Q. I've heard a lot about the diabetes epidemic. What can I do to try to prevent getting diabetes? A. You are quite right that there has been a worldwide increase in the number of people with diabetes. One of the most important causes is the obesity epidemic, since people who are overweight or obese are more likely to develop diabetes, which can cause many vascular complications that result in strokes, heart attacks, heart failure, kidney failure and blindness.
Q. How effective is screening for colon cancer? If it really isn't necessary, I'd rather skip it. A. The good news is over the past 40 years, the number of new cases of colon cancer in Americans older than 50 has fallen by almost half, and colon cancer-related mortality has fallen by more than half.
Q. I've tried everything to lose weight, but I can't seem to keep the pounds off. As a consequence, I'm so overweight that I barely can get around. Would bariatric surgery help? A. I've discussed the challenge of weight loss in prior columns and the effectiveness of surgery on the stomach (called bariatric surgery) to help selected patients who are morbidly obese.
Q. How much of a threat is the Zika virus that I've heard so much about recently? A. Over the past two decades, the Western Hemisphere has seen the emergence of four related viral infections that are spread by mosquitos and ticks, Zika virus being the most recent. You may have heard of the earlier three — chikungunya since 2013, West Nile before that, and dengue especially since the 1990s.
Q. I developed some pain in my abdomen and my doctor told me I had diverticulitis. What is it, what causes it, and what can be done about it? A. We say diverticulitis is present when outpouchings (diverticula) of the bowel (large intestine) become inflamed or infected (the "itis" in diverticulitis). Only a minority — probably less than one in five — of patients with such diverticula develop diverticulitis. What causes a diverticulum to become inflamed or infected is not known.
Q. I have surgery coming up, and my doctor told me I should continue to take my daily aspirin up to the time of surgery. But doesn't aspirin increase the risk of bleeding? A. Yes. Aspirin, like most medicines, is a two-edged sword, with both benefits and risks. The main benefit of aspirin is it inhibits the stickiness of small cells in the blood called platelets and thus reduces clotting of the blood.
Q. The number of people with Alzheimer's disease and dementia seems to be increasing. Is it known why? A. You certainly are right that the number of people with dementia is increasing. It is the main cause of disability and dependence in seniors not only in North Dakota but around the world. But the main reason for its increase is not that a larger fraction of the population is affected; it's just that as longevity increases, there are more people who are older and at risk of dementia.
Q. I try to follow a healthy lifestyle. I exercise regularly and try to eat smart. But what exactly should — and shouldn't — I eat? A. One of the most obvious suggestions is to watch your caloric intake. I've discussed the problem of obesity before, and part of the problem relates to consuming more calories than we need — those extra calories are quickly deposited around our bodies, usually in undesirable locations.
Q. I am concerned because my teenage son is quite overweight and nothing seems to be very effective in helping him lose weight. Is there anything else you might suggest? A. In youngsters like your son, there has been a virtual epidemic of severe obesity; its frequency has increased by about 50 percent in the recent past. While obesity has increased in adults as well, it is of special concern in obese children who will live shorter lives than their parents as a result of chronic problems related to obesity like diabetes, high blood pressure, and hardening of the arteries.
Q. Who should be screened for diabetes? I'm 60 years old, somewhat overweight but otherwise healthy, and my doctor wants to do a blood test to check. Should I proceed with the test? A. Diabetes is a condition where the level of sugar (glucose) in the blood is too high.