In The Blood
For diabetics, diet and exercise are just the beginning of a healthy lifestyle
For Baltazar Gutierrez, Saturday morning does not mean extra hours between the sheets. It is not about watching cartoons or going out for a mile-high stack of pancakes. At 10a.m., February frost has not yet faded outside his home in Bolingbrook, Ill., but Gutierrez is sweating hard.
For Gutierrez, Saturday morning means an early start to calorie burning. The gentle swish sound of an elliptical machine seeps through the basement floor and into the kitchen, where his wife Laura is making breakfast. She dices tomatillos and drops them in a blender. The green sauce looks good on a square plate with egg whites and chorizo; more importantly, tomatillos have a low glycemic index, and a small serving does not have a big carbohydrate load. Since Gutierrez was diagnosed with type 2 diabetes 17 years ago, healthy eating and exercise have never been far from his mind.
"If you love yourself, if you love your family and if you want to live long enough to see your kids grow up, that means you have to take care of yourself," Gutierrez says. "If you have time to eat and time to sleep, then you have time to take care of yourself. Or eventually somebody else will be taking care of you." He isn't just talking to the nearly eight percent of the U.S. population that has diabetes. He's talking to everyone at risk of developing the disease, which is the sixth leading cause of death in the country and can cause serious health complications including heart disease, blindness, kidney failure and lower-extremity amputations.
"Diabetes is controllable," Gutierrez says. "You should not let it kill you slowly."
Gutierrez sounds more like the doctor than the patient. That might be because he's used to giving orders; the 45-year-old owns a Berwyn, Ill.-based construction company called Ideal Construction. Between doing payroll, getting contracts and working with clients, managing his diabetes hasn't always been easy. Being mindful of one's health is hard, but it is key to surviving and preventing type 2.
Diabetes is a disease associated with high levels of blood glucose caused by defects in insulin production. Ninety to 95 percent of people with diabetes have type 2, according to the Centers for Disease Control and Prevention (CDC). Studies by the Diabetes Prevention Program show that people at high risk for diabetes can prevent or delay the onset of type 2 diabetes by losing weight through regular physical activity and a diet low in fat and calories. Losing five to seven percent of body weight and exercising for 30 minutes five times a week reduces the risk of getting type 2 diabetes by more than half.
"Look at new lifestyle habits or changes as an opportunity to improve your health rather than a drag on your day," says Joan Chamberlain, a writer for the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md. Small steps lead to big rewards is the motto of the National Diabetes Education Program's diabetes prevention campaign. Their brochures offer general guidelines for losing weight and eating healthy (eat less fat and burn more calories than you ingest every day ) as well as practical pieces of advice (make less food look like more by serving it on a smaller plate.) You can build physical activity into your day by simple things like parking far from a store's entrance. Tips for eating healthy and getting exercise are infinite, but the strategies for cultivating awareness of diet or exercise can be hard to master.
"People lead very busy, stressful lives these days," Chamberlain says. "But it's important to take steps to preserve your health through finding opportunities to get some physical activity, even if it is brief."
The first time Baltazar Gutierrez went to the gym, he had no idea what to do with the exercise equipment. Then he met a personal trainer named Zoo, a "48-year-old with the body of a 20-year-old," according to Gutierrez. Zoo put him on an exercise routine that had him improving endurance and losing weight in weeks. Studies in the early 2000s by the USA Diabetes Prevention Program and Finnish Diabetes Prevention Study have shown that frequent lifestyle advice, given by a trained health professional, is effective in reducing the development of diabetes in people at high risk.
But who is at risk? The CDC estimates that in 2007, 57 million people had pre-diabetes, a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes. Minorities are disproportionately affected by diabetes; Mexican-Americans, like Gutierrez, are over twice as likely to have diabetes as non-Hispanic whites of similar age, according to 2002 CDC estimates. Almost a quarter of men and women older than 60 had diabetes in 2007, so the National Diabetes Education Program recommends men and women of at-risk weight over the age of 45 get tested for pre-diabetes. If Gutierrez had filled out a risk test like the one on the American Diabetes Association's Web site that assess diabetic risk using factors like BMI, family history of the disease and hypertension, he might have avoided the weekend of agony 17 years ago that led him to a doctor's office.
"I was feeling tired and sleepy. I had this weird sensation in my body. I was thirsty, and my mouth was dry, so I thought I'd eat an ice cream," Gutierrez says. "So that's more sugar. Of course, I didn't realize that at the time."
Diabetes was the last thing on Gutierrez' mind. He was not alone in not worrying about diabetes. Although one in ten American adults reports having been diagnosed with diabetes, a 2008 Harris poll conducted on behalf of the American Diabetes Association found that while 49 percent of Americans claimed to be afraid of cancer, only 3 percent cited a fear of diabetes. Be afraid. Fear can be healthy if it means exercising and eating right.
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