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. So working to reduce excess weight is a key goal in the prevention of diabetes.
We already know a more healthful lifestyle can reduce the risk of the most common type of diabetes by about half, and a new large study from Sweden has provided important additional insight into the prevention of diabetes. That study followed about 1.5 million Swedish 18 year olds who underwent a compulsory military screening examination between 1969 and 1997. The men were then followed to see who developed diabetes. During the follow-up period that averaged just more than 25 years, a little more than two percent of them developed diabetes.
What was fascinating about the study was the development of diabetes was reliably predicted by reduced exercise capacity and reduced muscle strength at the time of the initial military screening examination at age 18 - and both factors predicted diabetes in those men who were initially of normal weight as well as those who were overweight.
This suggests efforts to improve exercise and muscle fitness in the young may pay big dividends in reducing the risk of diabetes, whether the youngsters are overweight or not. So let's get on our feet and start exercising.
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Q. I know I need to stop smoking cigarettes. I've tried before and failed. So this time I hope to quit on my birthday later this month, rather than trying to cut down as I have before. What do you think of my plan?
A. I think it's a great plan. Most smoking guidelines worldwide recommend abrupt quitting over gradual; setting a quit date as you've done is ideal.
A study that was just completed compared the long-term success rate of abrupt compared with gradual discontinuation of cigarettes by smokers, and the results were clear - abrupt cessation is superior to gradual.
Now, it isn't that gradual cessation never works - it does. But it is less effective in the long-term than setting a target date and completely stopping.
Other interventions that may help, in addition to abrupt cessation, include behavioral support therapy and medications (but not e-cigs). Behavioral support and education appear to be important adjuncts, and can help to equip patients with practical approaches to avoid restarting cigarettes.
An important resource for North Dakotans is the ND Quits program provided through the North Dakota Department of Health. You can learn more and enroll at ndquits.health.nd.gov.
So as to your plan to stop smoking, I'm reminded of the famous ad from 28 years ago that advises us to "Just do it."
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences and a professor of medicine.
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Submit a question to Health Matters at healthmatters@med.und.edu or Health Matters, 501 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037.
The content of this column is for informational purposes only and does not substitute for professional medical advice or care. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.
