Sweetpee? Leave sugar on the table

When I was in college, I saw a crazy, steamy movie called, 9-l/2 Weeks. There's a scene beside an open refrigerator in which blindfolded Kim Basinger eats unidentified food given to her by Mickey Rourke. Oscar-winner Basinger reportedly said later that Rourke's breath smelled like cigarettes the whole time, so I wonder if she opposed eating smoked salmon during that scene. Yuck!

I've eaten a lot of exotic things and "unknown" foods when my relatives or friends commanded, "Just eat it!" However, I do have my limits. In the old days, doctors detected diabetes by tasting the sugar in a patient's urine. Would you taste urine in the name of science? It reminds me of the old ginger ale jingle, "Not too sweet, I repeat, it's not too sweet..."

Because of the obesity epidemic, Type II Diabetes Mellitus (DMII) in our country is becoming more common than cell phones and iPods. Seventeen million Americans have been diagnosed with DMII, and there are millions more out there who don't even know they have it. On average, a person has DMII for seven years before being diagnosed.

Sixteen million Americans have pre-diabetes, which means technically they don't yet have DMII but, like Dorothy on the yellow brick road, are on their way. So the number developing or having DMII is 17M+16M = 36 million Americans. That's the number of beer-drinking, pork-rind-eating Super Bowl viewers each year.

What is glucose intolerance? The best example is a heroin addict. Not a heroine as in Joan of Arc but as in the narcotic. With repeated use, the body starts to become tolerant, if not resistant, to heroin, making larger and more frequent amounts needed to produce the same effect. That's why patients on chronic narcotics can become resistant to, or intolerant of their narcotics and require stronger doses.

Insulin is no different. As a person gets fatter, the body needs more insulin to pack away the glucose (sugar). In time, the body starts to become tolerant of the insulin and therefore requires more insulin for an effect to occur. In the glucose intolerance stage, the body is able to keep the blood sugars down– but not to a normal level. So the pancreas cranks out more and more insulin, like a sweatshop in Asia, until it burns out. Then DMII develops, and the sugars soar.

Will a person with pre-diabetes develop diabetes? Overall, yes. Sixty-six percent of American adults are overweight or obese, and the rate is rising faster than men on Viagra. People born in the year 2000 or later have a 35-50 percent lifetime risk of developing DMII. My experience has been that most people who become obese do not exercise and eat right to begin with. Therefore, changing one's lifestyle to include exercise and proper diet is as easy as having a sex-change operation.

Studies have consistently shown that eating a diet rich in fiber, fruits, and vegetables along with daily exercise reduces the incidence of DMII. Those with pre-diabetes who lose fat by diet and exercise can often get rid of glucose intolerance.

I can read minds better than Dionne Warwick's friends. When I tell my patients to exercise every day and eat well, I know most of them think I'm something that rhymes with itch (not ditch). One person came in with a 64-ounce soda filled with enough sugar to supply the Godiva chocolate factory for a year. I asked her, "Do you know that has as many calories as a Big Mac?" She responded with a slurp.

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