Why Sugar Matters Today. Finding Tools to Fight Diabetes.

By Dean Schillinger, MD

During the Iraq and Afghanistan wars, 1,500 American soldiers lost a limb in combat. During that same period, 1.5 million Americans lost a limb in surgical amputation due to Type 2 diabetes. That glaring fact is something we need to remember in the midst of current discussions around added sugar and food labeling. Right now the federal government is considering dietary guidelines for added sugar, plus changes to nutrition labels that would tell us how much sugar has been added. I think of these as tools for treating our current epidemic of Type 2 diabetes.

When I trained to become a doctor in the early 1990s on Ward 5A of the San Francisco General Hospital, half of my patients had AIDS. They were dying and there was little we could do to treat them. Today, when I roam the halls of Ward 5A, those AIDS patients are gone. Instead, I see both young and old people bearing the burden of Type 2 diabetes: blindness, kidney failure, amputations, heart attacks and strokes. All we have are tools to arrest the progression of the disease, but we can’t cure it.

The science behind the diabetes epidemic is clear: added sugar, especially in sugary drinks, is a major contributor to getting Type 2 diabetes. Having just one soda per day, over time, raises a person’s risk of getting diabetes by 26%¹.

Diabetes isn’t a new disease. What has changed is the age at which people get it. We used to call it “adult onset diabetes” because it affected parents and grandparents. But now it’s affecting our kids. In 1999, roughly 1 in 11 teens had “adult onset” diabetes or pre-diabetes² – a number we thought was alarmingly high back then. Fast-forward to today and that number has increased to nearly 1 in 4 teens – that’s one quarter of our kids.

An estimated 29.1 million Americans have type 2 diabetes and another 35 - 90 million are believed to have pre-diabetes². Projections suggest that 40 percent of U.S. children will develop the disease within their lifetime. To suggest that having diabetes at such a young age is devastating is a gross under-statement. These kids will face daily injections, amputated legs and feet, and kidney dialysis treatments three days a week.

The medical costs of Type 2 diabetes are taking a huge toll on our economy as well. In 2004, diabetes cost Americans $700 billion³ in direct medical costs and lost productivity — up by 41% from just five years earlier. To put that in perspective, that’s eight times the budget of the National Institutes of Health, which funds most of the biomedical research in the U.S. Providing care for people with diabetes accounts for more than 1 in 5 healthcare dollars in the U.S.

In facing AIDS, we have learned that the only way to change the course of an epidemic is to pull out every tool we have to treat it. We’re facing an even bigger epidemic today with Type 2 diabetes. In this case, better food labels and dietary guidelines alone won’t solve the problem, but they are a great start.

More Resources:

Take the Diabetes Test from the American Diabetes Association
http://www.diabetes.org/are-you-at-risk/diabetes-risk-test

Video: Dean Schillinger talks about the increased number of diabetes patients
https://www.youtube.com

Is there a high-incidence of diabetes in the area where you live?
http://www.cdc.gov/diabetes/atlas/countydata/atlas.html

^[1]Basu, S., Yoffe, P., Hills, N., & Lustig, R. (2013, February 27). The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS One . doi:10.1371/journal.pone.0057873. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057873
^[2]He, G., Sentell, T., & Schillinger, D. (2010, March). A New Public Health Tool for Risk Assessment of Abnormal Glucose Levels. Preventing Chronic Disease , 7(2). Retrieved from http://www.cdc.gov/pcd/issues/2010/mar/09_0044.htm
^[3]Eyre, H., Kahn, R., & Robertson, R.M. (2004, July). Preventing Cancer, Cardiovascular Disease, and Diabetes. Diabetes Care , 27(7), 1812-1824. doi:10.2337/diacare.27.7.1812. Retrieved from http://care.diabetesjournals.org/content/27/7/1812.full

Type 2 Diabetes

Type 2 diabetes mellitus, formerly called Non-Insulin Dependent Diabetes Mellitus (NIDDM) and Adult Onset Diabetes (AODM), is a disease in which our body acts as if it does not have enough insulin to keep our blood sugar levels down at normal levels. This is likely a combined effect of the body not being normally sensitive to the insulin the pancreas does make combined with the pancreas not making enough insulin for the circumstances. There is a genetic component to this disease. The body uses insulin as a signal to store glucose in liver, muscle, and fat cells. High blood glucose causes many changes in the body that lead to damage to many parts of the body over time

SugarScience Glossary

Sugary drinks

Means the same as sugar-sweetened beverages or liquid sugars.

SugarScience Glossary

Added sugar

Any sugar added in preparation of foods, either at the table, in the kitchen or in the processing plant. This may include sucrose, high fructose corn syrup and others.

SugarScience Glossary

Diabetes mellitus

Usually shortened to just diabetes. Sometimes called sugar diabetes. Look at Type 1 Diabetes and Type 2 Diabetes for more information

SugarScience Glossary

SugarScience is the authoritative source for evidence-based, scientific information about sugar and its impact on health.

Dean Schillinger, MD

Dean Schillinger, MD, is professor of medicine in residence at UCSF and Chief of the UCSF Division of General Internal Medicine at San Francisco General Hospital and Trauma Center (SFGH). He is a practicing primary care physician at SFGH, an urban public hospital, where he sees patients, teaches in the primary care residency program, and conducts research.

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