Hypertension, Diabetes, Cholesterol, Weight, and Weight Control

The 1998 National Health Interview Survey (NHIS) included a detailed examination of preventive health problems and behaviors. This report uses data from the 1998 NHIS to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities. —Rural“ was defined, following NHIS guidelines, as living in a non-MSA county.

"Self Reported Prevalence of Health Problems"
Hypertension: Rural residents of all racial / ethnicity groups were more likely to report having been told they have hypertension than were metropolitan residents. The highest rates of reported hypertension were found among rural African Americans, one third of whom (34%) reported having high blood pressure.


Diabetes: Across non-metro residents, about seven percent of African Americans and seven percent of —other“ race adults reported that they had diabetes.

Cholesterol: As a measure of the degree to which non-metro residents obtain needed clinical preventive services, we examined self-reported receipt of cholesterol screening.

Contents
Executive Summary
Chapter One
Hypertension
Chapter Two
Diabetes
Chapter Three
Cholesterol Screening
Chapter Four
Weight and Weight Control Behaviors
Chapter Five
Exercise
Chapter Six
Conclusions and Recommendations
Appendices
Appendix A
Method and Detailed Tables
Appendix B
References

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Obesity & Diabetes

Christos S. Mantzoros "Obesity and Diabetes (Contemporary Diabetes)

Humana Press | English | 2006-01-25 | ISBN: 1588295389 | 574 pages | PDF | 37 MB

International experts from world-renowned medical schools comprehensively review for practicing clinicians and scientists alike the latest understanding of the epidemiology, causation, and consequences of diabetes and obesity. The authors discuss in detail their diagnosis, clinical manifestations, complications, and best practices for diagnosis and treatment. They also review the history and epidemiology of these conditions, explain their genetics and pathophysiology, and illuminate their known mechanisms and interactions. State-of-the-art survey-chapters critique current approaches (lifestyle and pharmacological) to the treatment of these conditions.


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Alternative Therapies for Type 2 Diabetes

Type 2 diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients, as well as on the health care system. Exercise, diet, and weight control continue to be essential and effective means of improving glucose homeostasis. However, lifestyle management measures may be insufficient or patient compliance difficult, rendering conventional drug therapies (i.e., oral glucose-lowering agents and insulin injection) necessary in many patients. In addition to adverse effects, drug treatments are not always satisfactory in maintaining euglycemia and avoiding late stage diabetic complications. As an alternative approach, medicinal herbs with anti hyperglycemic activities are increasingly sought by diabetic patients and health care professionals. Commonly used herbs and other alternative therapies, less likely to have the side effects of conventional approaches for type 2 diabetes.

Diabetes mellitus is a serious chronic metabolic disorder that has a significant impact on the health, quality of life, and life expectancy of patients, as well as on the health care system. In the United States, diabetes is the sixth leading cause of death. 1 Diabetes is divided into two major categories: type 1 diabetes (formerly known as insulin-dependent diabetes mellitus or IDDM) and type 2 diabetes (formerly known as non-insulin dependent diabetes mellitus or NIDDM). The overall prevalence of diabetes is approximately six percent of the population, of which 90 percent is type 2. Treatment and care of diabetes represents a substantial portion of the national health care expenditure, over $105 billion annually. This represents a substantial portion of the health care expenditure more than one of every 10 U. S. health care dollars and one of four Medicare dollars.

Type 2 diabetes represents a syndrome with disordered metabolism of carbohydrate and fat. The most prominent clinical feature is hyperglycemia (fasting plasma glucose level > 126 mg/dL, or glycosylated hemoglobin A1c (HbA1c) > 6.9%). In most patients with type 2 diabetes, the onset is in adulthood, most commonly in obese people over 40 years of age. Hypertension, hyperlipidemia, hyperinsulinemia, and atherosclerosis are often associated with diabetes.

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Diabetes Mellitus is #6 cause of death by disease in U.S.

By: Pamela Egan, FNP-C CDE

I am diagnosing more and more new diabetics each week in our clinic. Diabetes and cardiovascular disease pose significant threats to our health and well being. When is the last time that you were screened for diabetes?

Diabetes mellitus ranks as the sixth leading cause of death by disease in the United States today. Over 20 million Americans have diabetes, and this number is growing. It is estimated that nearly one-third of those with diabetes are not diagnosed and therefore not receiving care for this disease.

