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Reversing the Diabetes Epidemic

By Caroline Trapp, M.S.N., A.P.R.N., B.C.-ADM, C.D.E.

This opinion piece was published in The News and Observer on June 29, 2007, and the San Jose Mercury News on July 2, 2007.

Larry Alan Stanford died of a heart attack May 21 -- the very same day that a study came out revealing that Avandia, a diabetes drug he had been taking, significantly increases cardiac risk. Although the lawsuit his family just filed against the drug manufacturer will no doubt warn many others of the medication's dangers, there's a larger lesson to be learned from this tragedy.

As a diabetes nurse educator for the last 20 years, I can tell you that Stanford's death may have been avoidable. And I'm not talking about a different, safer pill. Studies show that the right diet can actually be more effective than drugs at lowering high blood sugar -- and these healthy eating habits don't cause heart attacks.

Chances are you haven't heard about this. The amazing ability of diet to treat, and sometimes even reverse, type 2 diabetes is one of those best-kept secrets I'd like to shout from the rooftops. Perhaps if the pharmaceutical companies could profit from selling healthy food, more Americans would know that simple dietary changes could save their lives.

A study recently conducted by my colleagues and underwritten by the National Institutes of Health showed that a low-fat vegan diet is more effective at lowering high blood sugars than oral medications. But before you turn the page thinking that most people can't live without hamburgers and the like, consider this. Research participants in the vegan arm of the study actually had an easier time sticking with their diet than those following the conventional diabetes diet, recommended by the American Diabetes Association. The reason is simple: They didn't have to count calories, cut portion sizes, or limit carbohydrate intake.

In fact, after a few weeks of sampling new recipes, even the most old-fashioned meat-and-potato guys find this diet extremely easy to follow, especially since so many of them have such great results. Many patients are able to reduce their diabetes medications and, in some cases, even eliminate them. And this diet has side effects the drug companies can only dream about. It's great for reducing high blood pressure and high cholesterol, as well as helping with weight loss.

Of course, this dietary approach isn't just good at reversing disease. It could help control our out-of-control health care spending as well.

Just a few days before Stanford's family filed their lawsuit in Texas, a coalition of diabetes thought leaders presented to the Congressional Diabetes Caucus a shocking report showing that one out of every EIGHT federal health care dollars is spent on the disease. Looked at another way, in 2005, we spent nearly $80 billion more to treat people with diabetes than those without the disease.

You'd think this kind of investment would buy us a cure. Unfortunately, it hasn't. People with diabetes certainly get lots of treatment for all that money, but for many, it's not very effective. Many take three different pills for diabetes, plus pills for cholesterol and hypertension, yet they still go on to develop heart disease, kidney failure, loss of vision, amputations and other horrible complications. It is estimated that 75 percent of those on insulin, still the strongest drug for diabetes, do not achieve the American Diabetes Association's target of an A1c blood test below 7 percent.

Given the type of money we're spending on diabetes, the ineffectiveness of our current treatments, and the distressing future so many people with diabetes face, it's time to put a bold new approach to work. A varied and balanced diet rich in fruits, vegetables, whole grains and legumes -- and free of cholesterol and fat -- would make a world of difference. Especially to people like Larry Alan Stanford.

Caroline Trapp is the director of Diabetes Education and Care for the Physicians Committee for Responsible Medicine. She lives in Farmington Hills, Mich.



Caroline Trapp, M.S.N., A.P.R.N., B.C.-ADM, C.D.E.

Caroline Trapp, M.S.N., A.P.R.N., B.C.-ADM, C.D.E.


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