Lemme See… Where Do I Begin?

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I’ve been reading with interest the articles — and, especially, the comments — about Type 1 and Type 2 diabetes and thinking about misconceptions.

You’d think, by what you read and hear from the media, that everybody who is overweight is going to get Type 2 diabetes. I don’t think so. I remember watching a program on Discovery Health where somebody was going into paroxysms because a person “weighs 700 pounds! He’s going to get diabetes!”

I suspect that if you weigh 700 pounds and you don’t have Type 2 diabetes, you’re not going to get it. After all, most people who are overweight or obese don’t have any type of diabetes. Not even Type 2.

Don’t believe me? Check out this tome published by the Centers for Disease Control and Prevention. (Note: The CDC does not differentiate among the different types of diabetes.)

If you’re overwhelmed by the size of the report, I could give you some of the salient facts:

  • From 1988–1994, 8.3% of people ages 20 and over had physician-diagnosed and undiagnosed diabetes.
  • From 1999–2002, that number rose to 9.4%.
  • From 2003–2006, it was 10.2%.

I’m not sure if Type 2 diabetes is the fast-growing “epidemic” it’s claimed to be. I pulled the American Diabetes Association Complete Guide to Diabetes — copyright 1996 — off one of my bookshelves and found that diagnosed diabetes back then required a fasting glucose number of 140 mg/dl. Today, it’s 126 mg/dl.

You reckon maybe some of the elevated percentages are due to more people being eligible to join the diabetes club when the diagnosis criteria were changed? Also consider that the risk of diabetes increases with age and the baby boomers aren’t getting any younger. The “boom” began in 1945, at the end of World War II: That would be…oh…65 years ago.

Yes, more of us are overweight or obese. Those percentages are tracked more frequently, but here’s the deal:

For the group aged 20–74:

  • 56.0% were overweight or obese in the period from 1988–1994.
  • Rising to 64.0% in 1999–2000.
  • 65.3% from 2001–2002.
  • 66.0% from 2003–2004.
  • And 66.6% from 2005–2006.

(Data always lags a bit. After all, it needs to be collected and analyzed.)

Aside from the interval between the first and second periods, I don’t see a whole lot of difference in the percentage of Americans who are overweight or obese.

Going back to the baby boomers, 1999–2000 was when they began turning 55, right in the age range when menopause, which does fabulous things to your waistline, hits. Also, everybody’s metabolism begins to slow down around middle age.

I feel the urge to throw in here that one of my cats was a scrawny little thing until we had her spayed. She’s filled in quite a bit since then and cats can’t exactly sit around watching soap operas and eating bonbons: They have to eat what their humans put out. Our cats eat whatever is on sale, and we haven’t noticed having to buy extra cat food just because one of them hit the kitty version of menopause. Remember, too, that cats are natural couch potatoes at all ages and sizes.

To be fair, I will tell you that the percentage of people who are overweight but not obese only fluctuated by 0.4 of a percentage point — from 33.1% to 32.7% during that same period. So, yes, obesity is up.

However, I don’t know what was considered “overweight” and what was considered “obese” during that period. Are you aware that the “flappers” of the 1920s would be considered overweight now? Or that the “Gibson Girl” before that would be considered to be obese? Hmmm…I guess we’ve been reducing — no pun intended — our idea of what the “ideal” weight is. In the 17th century, artist Peter Paul Rubens would have sought me out for one of his full-figured models.

Here’s another fact for you to chew on: The incidence of Type 1 diabetes also is increasing. In the June 13, 2009, issue of The Lancet, which is a British medical journal, researchers noted that new cases of Type 1 children under 15 years of age in 17 European countries is increasing by around 4% per year, with younger children getting Type 1 diabetes at even faster rates: 5.4% up to age 4 and 4.3% in the 5-to-9-year-old group.

In numbers, they’re looking at 160,000 cases of Type 1 diabetes among children in Europe, compared to 94,000 when the data were collected.

Epidemiologist Dana Dabelea, MD, PhD, is a coinvestigator on the SEARCH for Diabetes in Youth Study, which tracks trends in both Type 1 and Type 2 diabetes in children. In 2007, the researchers reported finding higher-than-predicted cases of Type 1; an increase that was highest in non-Hispanic white children.

“I think that these data from Europe are telling us what is going to happen in the United States,” Dabelea told the news agency Reuters.

Why is this happening? Researchers don’t have the answers — yet — but “These findings suggest that the incidence of type 1 diabetes is increasing even faster than before, pointing toward harmful changes in the environment in which contemporary children live,” Dabelea wrote in a commentary for The Lancet article mentioned earlier.

You reckon the increase in Type 1 diabetes is contributing to the overall increase reported by the CDC? Maybe Type 2 diabetes isn’t the only kind that’s epidemic?

Ponder the information here. Think outside the box. Don’t make assumptions about what causes people to have Type 2 diabetes. Perhaps it isn’t as simple as you think.

On a personal note, as I write this it’s Monday morning, and I’m about to take off for outpatient (I hope) surgery to remove more infected bone from my heel. Next week, I will share some changes in attitude toward Type 2 diabetes by a friend of mine who has Type 1 diabetes.

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