Type 2 Diabetes is Now Controversial?

Today’s New York Times has a front page story by Gina Kolata, who seems to make a career of taking contrary positions on commonly held ideas about health matters. This time, she takes on common understanding of type 2 diabetes. Her article appears to argue that people with type 2 diabetes do not need to worry nearly as much about high blood sugar as they do about high blood cholesterol, that they need a mountain of drugs to stay healthy, that obesity isn’t really related to this condition (genetics counts more), and that rates of type 2 diabetes are not increasing, anyway (it’s just being diagnosed more frequently). Statisticians are unlikely ever to agree on the numbers but type 2 diabetes is the best reason I can think of to follow my “eat less, move more” mantra. Type 2 diabetes is a largely preventable condition. Yes, only small percentage of overweight individuals will develop type 2 diabetes, but the probability of getting it increases with increasing body weight. And if you look at the body weights of people who have been diagnosed with type 2 diabetes, most of them–95% in some studies–are overweight. It doesn’t take much of eating less and moving more to prevent or resolve symptoms. And that works for high blood cholesterol, as well.  Doesn’t doing that seem better than being tied to a lifetime of pharmaceuticals? And what about type 2 diabetes in young children? Isn’t type 2 diabetes something that everyone ought to be trying to prevent? I wrote about these issues in an editorial in the American Journal of Public Health a couple of years ago. Read the references to it and see how they compare to the this-won’t-work attitude expressed in Gina Kolata’s article. Will her article help clear up public confusion about how to approach chronic diseases related to diet and activity levels? Do weigh in on this one.