Why diabetes causes mortality? It is well explained by a comprehensive cardiovascular model. According to this concept multiple independent factors such as high blood sugar, lipid disproportions, high blood pressure, age, sex, tobacco use, cardiovascular disease, insulin resistance, and hormone dysfunction are pooled into a global model of cardiovascular disease.
The precursor of the metabolic syndrome has become known as the Insulin Resistance Syndrome:
1. Age: Over 40 years.
2. Body Mass Index (BMI) more than 25 kg per meter squared.
3. Waist circumference greater than 40″ in a man and 35″ in a woman.
4. Sedentary lifestyle.
5. Family history cardiovascular disorder, glucose irregularities, hypertension and early onset diabetes.
The diagnosis is based on the above plus several the following:
Triglyceride greater than 150
1. HDL less than 40 and Man and 50 in women.
2. Blood pressure written 130/85
3. Fasting plasma glucose greater than 110
It was noted in long-ago that populations which are slightly underfed tend to live longer. Many physicians see protein calorie wasting as a compensatory affect because of illness. Certainly, this is the case in the later stage of cardiovascular and pulmonary failure. However, this feature can be advantageous when the organ systems are being taxed. Sleep deprivation can cause similar physiologic changes.
Muscle loss has also been noted for professional athletes who see steroid use. These athletes develop premature joint and muscle failure and some have even succumb to cancer.
Taking all this information into account brings us to the simple conclusion:
The natural state of the human body & its most efficient is the slightly underfed state. Caloric utilization is better, adrenaline levels are higher and immune function is improved. The body gears up to seek food.
The alteration of caloric intake can be accomplished in many ways.
Limiting meal portion and other options should be reviewed with your physician. Episodic and dramatic diets tend to drop weight but are dangerous and many times unproductive. The accomplishment of systematic lifestyle changes he is possible even in a society which focuses on caloric dense nutrition.
I am certainly not the first person to propose that good health starts with good habits. But I recommend that health care professionals deliver a clear message to their patients. We can always give you a pill, device or procedural modification that can control illness; however, remission and cure rest in changing behaviors that brought you to our attention.
Mark Hirsch Levy, M.D., Ph.D., F.A.C.P.