CDC predicts diabetes incidence of 40%

ATLANTA – “In 2014 the CDC said that within our lifetimes, 40% of us in the U.S. will develop diabetes at some point,” A. Paul Chous, OD, said. “We need to push the diagnosis of diabetes as far forward as possible.”

Chous, who specializes in treating patients with diabetes, spoke here at SECO on prevention and treatment. The course was sponsored by Primary Care Optometry News.

“According to the newest guidelines for diabetes, they’re saying we should drastically cut down on the amount of red meat consumed, particularly sodium nitrate and nitrite meat products,” he said. “Iron seems to play a large role in the development of type 2 diabetes.”

Chous said that Alzheimer’s disease is being called “type 3 diabetes.”

“The first thing that physiologically goes wrong in Alzheimer’s is that the brain stops producing insulin, and it’s been linked to brain iron overload,” he said.

Chous said in his opinion, the three major causes for diabetes are nonalcoholic liver disease, too many calories in our diet and physical inactivity.

A. Paul Chous

“Patients get tired of hearing they need to exercise more,” he said. “I phrase it differently: Get more physical activity; add more movement to your day. I give a pedometer to every patient with diabetes I see. People like to play games and track what they’re doing.”

Chous said the Diabetes Prevention Program showed having patients walking 30 minutes a day, five days a week, lowered the risk of development of type 2 in those with prediabetes by 58% over a 4-year period.

“It was twice as effective as metformin,” he said.

Chous is now considering the potential impact of blue light on the risk of diabetes.

“Blue light stimulates the retina independently of photoreceptors,” he said. “Not enough sleep is a risk factor for obesity and developing type 2 diabetes.”

Chous outlined environmental risk factors for diabetes:

You will have some degree of insulin resistance with hypertension.
Sleep deprivation (less than 6 hours a night).
Half of women with gestational diabetes will get type 2.
Smog and particulate air pollution.
Corticosteroid use (consider punctal occlusion).
Thiazide diuretic use (ACE inhibitors are the best hypertension drugs to use in patients with diabetes).
Lipophilic statins.

Chous said smoking has been recognized as an independent risk factor for type 2 diabetes, with a pack or more a day increasing risk by 54%. On the other hand, drinking coffee or tea are associated with lowering risk.

Chous said those who have a parent with diabetes have a 50/50 chance of getting type 2, while it’s 10% for type 1.

“Type 2 is much more transmissible than type 1,” he said. “It’s not necessarily related to genetics, but you tend to share your family’s behaviors. If you marry someone with diabetes or your spouse develops it, your odds are elevated 26%.

“Not a week goes by in my practice when I am not seeing a morbidly obese child who gets type 2 diabetes,” Chous added. “And type 2 patients end up needing insulin injections if they live with it long enough. In kids it’s really bad, because the beta cells die off faster than in adults. It triples the rate of kidney disease, and those with type 2 are twice as likely to die as those with type 1.” – by Nancy Hemphill, ELS, FAAO

Disclosures: Chous is a consultant for Bausch + Lomb, dLife, Freedom Meditech, GlaxoSmithKline, Optos, Risk Medical Solutions, VSP and ZeaVision.