@Sam19 I do understand your perspective. And, respectfully, those who study prevention from a population level also have a perspective of prevention.
@Sam19, I believe you might enjoy the perspective of the renowned epidemiologist Leon Gordis. MD, MPH, DrPh. He is a professor Emeritus of Epidemiology at the Johns Hopkins University Bloomberg School of Public Health, and Professor Emeritus of Pediatrics at Johns Hopkins University School of Medicine. He stated regarding prevention that there are three types of prevention:
Primary prevention - defined as preventing the initial development of a disease. Dr. Gordis uses the example of immunization, reducing exposure to a risk factor.
Secondary prevention - defined as early detection of existing disease to reduce severity and complications. Dr. Gordis uses the example of screening for cancer.
Tertiary prevention - defined as reducing the impact of the disease. Dr. Goris uses rehabilitation for stroke as an example.
Highlighting further âpreventionâ Dr. Gordis stated that âprevention and therapy all too often are viewed as mutually exclusive activities. It is clear, however, the prevention not only is integral to public health, but also is integral to clinical practice. The physicianâs role is to maintain health, as well as to treat disease. But even treatment of disease includes a major component of prevention. Whenever we treat illness, we are preventing death, preventing complications in the patient, or preventing a constellation of effects on the patientâs family. Thus, much of the dichotomy between therapy and prevention is an illusion.â
I hope you found as interesting as I did. As always, thank you for the interchange.
Gordis, L (2014) Epidemiology (5th Edition) Elsevier Saunders: Philadelphia, PA
Did anyone have a doctor, who, before you were diagnosed with diabetes, tell you that you were at risk for it? Mine never mentioned anything about âpreventingâ it. An A1C test was never suggested either, and my big levels were always well within range. So, I am at a loss as to how I could have prevented something I had no idea I was at risk of developing.
A recent study showed that over half of the adults in California either have type 2 diabetes or prediabetes. At levels like this itâs not about individuals that are at risk and need to change their habits, itâs a civilization that needs to.
That canât happen though as long as we keep denying the problem.
Oh yes, I was told I was at risk for diabetes. I was told to follow a Low GI diet and to get a book re this diet, which I did. Since I donât eat manufactured food it didnât help much being almost entirely eat this pie as opposed to that pie or biscuit. So I decided to increase my whole grain bread intake, a dire mistake I now realise. If only someone had told me to cut down carbs, I would happily have done that since I am not a big potato, bread, pasta eater.
@Pat_Ann your statement regarding âriskâ is very profound as âriskâ and âpreventionâ and very much related. If an individual knows s/he is at âriskâ for disease then they can do something to reduce their risk.
Please know I am in no way blaming or victimizing anyone. I am simply sharing what most health care providers learn in their academic journey towards become a physician, physician assistant, nurse practitioner, nurse, etc⌠When I earned my second masters in diabetes education and management and my doctorate in (I am defending on Thursday) Health Education there were many courses that I took where I learned about risk factors pertaining to a host of illnesses. Classes like epidemiology, social determinants of health, pathophysiology of diabetes. These are topics I teach and discuss with the medical students that I teach so I know that physicians get similar training. Whether or not they share that information is a whole new conversation.
So that you might have the information regarding "risk factors for type 1 and type 2 diabetes may I suggest visiting the Global Report on Diabetes published by the World Health Organization. There is a section pertaining to risk factors. Some of the risk factors are what we call in the medical and health communities as âmodifiableâ some ânon modifiable.â As a woman of African-American descent I have a few ânon-modifiableâ risk factorsâmy race, family history, and the fact that I am, indeed, aging. Those are things I cannot change. However, I definitely wonât cry "Woe is me, I was born Black, itâs inevitable I am going to acquire, type 2 diabetes, hypertension and every other disease Black people are at a higher risk for.
Although it may appear I am âstuck like Chuckâ,Iâve chosen to reduce my risk by engaging in behaviors beyond diet and exercise that have been shown to reduce oneâs risk of development certain ânon-communicable diseasesâ also known as NCDs.
