From the department of bad jokes (of which I am the keeper, as my loyal readers will undoubtedly attest), let me start by saying that I tried but I just couldn't manage to sugar-coat today's message, which is about diabetes, of course.
And that unsugared message is this: you - we - all need to do a much better job in preventing diabetes because if you don't, then you'll suffer gravely as a result (and I use "grave" advisedly).
To appreciate why anyone gets diabetes, you should know that glucose (which is much more commonly referred to as sugar, the term I'll use for the rest of this article) gets pumped into your bloodstream after you eat. To get that sugar, which is the fuel source your tissues need to keep working properly, into the cells of your tissues, the pancreas produces the hormone insulin, which eases the entry of sugar into cells.
Frankly, diabetes is diagnosed by a blood sugar reading that stays above a certain level, in other words, it can't get into your cells fast enough. This happens either because your body can no longer produce enough insulin (as a result, say, of the death of pancreatic cells) leading to what is known as Type 1 diabetes (the old name was juvenile diabetes and it accounts for 10% of all diabetes cases), or when your tissues become resistant to the insulin that you do produce, leading to what is known as Type 2 diabetes (90% of all diabetes cases, and which used to be known as adult-onset diabetes, except that with the plague of obesity in our midst - see below - we're now seeing it in kids as young as 10).
What's important to understand with Type 2 diabetes is that at the beginning, the pancreas is still producing a steady stream of insulin, but for various reasons, the body's cells have become resistant to its effects. If this is still a bit hard to get, though, then think of it like this: you know how when your spouse or your parent continually nags you, and at the beginning, you respond to that nagging? But as time goes on, you stop paying attention, in fact, you may even stop hearing the nagging voice altogether (I don't know this firsthand, of course, it's just what I've been told), so to get any effort at all out of you, your spouse or parent will turn up the volume (or the heat).
Well, that's what happens with insulin, too. In people who are overweight or sedentary, the tissues often stop responding to the insulin that's supposed to goad them into accepting the sugar they need. In the earliest stages of insulin resistance, before the blood sugar level has gone too high yet, this is known as pre-diabetes, and it's thought that eventually most of these people go on to develop frank diabetes. In other words, people with pre-diabetes don't have diabetes - yet - but they're well on their way to it.
Now, there's been a lot of focus on pre-diabetes the last few years as the circumference of the average person in the developed world has grown so rapidly, with all the experts and health officials worrying that if the populace continues to get fatter and to do very little exercise, it's not long before we'll see an explosion of diabetes and its complications, which include (among many more) a much higher risk of heart attacks, strokes, blindness, amputation, kidney failure, and - yikes! - impotence.
The problem is, for people with pre-diabetes, the idea of getting diabetes eventually doesn't seem to worry them unduly because, well, it's pretty far off in terms of time, and in the meantime, pre-diabetes produces no symptoms or problems, so why worry, eh?
Well, I get paid to make you worry, so let me tell you of a study that discovered that people with pre-diabetes already have significant memory impairment, which presumably will only progress with time as their condition worsens.
Not only that, but with sophisticated imaging techniques, this study was also able to show that the hippocampus, an area of the brain crucial to memory, has also already begun to shrink in people with pre-diabetes.
In other words, if you're an overweight and sedentary midlifer, as so many of you are, there's a good chance that you have pre-diabetes, which means that there's also a good chance that your memory has begun to go. If you begin to work out, however, and lose weight, there's every reason to believe that you can not only arrest that memory decline but even improve it, too.
By the way, since you may not remember most of what you just read, why not write it down now so you can refer to it when you have time to digest what it really means? You're welcome.