In this column four years ago, we stated that the rapid growth in the incidence of diabetes mellitus was a metabolic time bomb that was waiting to explode, brought on by, among others, "super-sizing" of America (and obviously, the Philippines and some other countries), where 90% of Type II diabetics were overweight. The causal relationship between obesity (being overweight, even only to a moderate degree) and the higher risk of developing diabetes is a medically proven fact.

Actually, 2 out of 3 (66.6%) adult Americans, and 15% of the children, are overweight. In the United States alone, there are about 17 million diabetics. Five to 10% have Type I (juvenile), and the rest, Type II (adult onset) diabetes. Before insulin was discovered in the early 1920s, type 1 diabetes had 100% mortality. In the past 10 years, there has been a 33% increase in the number of diabetic patients.

Diabetes afflicts people around the world and is now actually a pandemic. Roughly 4.6 % of the population in the Philippines (or about 3.5 million) are diabetics. Not included in these statistics are the 4%-5% who are undiscovered and about 8 % pre-diabetics, or future diabetics. All these predicted to be twice as many in two decades. More than 65% of diabetics will die of some form of heart disease or stroke. These are indeed scary statistics.

A study published in the British Medical Journal May 30, 2008 suggested that individuals "who eat a Mediterranean-style diet are less likely to develop new-onset diabetes," reported WebMD. The findings also showed that the benefit was especially more among those persons who were at a higher risk of getting diabetes (the overweight, those who had high blood pressure and strong family history, etc.) Earlier studies have established a link between Mediterranean diet and the lowered risk of metabolic syndrome, of which diabetes is a component, but this recent study is the major one which showed this specific diet to reduce development of diabetes. Other studies have also suggested that this diet may reduce the risk for myocardial infarction (heart attack) and mortality from heart attack.

"Our prospective cohort study suggests that substantial protection against diabetes can be obtained with the traditional Mediterranean diet, rich in olive oil, vegetables, fruits, nuts, cereals, legumes, and fish but relatively low in meat and dairy products," stated Dr. Miguel A. Martínez-Gonzalez (University of Navarra, Pamplona, Spain) and colleagues, who did the research.

Minimizing red meat is key in this diet regimen, and moderate intake of wine is also a feature of the typical Mediterranean diet. While physical exercise was not a part of the study, various scientific researches have found beyond any doubt that exercise is an essential preventive factor in overall health, which can significantly ward off the development and reduce the risk of cardiovascular diseases and cancer.

It is very clear that we can minimize death from heart disease and other causes, including metabolic ailments, and even cancer, by following a diet that is low in saturated fats and sugar and high in fish, fruits, legumes, vegetables and whole grains, in combination with proper weight maintenance and daily physical exercises.

According to the Heidemann Study published in the July 15, 2008 issue of Circulation, people who faithfully adhered to the Mediterranean diet "had a 17 percent lower long-term risk of premature death from all causes, and a 28 percent lower risk of death from cardiovascular disease, compared to women with a low adherence to this pattern."

Other studies have shown that early detection of the pre-diabetes stage (before obvious and full blown diabetes develops) significantly prevents the onset of type 2 (the commonest kind of) diabetes. Pre-diabetes can be treated, and cured for good, with religious compliance with the proper diet and exercises alone, without medications. Done faithfully, this regimen will bring down the blood sugar level to normal. And if adopted as a lifestyle, this discipline can ward of the development of diabetes, cardiovascular and metabolic illnesses and cancers. Minimizing these last three diseases alone, especially the Big C, are great bonuses in themselves.

Since it is incurable, diabetes is a disease best prevented. To a great extent, it can be. The myriads of complications of diabetes are far worse than the ailment itself. These morbidities are the ones that ultimately shorten the lives of diabetics by destroying vitals organs in the body, from the arteries and nerve system in the eyes, to the heart, kidneys, liver, down to the legs and feet.

In view of all these potential misery and risk to life, it behooves all of us to learn and understand all we can about this dreaded malady, to discipline ourselves, and to make the needed sacrifices to prevent us from falling victims to this painful, expensive, debilitating, and treacherous killer.