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Holiday Gluttony Can Spell Disaster for Undiagnosed Diabetics

November 20, 2006

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Hearty feasts and couch-potato marathons are holiday traditions, but UT Southwestern Medical Center experts warn that packing on pounds and not exercising could be deadly for the 6 million Americans who have diabetes and don't even know it.

Diabetes, a metabolic disorder linked with obesity, can be a silent killer because its symptoms aren't sudden, but build up over time and lead to heart disease or other maladies.

That's bad news for those with undiagnosed diabetes.

"The obesity epidemic is surging and people don't realize they're setting themselves up to develop diabetes. They're like ticking time bombs," said Dr. Manisha Chandalia, an endocrinologist at UT Southwestern. "Without treatment, high levels of blood sugars in the body can damage blood vessels and nerves over time, leading to high cholesterol, hypertension, stroke, kidney disease and amputations."

If you are age 40 or older, obese, lack physical activity or have a family history of diabetes, Dr. Chandalia recommends making time during the holidays to visit a doctor for a diabetes test. Symptoms include excessive thirst or hunger, dramatic weight loss, fatigue, frequent urination or blurry vision.

The holidays also are a perfect time to start getting healthy, she said, offering these tips:

• Set consistent meal times. Avoid fast food.

• At parties, cut food portions in half or don't eat large portions of food, even healthy food. Eat skinless chicken or turkey.

• Use low-calorie ingredients when making treats.

• Exercise regularly. Go on walks to see holiday displays.

• If you are an appropriate weight for your age, maintain your weight. In certain ethnicities, such as Asians, even modest weight gain can set the stage for developing diabetes.

• Long-term tips include:

• If you are overweight, try to lose 5 percent to 7 percent of your body weight through exercise and eating right.

• Exercise regularly. Walk at least 30 minutes a day.

• Eat a nutritious diet high in fiber and whole grain. Reduce the intake of high-calorie food.

"Various research studies have shown that maintaining a healthy lifestyle with a balanced diet, weight management and regular exercise can prevent the development of diabetes or help control an existing condition," said Dr. Chandalia, an associate professor of internal medicine.

Diabetes has several basic forms and stages:

• Pre-diabetes: People have higher-than-normal blood sugar levels but the levels are not high enough for a diabetes diagnosis.

• Type 1: The immune system attacks insulin-producing beta cells in the pancreas, requiring insulin to survive. This typically affects children.

• Type 2: The body can't efficiently use its own insulin and insulin production can't keep up with the high demand, so glucose builds up in the blood and the body can't burn the blood sugars that are its main source of fuel. This is normally associated with older age, obesity, diabetic family history, physical inactivity and certain ethnicities, but is increasingly diagnosed in overweight children as well.

With about 14 million diagnosed cases of type 1 or type 2 diabetes and 6 million undiagnosed cases, it's vital to stay healthy during the holidays, Dr. Chandalia said.

Keep in mind, she said, that it takes more than avoiding sugary treats.

"Diabetes doesn't occur just because of eating sugar. Sugar, as any other food, provides excess calories that can lead to obesity and a predisposition to diabetes," Dr. Chandalia said. "If you don't eat sugar, and continue to eat extra calories from other foods, you may still develop diabetes."

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