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Simple measures reduce the incidence of diabetes

Certain health "secrets" are not really secrets at all. But they are simple.

Simple to establish, that is.Following them for many, however, seems to be another matter.Take the increase in type 2 diabetes, for instance, an increase so great that the World Health Organization has declared it an epidemic. At the current pace, the number of cases worldwide will double by 2030, with the U.S. having nearly 50 million stricken with the disease no more than 20 years later.So why hasn't a recent column been devoted to sharing the "secrets" to keep you from becoming afflicted with diabetes? Because the secrets are not really secrets at all.They're simple. And well established.Nearly 10 years ago, research based on data of nearly 85,000 U.S. women showed you can reduce your risk of developing type 2 diabetes by 90 percent simply by doing three things: exercising moderately, eating well, and stopping smoking if you engage in the habit. Moreover, a separate study, found this strategy even helped 58 percent of subjects with such high blood sugar levels that doctors deemed them on the verge diabetes.After other studies continued to demonstrate the efficacy of exercise and diet against diabetes, Consumer Reports on Health, a rather middle-of-the-road publication, wrote: "A combination of weight loss, a healthy diet, and exercise . . . is more effective than medication in preventing type 2 diabetes."Ironically, that was in 2008 after a two-year period in which the Centers for Disease and Control reported that the incidence of the diabetes in the U.S. had increased by 15 percent.Obviously many have been unable or unwilling to follow what seems to be a simple solution even when not doing so and developing diabetes can result in kidney failure, amputation, blindness, stroke, or heart disease.So why an article about diabetes now? Because new research has discovered more simple ways to reduce the incidence of getting the getting disease.The first study is especially important, for it suggests an immediacy previously undetected. Type 2 diabetes occurs when the body can no longer use not insulin for one of its most important functions: to control blood sugar. Insulin resistance, the muscle cells' reluctance to accept the blood sugar transported by insulin to the cells is both a precursor and characteristic of the disease.Prior to this study, researchers believed insulin resistance was progressive, occurring over time, primarily through poor food choices though sleep deprivation over a period of time could also create it. A study performed at the Leiden University Medical Center in the Netherlands and published in the June issue of the Journal of Clinical Endocrinology & Metabolism, however, shows that insulin resistance increases with just a single night of reduced sleep.In the study, nine healthy subjects had their insulin sensitivity measured after a typical night's sleep, approximately eight hours. They then were limited to four hours of sleep on another night.The difference in insulin sensitivity was significant, making it clear, according to Esther Donga, MD and lead author of the study, that "A short night of sleep has more profound effects on metabolic regulation than previously appreciated."In other words, a sleepless night could be the culprit for the food craving after food craving after food craving the next day. So what can you do about it?Drink coffee.Research conducted at Nagoya University in Japan and also published in June in the Journal of Agricultural and Food Chemistry found that coffee consumption in mice improved insulin sensitivity, preventing the development of high blood sugar. While there seem to be other elements in coffee that help, additional studies performed at the Nagoya University indicated that caffeine is probably most responsible.A third study, which appeared first online and then in the June 29 issue of The New England Journal of Medicine, showed that there are three simple steps schools can take to lower the factors, like obesity, that lead to type 2 diabetes: furnish healthier cafeteria choices, increase and intensify gym classes, and provide in-school educational programs. The national study, known as HEALTHY, used 42 different middle schools and 4,603 students primarily from areas of low income and ethnic minorities because diabetes is disproportionately high in these areas, yet at the end of the two-year study, students who had been overweight or obese at the start of the program had a 21 percent lower rate of obesity than students in control schools that didn't implement the three aforementioned changes.The changes included adding more low-fat, high-fiber meals in the cafeterias, along with a greater selection of fruits and vegetables (also low in fat and high in fiber), and creating highly interactive classroom activities for small groups of students in classrooms, but, in all likelihood, the most important change occurred in gym classes through the increase in intensity.The goal was for students to engage in two and a half hours of exercise that kept their heart rate at 140 beats per minute or higher a level of exertion that makes it difficult for most to speak full sentences without pausing for breath every 10 days.