Reflections On My Treadmill
I just returned from the 29th Annual Clinical Conference on Diabetes, held by the American Diabetes Association, entitled “Reducing Risks: Primary and Secondary Prevention.” I enjoy attending these continuing medical education conferences for a multitude of reasons including:
- Reviewing the latest breaking research
- Networking with my fellow professionals across disciplines
- Learning about topics other than my focus of pediatric, primarily type 1, diabetes
- Renewing my inspiration to continue caring for people with diabetes by applying novel approaches, both technological and behavioral
This particular meeting focused on risk reduction and provided practical suggestions for preventing diabetes, as well as treating established diabetes. Although insulin, medication, and surgical strategies were presented, epidemiological trends, behavioral, and dietary approaches were emphasized. A speaker even attempted, successfully, to dissect the Affordable Care Act.
Each speaker repeatedly emphasized the increasing number of people with diabetes—both type 1 and type 2. Essentially, the bottom line conclusion found for type 2 diabetes prevention was output must be more than input! Unfortunately, at this juncture, we do not know how to halt the development of type 1 diabetes. We do have strategies for treatment, but as of yet, no cure.
We do know that there are multiple risk factors for type 2 diabetes including family history, obesity, and certain ethnic populations who are more prone to the disease. We also know how to halt pre-diabetes into becoming diabetes. The Diabetes Prevention Program demonstrated that lifestyle intervention decreased the incidence of diabetes by 60 percent—almost twice as much as prescribing Metformin alone.
What does this mean?
It means we need to change our culture. Obesity rates have trended with the adoption of Western diet—particularly large portions, processed and fast food. Thus, it is no surprise that obesity rates started to increase with the introduction of eateries such as McDonalds® or Burger King ®. Therefore, to put it out in direct terms, we need to decrease our caloric intake. This does not mean we have to go on a diet. Rather, we, as a culture, need to undergo a huge change in direction—more is not better.
One presentation emphasized the reasons people exercise. Women exercise primarily to lose weight. Men, on the other hand, exercise to look good. Exercise increases insulin sensitivity and assists with fat burning. It also enhances the release of many good factors in the body and improves overall health and well-being.
Having stated quite clearly that we need to eat less calories and exercise more frequently, what is stopping us? Why do I personally “talk the talk” and not always “walk the walk?”
Lifestyle change is hard; just ask the family that presented the first session at the conference! The mom had pre-diabetes, and her son developed type 2 diabetes at 10 years old. Understanding that diabetes was responsible for the loss of her parents and grandparents, the mother thankfully had an epiphany. She changed her entire family’s lifestyle to eating healthier and exercising, but it was not easy and required a huge commitment.
As I was walking on the treadmill, my trainer, that I am fortunate enough to work with weekly, made a provocative comment. “Why do we call it a war on obesity?” she asked.
Think about it. War makes us anxious, sad, and generates “fight or flight” hormones. These hormones actually contribute to obesity. If we changed the paradigm and re-placed war with a positive supportive message, would it make a difference?
If we advertised differently on social media and video programming, placing fruit or healthy items in commercials instead of tasty high caloric items, would children grow thinking, “grapes are great?”
I was brought up in the 1950s loving Hostess Cupcakes® and other processed sweets. I was rewarded for good behavior with treats, just like my bichon frise! It is time to actually implement a lifestyle change, rather than just talk about it.
I must start listening carefully to myself and “walk the walk!”
PS: No one is perfect! But we do have to try and start somewhere..