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A24 HEALTH
Thursday 22 November 2018

Pre-diabetes and diabetes

management

Obesity is a symbol of type II diabetes. A tendency toward belly fat is
associated with increased insulin resistance and contributes to its early
onset. This may explain why 85% of children in Aruba who develop type II
diabetes are overweight or obese at the time of diagnosis.
The preclinical stage (pre-diabetes) of type II diabetes is Metabolic Syn-
drome or Syndrome X. Metabolic syndrome is a collection of changes
in your body that progress silently over a period of years. The critical
change is increased resistance to insulin, the hormone that suppresses
liver glucose output and removes excess glucose from the blood.
Your body is making the insulin, but the insulin in not available to your cells
to convert glucose to energy. We know that virtually everyone who de-
velops type II diabetes starts with insulin resistance. We also know that the
risk of developing type II diabetes is highest among obese people who
have an abnormal accumulation of fat. Determining insulin resistance is
not so much by the amount of body fat as by where the fat is located.
In fact, one of the best predictive markers for insulin resistance is excess
body weight, in particular around the waist or hips.
In the change from being overweight to being obese, the liver becomes
resistant to insulin and the hormone’s ability to suppress liver glucose pro-
duction. Under these conditions, the excess insulin turns the liver into a
‘fat-producing factory’ with all of its negative effects. Once established,
these disturbances in fat metabolism are devastating to blood sugar bal-
By: Dr. Carlos Viana ance and weight management. Acceleration of this negative cycle and

Here in Aruba, as in most modern societies, everyone knows someone the collapse of pancreatic insulin production change Metabolic Syn-
drome or Pre-Diabetes which can be controlled or slowed with lifestyle
who has diabetes. The World Health Organization estimates that by 2025, changes into the ever deteriorating health condition, Diabetes.
the number of people with diabetes will reach over 300 million—a stag- Get The Point! Diabetes is the one of the top causes of death Aruba, Bo-
gering 122% increase in less than 30 years. Type 2 diabetes is an epi- naire, Curacao the United States and Europe. From a study I conducted
demic requiring global attention and urgent action. However, control- on Aruba and then published I was invited to lecture to an international
ling your blood sugar levels and preventing diabetes type II can only be scientific group of experts on the prevalence of Insulin resistance and re-
managed by you lated metabolic features, I presented facts and treatment options. Op-
tions that showed improvement in symptoms and on blood tests from life-
As a medical anthropologist I know diabetes exhibits a strong ethnic style changes such as drinking more water, using a metabolic or blood
preference: Native Americans, Hispanic-Latino Americans, and African- type diet, daily supplements and regular exercise. If you are interested in
Americans show an increased prevalence compared to the non-Hispan- getting your sugar under control, read my book, make an appointment,
ic white population. check for events. Let us help you become your best doctor.q
Misunderstood as a simple sugar imbalance that can be readily correct-
ed through medical treatment; diabetes, in fact, it is a complex medi-
cal disorder. Our communities have fundamental genetic predisposition,
made worse by our social, behavioral, dietary, and lifestyle factors. The
disease has serious implications for vision, cardiovascular health, kidney
and nerve functions. Its control and prevention largely depends on life-
style issues, including diet, weight management, and physical exercise—
a many-sided combination of factors that makes treatment complex
and challenging