Since 1990, the prevalence of diabetes has increased by 61%. Not surprising, this increase in diabetes corresponds with the increase in obesity. I was walking in my neighborhood this morning and noted that the school bus stopped to pick each child up at their driveway. When I was a child, we had to walk one block to meet the school bus. Are we really helping them by doing this? It’s no surprise that the obesity epidemic is essentially triggered by excess calorie consumption and sedentary lifestyles.

Obesity, especially abdominal fat, has become an important risk factor for cardiovascular disease and diabetes. It is also a sign of insulin resistance, vascular inflammation, high cholesterol and high blood pressure.

We are seeing more and more children who are overweight classified as both Type 1 & Type 2 diabetes. Many are treated with insulin but without treatment for their insulin resistance. This lack of treatment is compounding their complications.

Type 1 is an autoimmune disease of the pancreas resulting in a lack of insulin and comprises about 5 – 10% of all diagnosed cases of diabetes. People with type 1 diabetes in childhood have a high risk of early heart disease.

Type 2 comprises about 90 – 95% of all diabetics. Plasma insulin levels are normal to high. Many have insulin resistance that needs to be reversed. Insulin is the fat storing hormone and an inflammatory hormone. Too much insulin in the blood can actually lead to coronary artery disease. Adults with diabetes have a 2 -4 fold increased risk of stroke and a 3-fold increased risk of heart disease, not to mention peripheral arterial disease, chronic kidney disease and many other disorders.

Diabetes and cardiovascular disease cause nearly 1 million deaths per year and result in over $620 billion in health care costs.

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Your Weight and Diabetes

What is diabetes?

Over seventeen million Americans (6.2% of the population) have diabetes. Almost 6 million Americans are unaware they have the disease. There are two main types of diabetes. Both types are caused by problems in how a hormone called insulin (that helps regulate blood sugar) works. Type 1 diabetes most often appears in childhood or adolescence and causes high blood sugar when your body can't make enough insulin. Over 90% of all diabetes cases are what we call type 2 diabetes. Type 2 diabetes is usually diagnosed after age forty; however it is now being found in all ages including children and adolescents. Type 2 diabetes is linked to obesity and physical inactivity. In this form of diabetes your body makes insulin but can't use its insulin properly. At first, your body overproduces insulin to keep blood sugar normal, but over time this causes your body to lose its ability to produce enough insulin to keep blood sugar levels in the normal healthy range. The result is sugar rises in your blood to high levels. Over a long period of time, high blood sugar levels and diabetes can cause heart disease, stroke, blindness, kidney failure, leg and foot amputations, and pregnancy complications. Diabetes can be a deadly disease: over 200,000 people die each year of diabetes related complications.

How does my weight relate to type 2 diabetes?

Carrying extra body weight and body fat go hand and hand with the development of type 2 diabetes. People who are overweight are at much greater risk of developing type 2 diabetes than normal weight individuals. Being overweight puts added pressure on the body's ability to properly control blood sugar using insulin and therefore makes it much more likely for you to develop diabetes. Almost 90% of people with type 2 diabetes are overweight. The number of diabetes cases among American adults jumped by a third during the 1990s, and more increases are expected. This rapid increase in diabetes is due to the growing prevalence of obesity and extra weight in the United States population.

What can you do to prevent diabetes?


The good news is type 2 diabetes is largely preventable. Research studies have found that lifestyle changes and small amounts of weight loss in the range of 5-10% can prevent or delay the development of type 2 diabetes among high-risk adults. Lifestyle interventions including diet and moderate-intensity physical activity (such as walking for 150 minutes per week) were used in these research studies to produce small amounts of weight loss. The development of diabetes was reduced 40% to 60% during these studies that lasted 3 to 6 years. Preventing weight gain, increasing activity levels and working toward small amounts of weight loss if you are overweight can have a big impact on the likelihood that you will develop diabetes in the future. Managing your weight is the best thing you can do to prevent the development of diabetes.

What can you do if you already have diabetes?

You can have a positive influence on your blood sugar and your overall health by choosing foods wisely, exercising regularly, reducing your stress level, and making modest lifestyle changes. Small amounts of weight loss (losing 10 pounds or more) can also have a big effect on how easily you can keep your blood sugar in the healthy range and can help prevent the complication of diabetes. Small amounts of weight reduction can decrease the amount of medication you need to keep your blood sugar in the healthy range. Overall better nutrition, physical activity, and control of blood glucose levels can delay the progression of diabetes and prevent complications.

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