THE EPIDEMIC OF DIABETES
By Dr. Lon Jones, D.O.

Adult onset diabetes, what is now called Type 2 diabetes, is epidemic in this country. And the causes, openly known, are lack of activity and diet. The medical approach to diabetes is medication and treatment of the problems—blindness, kidney failure, heart disease, or peripheral vascular disease that results in amputations—that eventually come from diabetes. Under ideal circumstances medical treatment will keep problems to a minimum by maintaining strict blood glucose control. Many studies have shown this to be possible. But it requires intensive monitoring both by the patient and the doctor. Considering the scope of the problem, intensively treating all of the people involved will bankrupt our already challenged system. We are currently paying close to 14% of our Gross Domestic Product on health care. It is estimated that this will grow to 18% as this epidemic continues. We need other options.

Type 2 diabetes is also a genetic disease—if a parent has diabetes the children have a greater risk. As such it follows the pattern of phenylketonurea. Most people are somewhat familiar with this illness because there are warning labels on cans of diet soda and packages of Equal cautioning people with phenylketonurea to avoid the protein, phenylalanine, which their body's are not able to handle. If they avoid this protein, they can live normal lives. We have made it easier for them to do this by putting warning labels on foods. 

People prone to diabetes have a similar problem, but the food they need to avoid is glucose. Glucose, however is in most of the foods we eat. The most widely used bulk sweetener is corn syrup which is almost entirely glucose. And bread is almost completely broken down into glucose. We have a problem avoiding this sweetener. But it can be done, indeed it has been done in the past. Diabetes is very common among the Pima Indians. About four out of five Pima Indians in Southern Arizona are affected with diabetes when they get older. Interestingly, the Pima Indians in Mexico have a much lower incidence of diabetes and neither group had a problem with diabetes before they were put on a reservation. Why the differences and why now?  When the Pima Indians were independent, their diet consisted of venison, nuts, squash and corn. Of these foods, corn is the only one that is converted to glucose. When these Indians were put on a reservation, their diet was changed into one containing many more foods that are rapidly converted to glucose. The Indians in Mexico do not have the social services that provide them with such a rich selection of high sugar foods.

Now there is a way to measure different foods and the rate at which they convert to glucose, called the glycemic index. There is a lot of information on the internet about glycemic index, along with about five pages of the glycemic index of various foods. A medical writer in California named Rick Mendosa maintains this information on his web site, www.mendosa.com. Many diabetics can control their diabetes by avoiding food with an index higher than 50 to 80, depending on the severity of their diabetes. Perhaps some day there will be warning labels on food containing information for diabetics, just as there are for the less common disease, phenylketonurea.

If Sara Baker was the Surgeon General and could influence some of our laws she would encourage the government to tax glucose. If foods containing this sugar were taxed the food industry would find more healthy alternatives and the epidemic would be lessened. She would also promote physical education in all grades, give tax credits for those that exercise regularly,  and allow membership in exercise facilities to be paid for from pre tax dollars in our Medical Savings Accounts. With radio and television we have a much more effective means of educating the public than we have ever had before. We need to make better use of them.