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Diabetes in Men --- Why Is It Harder to
Control?
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December 15, 2014
By Joseph Strongoli, Contributing Columnist









Diabetes is a major condition in the United States today. According to
the CDC’s 2014 report, 29.1 million people in the U.S. have diabetes.
That is 9.3% of the population. Diabetes costed the nation $245 billion
in health services and care, medication, disability, work loss, and
premature death.

And the epidemic seems to be worse in men: 15.5 million men, or 13.6
percent of the male population have diabetes, compared to just 13.4
million women at 11.2 percent of the female population.

Why the disparity? Male reluctance in consulting a doctor or opening up
about a condition is well documented. A 2001 report published in the
British Medical Journal states that “US research shows that men with
health problems are more likely than women to have had no recent
contact with a doctor” and that this resulted in a startling discrepancy
in morbidity/mortality rates across gender. One such example of this
phenomenon is the following startling statistic: “deaths from melanoma
are 50% higher in men than women despite a 50% lower incidence of
the disease”.

The report postulates that this discrepancy in male/female health has at
its root a socio-cultural climate that leads men to have differing
attitudes and awareness towards health matters than women.  

According to the report, men’s general knowledge of health issues is
often less than that of women’s, and on the whole, poor.

Gender is an important factor in determining the awareness and
utilization of health information: “women are more likely to seek advice
from peers, magazines, books, and television than are men” and that
“girls tend to pick up more information from other sources and are
enabled to talk about it” while “health and the lack of it is perceived by
many men from an early age to be the domain of women.”

Moreover, the “macho male maxim of ‘strength in silence’ has an
important effect” on their desire for information and treatment: the
report found that “the average man is unlikely to access any help or
support at all if he has a problem. Instead, he will manage on his own”
and “may view attending the general practitioner as wimpish and
consequently look down on those who bother the doctor with ‘minor’
symptoms”.

Hence the male population suffers from a general lack of awareness
and knowledge about health issues, and this problem is compounded
by the societal gender role of the male that inclines him to avoid
seeking external help, to bear his pain in silence.

The result is that men are at a much higher risk than women, all else
being equal: “Lack of awareness can lead to late diagnosis. Late
presentation can have serious consequences. The effects of heart
disease, the greatest cause of early male death, and type 2 diabetes,
could be reduced if the conditions were detected earlier.”

This phenomenon is reflected in the CDC estimate that 28% of people
with diabetes are undiagnosed. Education and awareness are the first
steps.

Here are 5 tips for the control and prevention of diabetes.































1.
Exercise

A 2013 report by the Mayo Clinic says that regular physical activity can
help lower your blood sugar and boost your sensitivity to insulin, which
helps to keep your blood sugar in a normal range. According to the
report, aerobic exercise and resistance training both can help control
diabetes.  Don’t like running? A 2013 study at the Lawrence Berkeley
National Laboratory showed that a 30 minute brisk walk compared with
a shorter, more vigorous run produced similar reductions in risk for
diabetes, in addition to hypertension and hypercholesterolemia.


2.
Healthy Diet

Exercise is only a part of the equation; without a healthy diet, exercise
loses much of its efficacy.  

Choose foods with a low glycemic index, a measurement of the extent
to which a given food raises the level of glucose (sugar) in the blood
when digested.

A report from the Harvard School of Public Health found that whole
grains are rich in essential vitamins, minerals, and phytochemicals that
may help reduce the risk of diabetes.

More importantly, the bran and fiber in whole grains makes them more
difficult for the digestive system to break down into glucose. This leads
to slower increases of blood sugar and insulin, and a lower glycemic
index.

In contrast, simple carbohydrates like white bread, white rice, and
potatoes break down immediately into glucose upon digestion, meaning
when ingested they cause a spike in blood sugar levels. This gives them
a high glycemic index.  Other foods to limit are sugary drinks, candy,
and red meat.

3.
Lose Weight

Exercise and a healthy diet both directly protect against diabetes in
their own ways, but they also help in another way: they help you to
lose weight.  

Being overweight or obese  is a huge risk factor in developing diabetes.
The Mayo Clinic report in 2013 found that participants in a large study
who lost even a modest amount of weight – around 7 percent of initial
body weight – reduced the risk of developing diabetes by nearly 60
percent.

A 2001 study at Harvard University found that being overweight
increased the chance of developing type 2 diabetes seven fold, and that
being obese increased the odds 20 to 40 times.

4.
Tobacco and Alcohol

The bad news is that a 2007 study published in the Journal of the
American Medical Association found that active smoking is associated
with an increased risk of type-2 diabetes.  

The good news is that a 1995 study published in the British Medical
Journal found that moderate alcohol consumption may be associated
with increased insulin sensitivity and a reduced risk of diabetes.

If you are already at risk for diabetes, and millions of Americans are,
then smoking only exacerbates the problem. If you don’t already drink
alcohol, certainly a healthy diet, exercise, and weight regulation are
sufficient measures to prevent diabetes and it isn’t recommended that
you start drinking now in order to combat the disease. If you do drink
though, moderate use is the key.

5.
Metformin

A lifestyle intervention including all of the above modifications work
wonders in preventing diabetes. However, for individuals at high risk of
prediabetes and those recently diagnosed with diabetes, the American
Medical Association recommends oral metformin as a first-line
treatment. An organic compound in the biguanide class, a Diabetes
Prevention Program Research Group study published in 2006 in the
New England Journal of Medicine found that metformin treatment
reduced the incidence of diabetes in at-risk non-diabetic participants by
31%. However, the study reported that the lifestyle modifications of a
healthy diet, regular exercise and at least a 7% loss in weight resulted
in a 58% reduction in the incidence of diabetes. Therefore, metformin
should not be viewed as a replacement for a healthy lifestyle.



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Even losing just 7% of your weight, if you
are overweight, drops your diabetes risk by
60%.
.