difficult and therefore increases the risk of diabetes. With a 300 percent increase in childhood obesity in the last 30 years, we have seen a marked increase of diabetes in younger and younger people.
SHAPE will serve as an excellent, accurate measurement of where we are. But insulin might tell us where we’re going.
Insulin is the key to regulating glucose in the blood. Glucose leaves the bloodstream when used as fuel for activity. Too little activity and glucose increases. Eat too much, or eat foods which digest into glucose too quickly, and glucose increases. Either scenario forces the body to create more insulin. At some point, this balancing act becomes too difficult for the body to manage and Type II diabetes is the result.
At the Georgia Department of Public Health, a new and innovative pilot program with employees will allow us to look more deeply into insulin levels as indicators of future health issues. Soon, it is my hope that every American learns and understands the simple facts about diabetes, insulin and what we might learn from insulin levels.
We in the department will look at insulin. But I encourage you to look at what you eat — and how much you move.
Dr. Brenda Fitzgerald is commissioner of the Georgia Department of Public Health.
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