TORONTO — There is not just an epidemic of diabetes in the western world, but that epidemic is spreading even to non-developed countries, says Michael Walker, RIGHT, a professor in the department of biological chemistry at the Weizmann Institute of Science in Rehovot.
One out of 12 people in the western world suffers from Type 2 diabetes, previously called adult onset diabetes, with 150 million worldwide, a number that is expected to double in the next 20 years, Walker said at a program sponsored by Mount Sinai Hospital and Weizmann Women and Science, held at the Oakdale Golf & Country Club.
Scientists believe these statistics are due to the growing incidence of obesity, he said.
However, researchers are puzzled about why there is a correlation between excess body fat and diabetes, he added.
Normally, Walker said, the body successfully and efficiently maintains a stable body chemistry. The pancreas, which is attached to the wall of the small intestine behind the stomach, produces insulin. Cells called beta cells pump the insulin into the blood stream, where it controls the level of glucose and carries it throughout the body. All of the body’s cells need glucose to function.
In Type 1 diabetes, which used to be called juvenile onset diabetes, this cell system is destroyed by the immune system, but “we are not sure why this happens,” he said.
In Type 2, on the other hand, the pancreas does produce insulin, but the body is unable to use it.
Walker said, however, that today, adults are developing Type 1 diabetes, and some children are developing Type 2. This appears to be caused by the levels of obesity, he added. The question, though, is why some obese people develop diabetes and some don’t.
There is no cure for diabetes, Walker stressed. “We can only treat the symptoms, but we can’t reverse the damage that has already been done. We can’t make people ‘normal.’ We can only make their bodies do what they are supposed to do naturally.”
There are several treatments currently being used or researched. Pancreatic transplantation would be a cure, but it is major surgery, lasting about eight hours, it is not always successful and as with all organ transplants, there are never enough donors.
Researchers at the University of Alberta are studying transplanting the islets of Langerhans, clusters of cells in the pancreas that include insulin-producing cells, Walker said. It is a much simpler surgery, he said, but again, the effects frequently don’t appear to be permanent, and there is a shortage of donors.
In his lab at the Weizmann Institute, Walker is studying the cells that produce and store insulin until it is needed: “What switches cell activity on and off? Can we use embryonic stem cells to manipulate the process?”
Other research is focusing on improved forms of insulin, how the insulin-producing cells are destroyed in Type 1 diabetes, and the use of pig islets for transplantation.
George Fantas, associate dean of research and director of the division of of endocrinology and metabolism at Mount Sinai Hospital, said that in Canada, five to 10 per cent of the population, about three million people, have Type 2 diabetes, largely because they are overweight, sedentary and have a family history.
Other triggers are a high waist circumference, high blood pressure and high levels of triglycerides in the blood.
Complications, including blindness, kidney and nerve damage, heart conditions and amputations, contribute to about 10 per cent of the health-care budget, Fantas said.
Even in underdeveloped countries, the incidence of diabetes is rising, as people there embrace western lifestyles, including less physical activity, poor nutrition and increased stress.
Jennifer Sampson, clinical dietitian at the Leadership Sinai Centre for Diabetes at Mount Sinai Hospital, stressed the importance of maintaining a healthy diet, even when losing weight.
She warned against diets that promise quick weight loss (a healthy weight loss is two to four pounds a week), limited selection of foods, testimonials from celebrities and cure-alls.
A diet should include all the food groups, including carbohydrates, lots of fish, fruits and vegetables, Sampson said.
She also advised exercise – 60 minutes of light exercise daily, or 150 minutes per week of moderate exercise.