"Diet and exercise."

"Diet and exercise."

"Diet and exercise."

It should be the Boomer mantra, the golden rule for growing old and steering clear of a menu of preventable illnesses, including Type 2 diabetes that hits about 18.3 percent of Americans 60 and over.

"Type 2 diabetes is definitely not something you want to hide from," says Amanda Denney Queen, MD, endocrinologist and medical director of The Christ Hospital Diabetes and Endocrine Center on Red Bank Expressway.

As you age there's a higher risk that comes with that inevitable weight gain and thicker middle. "As the body ages, it doesn't process food as well, and glucose tolerance declines. If you are eating the same food you ate 20 years ago, the sugar may be higher now because the insulin sensitivity and insulin secretion decreases with age," she says.

The insulin your body helps the body's cells turn glucose from food into energy. Usually the problem lies with the body's insulin receptors, the location on the cells where insulin binds so that glucose can enter. This is called insulin resistance.

The glucose that can't be absorbed by the cells starts building up in the bloodstream creating high blood sugar, and the pancreas keeps pumping out the insulin trying to keep up with the rising sugar levels, increasing the risk of cardiovascular disease and a list of other problems including vision problems, nerve damage and kidney failure.

"It's the No. 1 cause for end stage kidney disease in which patients end up on dialysis, and it's the No. 1 cause of blindness in people of working age," says Denney Queen. "And people with diabetes have the same risk of having a heart attack as those who have already had a heart attack."

"There are a lot of bad things that can happen with Type 2 diabetes but it doesn't have to," she says. "If we can get people diagnosed and control the blood sugar, we can prevent a lot of those complications."

The keys to prevention? The mantra "” "diet and exercise."

A study done with a group of people with high blood sugar (but not in the diabetic range) found that the group that watched their diets and did 150 minutes of cardiovascular exercise a week had an almost 60 percent reduction in developing diabetes.

"I use this example for patients," says Denney Queen. "If you weigh 256 pounds and you lose 18 pounds, you would significantly cut your risk of developing diabetes by almost 60 percent."

The recommended diet "” be it low-carb or low-fat "” isn't as important as achieving and sustaining the weight loss, she says.

Screening for Type 2 diabetes should begin annually after age 45, or sooner if there are other risk factors such as high blood pressure, heart problems or a family history of diabetes.

The earlier the diagnosis the better, says Denney Queen. For men with
diabetes there's an increased risk for low testosterone levels that could lead to problems with sex drive and erectile dysfunction.

Treatment includes diet, exercise and lifestyle changes, a diabetes education program, regular doctor visits to maintain good sugar control and Metformin, the standard initial therapy that helps to control the amount of glucose (sugar) in your blood.

And some people may need insulin therapy. "Some people think they have failed if they need insulin," says Denney Queen. But we know that diabetes is a progressive disease... if you have it long enough you may eventually need insulin. Our hope is that with earlier diagnosis we may be able to decrease that rate of decline and prevent further progression of diabetes."

"The thing to remember is that we can prevent a lot of complications."





American Diabetes Association: cure, care, commitment

The American Diabetes Association in Cincinnati takes the spotlight several times a year to raise money and spread the word about diabetes, which affects 10 percent of American adults, through Diabetes Alert Day on Fountain Square, the Tour de Cure bike rides, Camp Korelitz for kids with diabetes and the fall Step Out: Walk to Diabetes.

But it's the backstage work that the American Diabetes Association does day-in and day-out that tells the group's story. Their accomplishments for 2009 include:

Family Link was established to connect families affected by diabetes to expert guidance, peer support and tools to help parents care for a child with diabetes from initial diagnosis to adulthood. Nearly 115 Family Link volunteers provided informational and emotional support to newly diagnosed families and it awarded more than $350,000 for scholarships for diabetes camps.

The www.diabetes.org site was re-designed to invite visitors to volunteer, advocate, donate and participate in events, and the new My Health Advisor Type 2 diabetes prevention tool lets users share stories, learn about the disease and take action to stop it.

The association provided $33.55 million in research funds to combat Type 1 and Type 2 diabetes.

The call center received about 25,000 calls and e-mails each month, and Stop Diabetes was launched to raise awareness and rally support across the country.

I Decide to Stop Diabetes at Church campaign, part of the African-American Initiatives, reached more than 400,000 people in one month in more than 600 churches.

The Safe at School Campaign, which protects the health and educational opportunities of children, led more than 100 workshops to help parents advocate for their children and the development of legal advocacy materials for post-secondary students.