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Show Perceived Seriousness of Type 2 Diabetes and Engagement in a High-Risk Lifestyle Among Utah Adults: A Seeming Paradox? Brenda Rails, Ph.D., Craig Merrill, M.P.H., William F. Stinner, Ph.D., Michael Friedrichs, M.S. Sandra Assasnik, M.A., Ladene Larsen, R.N. Abstract Diabetes is a serious, often debilitating, disease that has no cure. Prevalence is increasing at an alarming rate nationally and in Utah despite increased interventions to change lifestyles. These lifestyle interventions may be ineffective if the general public does not regard diabetes as a very serious health condition. This study, therefore, assessed the relationship between perceived seriousness of diabetes and engaging in a high-risk lifestyle (defined as being overweight and not exercising), overall and across age and gender categories. Data were obtained from a pooled sample of 2,052 non-diagnosed Utah adults drawn from the Behavioral Risk Factor Surveillance System (1998-2000). Contrary to expectations, non-diagnosed Utah adults who viewed diabetes as very serious were actually more, rather than less, likely than their counterparts to be engaged in a high-risk lifestyle. This association was observed among both males and females, as well as young adults, but not among midlife or older adults. An estimated 11 million Americans have been diagnosed with diabetes, and this figure is projected to double by 2050. Diabetes costs the nation over $100 billion annually in medical care and lost productivity. The cost is even greater when the toll on quality of life for many individuals with the disease, including blindness, cardiovascular problems, renal failure, and lower-extremity amputations, is considered. There are two main types of diabetes. Type 1 diabetes is an autoimmune disease not related to lifestyle. In sharp contrast, type 2 diabetes, constituting 90 to 95 percent of newly diagnosed cases, is closely associated with obesity and sedentary lifestyles. While these two factors are linked to most chronic conditions, their link to diabetes is particularly pronounced. Even being moderately overweight increases the risk of developing diabetes as much as fivefold. Sedentary lifestyles are also strongly associated with development of diabetes. Several clinical studies have established the beneficial effect of exercise on decreasing insulin resistance, often a precursor to diabetes. The results from a recent clinical trial conducted by U.S. Department of Health and Human Services (DHHS) illustrate the significance of healthy lifestyles. Participants in the study who exercised and had low-fat, high-fiber diets cut their risk of developing type 2 diabetes by more than half. Type 2 diabetes is the focus of this report. Some risk factors for diabetes cannot be modified, such as age or membership in a minority ethnic or racial group. Nevertheless, even the risk from demographic factors could be reduced through weight control and exercise. This recognition has prompted the Centers for Disease Control and Prevention (CDC) to shift its emphasis from secondary prevention, focusing on those already diagnosed, to primary prevention, promoting lifestyles that reduce the risk of developing diabetes. Nevertheless, despite the potential for preventing this disease, prevalence continues to increase dramatically. National data indicate that a 33 percent increase in diabetes among adults took place during the 1990s. The increase in diabetes prevalence in Utah is similar. An estimated 3.6 percent of Utah adults had been diagnosed with diabetes in 1990, compared to an estimated 4.7 percent of Utah adults today, an increase of 30 percent. This increase parallels the increase in the percentage of Utah adults who are overweight (defined as body mass index greater than or equal to Utah's Health: An Annual Review Volume VIII |