@Pat_Ann, I do hope this is helpful to you. That is my only motive. I am cognizant that people other than those who are responding are reading this thread. In fact, if you have a look you will see that over 1000 people are following this thread. Sharing your experience does much to help those who are less inclined to post their response navigate working with health care professionals as well as manage their condition.
Thank you for sharing and giving me an opportunity to share as well.
@Sam19 you are correct. We call it âsocial determinants of health.â Same concept, different language. Itâs unfortunate thought that those factors are a lot harder to change.
For the sake of bandwidth, Iâm wondering whether you should just go ahead and make a separate topic in which you, for once and for all, list your too-numerous-to-count degrees, credentials, and teaching experiences to which you can refer readers whenever you post. It would save everyone a great deal of time in not having to read the same thing over and over.
Two years before my diagnosis, I was told my BG was a little high and I should lose weight so I wouldnât get diabetes. Thanks to LADA, my weight dropped 30 lbs.
Because we were unable to prevent a disease in our own life does not mean that we should discourage the rest of the world and future generations from at least trying.
That makes as much sense as handing out cigarettes to kids because we have lung cancer. Itâs no longer about us. At this stage of the development of this epidemic, itâs about the future of the worldâ yet our own denial is accelerating the epidemic.
Sam, I realize we donât see eye to eye on this issue. But, at least from my point of view, we both respect each otherâs opinions.
I donât disagree with you about the importance of having a more future-oriented world view. But IMO, the majority of people who come to this Forum do so because of their own very personal struggles with either being a PWD or the parent or a spouse/partner of a PWD. I believe that is why so many members take offense at someone who is not a MOT (Member of our Tribe) furthering their own agenda about âpreventionâ. For us MOTâs, itâs sadly too late for âpreventionâ (if we even believe this is possible) and/or ârisk factorsâ. For the record, I am not against someone who is not a MOT joining this Forum. I just think that such individuals should strive to have more insight into where MOTs are coming from. The last thing many of us are looking for on this Forum is a non-PWDâs posts full of scientific jargon.
I donât see where I have said anything about anyone else. I would never discourage others from trying to prevent it. I am just trying to make sense of this disease and what happened with me. I am at a loss, and my doctor says he doesnât know. If this is what you think I am doing, I am very sorry.
When I was DXâd in 1983 at age 28 the nomenclature was still in flux. My Dr told me I had what was commonly called âjuvenile diabetes,â but that the medical profession knew it was a misnomer and it wasnât that rare for adults to get it. He explained that the real point was that it was the auto-immune kind, probably triggered by a virus (in fact Iâd had a nasty cold just before the symptoms cropped up), not the insulin-resistant kind usually called âmature onset.â I certainly wasnât âjuvenile,â but I was young enough that the fact that the record-keeping notebooks and whatnot that they handed out all featured pix of healthy old geezers on their bikes really annoyed me. âAdultâ was by far more predominant back then too. Of course now I AM one of those (reasonably healthy) old geezers on a bike, and glad to still be here.
@Pat_Ann. Not meaning to sound like I was singling you out at all, that wasnât my intent, just remarking on what I consider to be the prevailing attitude of people with diabetesâŚ
These are the main things that I found online few years ago, included in my regime and I kept on following them. I think this is helpful for all of you too:
Low-carb balanced diet. Increase the number of unprocessed foods, including vegetables and whole grains. Reduce the amounts of high-fat or sugary foods and drinks. Aim to eat varied and balanced meals and stay within your calorie budget. It is even better to get personalized diet - it makes you stick to the schedule.
Regular meals and small portions. Ensure that you keep your blood sugar levels at bay, eating frequent, smaller meals. Drink enough water each day.
Daily workouts. Dedicate at least 30 minutes per day to working out. It can be anything from hitting the gym to gardening. As long as you raise your heart rate up, you are golden.
Controlled stress. Try out meditation or mindfulness exercises to reduce stress and anxiety. Managing stress will help you to become more focused and faster improve your health.
High-quality sleep. Rest is necessary for you to manage diabetes because your muscles recover after exercise while sleeping, and your digestive tract has enough time to digest your food. Set up a routine and ensure that you get at least 8 hours of uninterrupted sleep each night.
