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Today, more than 18 million Americans are walking around with diabetes, about one-third of them undiagnosed. Another 41 million U.S. adults between the ages of 40 and 74 have prediabetes, with elevated blood sugar levels putting them at increased risk of developing the disease. Unbelievably, "new evidence shows that one in three Americans born in 2000 will develop diabetes sometime during their lifetime," according to Julie Louise Gerberding, MD, MPH, director of the Centers for Disease Control and Prevention (CDC).
One of the more disturbing developments is the growing incidence of Type 2 diabetes among youngsters. The number of overweight children in the U.S. has tripled in the past 25 years.

Blame It on Obesity
Why have the numbers skyrocketed? The incidence of diabetes was up 41 percent in the last six years alone. There's an amazingly simple answer - obesity. "We've certainly seen an increase in obesity over the last few years, so we would expect to see an increase in diabetes," says Linda S. Geiss, PhD, chief of diabetes surveillance at the CDC. In 2003, nearly 60 percent of people newly diagnosed with diabetes were classified as obese, while an additional 30 percent were termed overweight.

About Insulin
Diabetes occurs when the body produces too little insulin or doesn't use insulin properly. This pancreatic hormone's main job is to transport glucose, or sugar, from the food we eat to our cells, where it's used as energy. When it fails to do that properly, too much glucose ends up in the bloodstream, rather than in the cells where it belongs. Over time, excess glucose damages vital organs and makes patients with diabetes more vulnerable to a host of other health problems, including heart disease, stroke, kidney failure, and blindness. According to the CDC, up to 65 percent of those with diabetes die of heart disease or stroke.

Turn to Diet, Supplements, and Exercise
Two landmark clinical trials strongly suggest that you can take steps to halt the progression toward diabetes, even if you're already in the prediabetic stage. This research "demonstrated that sustained lifestyle changes that included modest weight loss and physical activity substantially reduced progression to diabetes among older adults who were at very high risk [for Type 2 diabetes]." In other words, "taking preventive measures can return a prediabetic person to normal," says Dr. Geiss.


In addition to eating a diet that emphasizes low-fat and high-fiber foods as well as exercising moderately, a number of dietary supplements are showing promise in medical studies. Here are just a few of the nutrients that can augment a high-potency multivitamin/mineral formula.
Alpha lipoic acid (ALA) is a potent antioxidant that goes after free radicals both inside and outside cells, boosts the impact of vitamins C and E, and lowers glycemic (sugar) levels in the blood.

Chromium improves glucose tolerance, is an essential component in working with insulin to move glucose into cells, and is critical for normal metabolism of carbohydrates.

Cinnamon reduces levels of serum glucose, LDL cholesterol, and total cholesterol in people with Type 2 diabetes.

Vitamins C and E are extremely important in the prevention and treatment of diabetes. It's not uncommon for people with this disease to be deficient in C, since insulin helps move this vitamin into cells. Vitamin E's antioxidant abilities include preventing cell and nerve damage while improving insulin's effectiveness.

Zinc, an important antioxidant trace metal, has "a positive effect on insulin signaling, leading to glucose uptake," according to a recent study. "Zinc deficiency, like chromium deficiency, has been suggested to play a role in the development of diabetes. Zinc is involved in virtually all aspects of insulin metabolism: synthesis, secretion, and utilization," explains Michael Murray, ND.

SELECTED SOURCES
"The Burden of Diabetes in the United States" by R. Mathur, MD, American Diabetes Association National Meeting, 6/12/05, www.medicinenet.com
"Cinnamon Improves Glucose and Lipids of People with Type 2 Diabetes" by A. Khan et al., Diabetes Care, 12/03
"Complementary Therapies for Diabetes: The Case for Chromium, Magnesium, and Antioxidants" by F. Guerrero-Romero et al., Arch Med Res, 5–6/05
"Diabetes: Disabling, Deadly, and on the Rise," www.cdc.gov
How to Prevent and Treat Diabetes with Natural Medicine by Michael Murray, ND, and Michael Lyon, MD ($25.95, Riverhead Books, 2003)
Prescription for Nutritional Healing by James F. Balch, MD, and Phyllis A. Balch, CNC ($23.95, Penguin Group/Avery, 2000)
"Role of Chromium in Human Health and in Diabetes" by W. T. Cefalu, MD, et al., Diabetes Care, 2004

Glycemic Index & Glycemic Load
The glycemic index (GI) measures the rate at which glucose (or blood sugar) enters the bloodstream. Glycemic load (GL) measures both the GI and the total carbs in a particular food.
"While the glycemic index is a useful number," explains Walter C. Willett, MD, chairman of the nutrition department at the Harvard School of Public Health, "it doesn't always reflect the real effect of eating a food. Carrots, for example, have a glycemic index of 131. But to get 50 grams of carbohydrates from carrots (the amount used in measuring the glycemic index), you would have to eat about one-and-a-half-pounds' worth.

"Glycemic load better reflects a food's effect on your body's biochemistry than either the amount of carbohydrate or the glycemic index alone," Dr. Willett adds.



Smart Food Choices
Even with the holiday season fast approaching, you can enjoy a high-fiber, low-fat diet consisting of low-glycemic foods. As a general rule, most fruits (apples, apricots, cherries, citrus, grapes, melon, plums, strawberries) and vegetables (asparagus, broccoli, celery, green beans, lettuce, mushrooms, onions, peppers, spinach, tomatoes, squash) have a low glycemic load, as do legumes, nuts, seeds, and whole grains. Because these foods are high in fiber, you'll feel satisfied without overeating and raising your blood sugar levels.