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Disease Risk Rising; Diabetes Screening Urged for All Aged Over 40; Change of Food Wards Off Ailment

Posted on: Tuesday, 21 December 2004, 15:00 CST

About 10 people a week are dying in Canterbury from diabetes- related complications, says a Christchurch expert, who is urging every person over the age of 40 to get their blood- sugar levels checked.

Professor Don Beaven said as many as one in four adults 25 years and over was likely to have diabetes or a pre-diabetes condition. If the latter was diagnosed early, people could halve their risk of developing diabetes -- an illness that could cause blindness, heart disease, amputation and kidney failure -- by exercising 200 minutes a week and halving their animal fat intake.

He urged everyone over 40 to have their blood-glucose levels tested and for Government funding to make such screening accessible.

His comments follow the release of research revealing diabetes may be more prevalent than feared. Half of all Maori adults tested in the Gisborne area were either diabetic or insulin-resistant (the under- lying cause of most type 2, or lifestyle- related, diabetes), according to research published in the latest New Zealand Medical Journal, which has devoted the issue to diabetes. Another New Zealand study found more than half of 3400 post-menopausal women screened were at high risk of developing diabetes.

The results were a wake-up call to health authorities, said experts writing in the journal.

Otago University nutritionist, professor Jim Mann said type 2 diabetes already cost the health system nearly $400 million a year and was forecast to soar to more than $1 billion by 2021. He called for urgent implementation of lifestyle modification programmes.

A "degree of apathy and indifference" prevailed at the Health Ministry and district health boards, said Auckland University associate professor Robert Scragg. This created the impression they did not believe urgent action was needed.

Canterbury had 30,000 to 40,000 diabetics, but only about 15,000 were diagnosed. Thousands more had pre-diabetes, and without lifestyle changes were likely to develop diabetes.

Beaven said many people were diagnosed only after they had had a heart attack or kidney failure.

The diabetes epidemic sprang from dramatic lifestyle changes. The human body had evolved to cope with the hunter-gatherer lifestyle with lots of exercise and only about 5 per cent of animal fat in the diet. Today's typical New Zealand diet was 30% fat.

"That is six times the amount the body is designed to handle," Beaven said. "So what is going to happen to this overworked machinery?"

He said a young, active, lean adult needed to make only about 1mg of insulin every day. If that person became inactive, gained 10kg and doubled the animal fat intake, they would need to produce 30mg of insulin by the age of 40.

"We have a whole nation of people trying to make 30mg of insulin with machinery designed to make 1mg," Beaven said.

Canterbury medical health officer Dr Alistair Humphrey said diabetes was the most common cause of blindness, non-traumatic amputations and kidney failure. It increased the risk of heart attacks and strokes. Prevention and early detection were important "so people do not suffer from these terrible complications".

Health Ministry chief public health adviser Dr Ashley Bloomfield said there was no evidence to suggest that nationwide diabetes screening was necessary from the age of 40.

A diabetes check was already recommended as part of a cardiovascular risk assessment for men over 45 and women over 55, Bloomfield said.

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Change of food wards off ailment

Ian Whitehead found it surprisingly easy to replace white toast with porridge after learning he was in danger of contracting type 2 diabetes.

Others could also avoid getting diabetes later in life by having their glucose levels checked and eating less sugar, he said. Whitehead, who is in his early 50s, went to the doctor for a check- up four months ago and was told he was pre-diabetic. The news was enough to shock the facilities manager into action.

"If it meant pills or injecting yourself with medication, I thought there's no way I want to go there. So I have porridge every morning and man is it a discovery.

"In the past I had a couple of bits of toast for breakfast. Now I go along to work and I don't need that biscuit mid- morning."

Giving up white bread, pies and cakes was a small price to pay for avoiding type 2 diabetes, he said.

"If I had not done anything I would have had to be on medication within a year or so, and if you go too far it's hard to come back. There are millions of people becoming diabetic because we eat so much sugar."

As his sugar consumption dropped, Whitehead's energy levels increased, making it even easier to continue snacking on celery sticks and feta.

He said many people would benefit from pre-screening for diabetes.

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Source: Press, The; Christchurch, New Zealand

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