Researchers have found that many people have diabetes and don't realize it, while others are prediabetic and also unaware of their condition. If left unchecked, diabetes can wreak havoc on your cardiovascular system and cause kidney disease, blindness, pregnancy complications, sexual difficulties and reduced immune-system function: not a pretty picture. But you can do a lot to encourage this quiet epidemic to pass you by.

Diabetes Risk Reduction
Type 2 diabetes, so-called adult onset diabetes, usually strikes people over the age of 30, although the incidence among kids has grown greatly. Type 2 diabetes cuts down the amount of insulin produced by the pancreas, or may make the body less responsive to the insulin that is present. Insulin is a hormone-like substance that speeds the removal of sugar from the blood. During diabetes, blood sugar climbs and causes serious physiological damage.

Fortunately, you can reduce your risk of type 2 diabetes by changing your lifestyle. In a recently completed study (Diabetes Care 2004 Jul; 27(7):1570-6), researchers found that a diet which helped people lose weight, combined with a consistent exercise program, significantly reduced the chances of developing diabetes. According to Tommy G. Thompson, head of the Health and Human Services and the National Diabetes Education Program, "There are effective steps that people can take for themselves to hold off the progression of type 2 diabetes."

Shape: Apple or Pear?
America's increasing girth has increased our risk for diabetes. Where you store body fat influences your chances for diabetes. Those who store fat in the upper half of their bodies and around the stomach (apple-shaped) are at higher risk for diabetes than people who store fat in the hips, thighs and buttock (pear-shaped). For men, unhealthy fat storage often takes the form of a potbelly. For women, the riskiest fat storage centers are in the midriff area, forming the midriff bulge at the waist.

According to researchers, stress plays an influential role in where your body fat accumulates. Central fat, fat stored in the abdominal area, is encouraged by the stress hormone cortisol. Cortisol is released when our bodies respond to stressful situations or events, and some people excrete much more cortisol than others. Women with a high waist-to-hip ratio are especially vulnerable to the effects of stress and have greater abdominal fat storage (Psychosom Med 2000; 62:623-32).

High-Protein Approach
A study in Australia (Diabetes Care 2002; 25:425-30) found that when people with diabetes used a high-protein, low-carb diet to lose weight, they enjoyed improved heart health and lost more fat around the middle. They also reduced their LDL (bad) cholesterol.

The researchers concluded that "the greater LDL cholesterol reduction in both [men and women] on the high-protein diet suggest that it is a valid diet for reducing cardiovascular disease risk in type 2 diabetes." (If you already have diabetes, consult your health practitioner before going on any kind of special diet, and use special care if you have kidney problems.)

Fighting Back With Fitness
Exercise also improves the blood sugar levels of people who either are at risk of diabetes or already have the disease. Physical activity helps the body take glucose (blood sugar) out of the bloodstream.
If you have diabetes and you want to exercise:
• Discuss your exercise program with your health practitioner
• Double check your blood sugar before and after exercise
• Wear properly fitting shoes to prevent blisters or sores
• Stay hydrated and drink plenty of fluids
• Warm up before strenuous exertion and cool down for 5 to 10 minutes at the end of an exercise session
• Keep an energy bar or other snack handy in case your blood sugar drops

Take Your Multi for Protection
Research shows that if you have diabetes you can boost your immune system by taking a daily multivitamin/mineral.
A study at the University of North Carolina that involved 130 adults with type 2 diabetes found that they suffered fewer infections when they took vitamins. After a year of taking multis, only 17% of the folks with type 2 diabetes suffered infections, compared with 93% of the people who didn't take supplements (Ann Intern Med 2003; 138:365-71).

The investigators involved in this study believe that a multi would be useful for anyone who doesn't get all the nutrients they need from their meals-and that probably includes just about everyone. "Various degrees of malnutrition, even of individual micro-nutrients, are known to markedly impair immune function," says Thomas A. Barringer, MD, leader of the research team.

In a related study, researchers found that antioxidants reduce oxidative stress (J Investig Med 2004 Jan; 52(1):24-32) in folks with diabetes. Oxidative stress increases damage to tissues, boosts inflammation and speeds aging.

In people with diabetes, oxidative stress also damages the insulin-producing tissues in the pancreas. Vitamins A, C and E were shown in this research to help rid the body of free radicals (tissue-damaging molecules) that can cause physiological problems.
People who have diabetes are particularly prone to shortages of vitamin C (Diabetes Care 2000 June; 23(6):726-32).

Fabulous Fish Oil
About 30 years ago, a generation of children was told by diligent mothers to open up and swallow spoonfuls of cod liver oil. Now research validates that venerable tradition.

Giving your child cod liver oil during the first year of life can reduce their risk of developing type l diabetes (juvenile diabetes), which is caused by an immune-system malfunction. Researchers in Norway found that cod liver oil, an important source of vitamin D and omega-3 fatty acids, either taken by moms during pregnancy or given to babies, lowered the children's diabetes risk (AJCN 2003 Dec; 78(6):1128-34).

Fish oil also helps reduce the risk of developing heart disease in people with diabetes, according to researchers at the Harvard School of Public Health. Supplementing with fish oil capsules may cut your chances of heart disease by 64% if you also eat fish at least five times a week (Circ 2003; 107:1852-7). Fish oil has been used to reduce inflammation, improve the immune system and strengthen the cardiovascular system.

The Chromium Edge
Minerals, especially chromium, can also help alleviate blood sugar problems linked to diabetes. Evidence suggests that people with diabetes have lower levels of chromium in their bodies, and that their ability to turn chromium into a usable form becomes impaired (Diabetes 1997; 46:1786). Chromium has also helped reduce cholesterol in several studies.

Research shows that chromium can improve blood glucose balance by improving insulin sensitivity. In an investigation reported at the 18th International Diabetes Federation Congress (Aug. 28, 2003; Abstracts 154 and 756), Dr. William T. Cefalu from the University of Vermont College of Medicine, reported that people who took chromium showed an increase in insulin sensitivity of about 9%.

Herbal Help From Fenugreek
Fenugreek, an herb used as a spice in many parts of the world, can help protect the cardiovascular system from the ravages of diabetes. Originally cultivated in Europe and Asia, this culinary delicacy is now grown and consumed all over the world.
Historically, fenugreek (Trigonella foenum-graecum) has been used to alleviate arthritis and digestive ills, and to heal wounds. In Traditional Chinese Medicine it has been employed to treat kidney problems and male reproductive difficulties. Today, research has shown that seeds from this herb can reduce the possibilities of heart problems in people with diabetes by reducing blood cholesterol and triglycerides (Phytotherapy Research 1996; 10:332-4).

Other herbs that have been used to address blood-sugar problems include American ginseng (Panax quinquefolius), cinnamon (Cinnamomum verum) and gumar (Gymnema sylvestre).

If you are you at risk for diabetes, or if you're already been told you are prediabetic, make up your mind not to be a passive victim of this epidemic. Taking long walks while taking control of your diet and weight can help you take down your chances of developing diabetes.