The deadly sins and diabetes.

Type 2 diabetes is a spectacularly large and growing health problem. Patients with diabetes have healthcare expenditures that are twice those of the average citizen. We do not clearly understand the genetic predisposition that allows type 2 diabetes to develop, but we do know that lifestyle factors are the most important modifiable factors leading to that disorder. A proper diet and regular exercise (manifested by the presence of a healthy body mass index) can prevent development of latent diabetes, or reverse the manifestations of overt diabetes. It is unlikely that the food industry-already bloated by the high profits from enticing people to buy and consume more and more calories-will voluntarily decide to limit its income. So we will need a number of initiatives from healthcare professionals and from governments at all levels of society to turn this situation around. Some of the measures will require enormous political courage and foresight on the part of our elected officials. Without that, we will hardly need to worry about defense from external enemies. As a nation, we will soon be so fat that we will not be able to waddle to work or to war; those who can will be trying to earn enough money to pay for all the glucose meters and insulin needles and hypoglycemic, antihypertensive, and cholesterol-lowering drugs "required" for the evidence-based treatment of hundreds, even thousands, of blind, neuropathic amputees crowding our cardiac care and dialysis units.

Duke Scholars

Author Francis Albert Neelon Medicine, Endocrinology, Metabolism, and Nutrition