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CHRONIC DISEASE: LEARNING TO LIVE WITH IT

Author: Michael F. Roizen, M.D. with Elizabeth Anne Stephenson
Source: Real Age: Are You As Young As You Can Be?

Although having a chronic condition like diabetes or arthritis can age us, how we manage that disease can make an enormous difference. For example, if diabetes is not managed properly, a diabetic can age at twice the expected rate; he or she will experience almost two years of biological aging for each passing calendar year. However, careful management of the disease can reduce the aging effect by over 50 percent, and by as much as 80 percent. For Type II diabetes (non-insulin-dependent diabetes), proper management can make manifestations of the disease virtually disappear, leaving no significant aging effect. Similarly, the aging effect of heart disease can be retarded by as much as 70 percent with proper vigilance, and if the disease is diagnosed before significant structural damage occurs, the aging it causes can even be reversed. We see similar benefits of disease management for everything from kidney disease to neurologic disorders to thyroid problems to cancer. No matter what ails you, the aging damage that a chronic condition causes is always, always improved by proper management.

There are two types of diabetes, Type I and Type II.  Although they have different causes, the two types have largely the same effect: high levels of sugar in the blood. Diabetes, if not treated properly, can cause arterial aging; blindness; kidney failure; liver damage; and, in advanced stages, limb loss and heart failure. However, by keeping blood sugar within the levels of people who don’t suffer the disease– by managing diet, insulin, and exercise– diabetics can avoid much of the aging that high blood sugar causes. A diabetic can control the ecosystem, as it were, of his or her body in such a way that the disease has little impact. However, doing so requires a lot of attention and commitment. Not just once in a while, but every single day.

Type I diabetes– sometimes called juvenile diabetes because the disease often begins it childhood– occurs when the body quits making insulin, the hormone necessary  to metabolize sugar in your food and to regulate glucose levels in your blood. Patients with this type of diabetes generally inject artificial insulin that substitutes for the natural insulin their bodies should produce. Carefully monitoring blood sugar and making sure to balance diet, exercise, and insulin levels, in such a way as to keep glucose levels within a normal range is a way of preventing damage,

Type II diabetes, or adult-onset diabetes, usually develops when a person is over forty, often older. It occurs when the cells in the body become insensitive to insulin. The insulin receptors on the outside of each cell no longer react to the insulin molecule that signals the cell to break down glucose. Hence, blood glucose levels remain high. Type II diabetes occurs most often in people who are overweight: although the reasons are unclear, excess weight seems to impede the body’s ability to metabolize sugar properly. Type II diabetes affects about 10 to 15 percent of adults over age fifty-five but is more prevalent among some population groups than others, confirming a genetic component. For example, African-Americans, particularly African-American women, are much more susceptible to the disease. Indeed, one out of four African Americans over age fifty-five has Type  II diabetes. Among certain Native American populations, the prevalence can be as high as 80 percent. However, in many cases, the disease is triggered by a combination of genetic predisposition and lifestyle choices. Some 90 percent of the people who develop Type II diabetes are considerably overweight and most of these people also do not exercise or have proper diets, both of which further exacerbate the condition. If you “live young,” you will have less chance of developing the disease, no matter what genes you have.

Diabetic patients who take charge of their condition, vigilantly keeping their blood sugar levels within normal ranges, experience little premature aging. Patients who lose excess weight, begin exercising, and eat balanced diets that are carefully calibrated to their diabetic condition can reverse the aging effects of the disease altogether, suffering no more aging than their disease-free peers. Think of it this way: The diabetic’s body can no longer create the conditions it needs for healthy existence all on its own. However, it is possible for the diabetic to create an environment inside the body that keeps him or her  in an equally healthy state.