Our junkfood society has done more than turn a lot of us into junkfood addicts. It seems to have turn some of us into diabetics.
This doesn't mean, of course, that anybody who eats junkfood is going to get diabetes. It does mean that a lot of people who have inherited a susceptibility to diabetes may have it hurried along by the good old American junkfood way of life.
What we're talking about here is not the more serious form of diabetes known as insulin-dependent or juvenile-onset diabetes. The diabetes associated with overweight and bad eating habits usually strikes after the age of 35 and is known as adult-onset diabetes. It is considered less serious than the insulin-dependent form because in most cases it is almost completely controlled by diet and weight loss, usually without insulin or other drugs.
Most of its victims are fat (perhaps as many as 80 percent) and often grossly so -- 100 or more pounds overweight -- and have atrocious eating habits which they've maintained for years. Over-weight women are 10 times as likely to contract diabetes as others. The greater the number of pounds over weight, the greater the likelihood of diabetes.
If their disease remains uncontrolled, adult-onset diabetics share the gloomy prognosis of their juvenile-onset cousins: They are 25 times more prone to blindness (in fact, diabetes is the No. 1 cause of new blindness), 17 times more likely to get gangrene (sometimes requiring multiple amputations) and twice as likely to get heart disease as nondiabetics. Older victims tend to have additional circulatory problems, such as high blood pressure.
Despite considerable research, and most recently the discovery of a viral link, the immediate prognosis for those with juvenile-onset diabetes (which can strike at any age, despite its name) is less than wholly optimistic.
But in more than 90 percent of the cases of adult-onset diabetes, a nutritionally sound, low-calorie diet and accompanying weight loss will eliminate all signs and symptoms and forestall complications and side effects. (Of course, if the lost weight is regained, so is the diabetes, which is why doctors don't flat out call it a "cure.")
There are probably about 10 million diabetics in this country, about 80 percent of whome have adult-onset diabetes. Women are 50 percent more likely than men to get it and non-whites about 20 percent more likely than whites. Poor people are more prone than rich. Because the symptoms creep on -- much as added poundage does over the years -- adult-onset diabetes is often discovered by accident, by dentists, perhaps, or ophthalmologists who spot certain signals or changes, or sometimes not until one of the inevitable complications sets in.
As diet and weight loss are more and more the preferred treatment for this illness, and as the number of sufferes cntinues to soar, increasing at a rate of about 6 percent a year, nutritionists and dieticians are discovering that it is a lot easier to tell someone to revolutionize a lifetime's eating habits than to get them to do it.
It is even harder, when dealing with the group most prone to the disease: the poor, non-white, poorly educated, often illiterate or non-English speaking man, or more often, woman, with the least capacity to understand the ominous nature of the illness.
"I feel I've accomplished a lot if I can just get my patients to stop buying potato chips," sighed a clinical research nutritionist.
Taking its lead from some trail-blazing work being done in the drug-free treatment of adult-onset diabetes by Dr. John K. Davidson at the Diabetes Clinic of Grady memorial Hospital in Atlanta, the American Diabetes Association is preparing bulletins geared to special ethnic groups. (These are also, of course, used in cases of juvenileonset diabetes where, even with insurlin, diet still can take on life-and-death proportions at almost any instant.)
A vegetarian diabetic "exchange list" for diabetic vegetarians is available now from the organization's D.C. area affiliate in Silver Spring. One incorporating traditional Jewish foods also is available and another for oriental foods is near completion. Yet another, geared principally to black Americans, is being researched at Howard University under the supervision of Ruby Cavanaugh, chief dietician for the Howard University Hospital Outpatient Clinic.
Once the doctors have diagnosed the adult-onset diabetic, it is Mrs. Cavanaugh's task to take the medical records and the lab reports and "set up a menu (for each individual) that will keep them happy." Her patients at the Howard clinic are mostly Puerto Ricans, West Indians, Cubans, Chinese and blacks, "most either indigent or with severly limited incomes."
"First," she said, "we try to find out what they like to eat, when they eat and where they eat and then we keep their cultural backgrounds in mind.
"If we just say to a Southerner, 'You can't cook turnips and turnip greens with fatback,' they won't pay any attention. But if you show them they can cook it up with safflower oil and half a teaspoon of Bacos for flavor, they'll find out it has that 'downhome' cooking flavor."
"So," she said, "we have tasting parties where we teach patients, for example, that fish poached with tomatoes and celery and green peppers and onions" us as good as fried.
Literally spoonfeeding the diabetics she sees into healthy -- and economical -- eating habits Mrs. Cavanaugh becomes teacher, guidance counselor, taskmaster and confessor to her patients. She teaches them about "the sugar you can't see" (in orange juice, for example), has pictures and food models for those who can't read, conducts "chopping-time" to teach them to make turkey salad out of lean (and cheap) turkey necks and now is collecting her "goodies," as her patients call them, for the benefit of the larger community.
"Sure, it's hard sometimes," she said, "but once they know they can like it," they'll stick to it.