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| |  AACE: Diet And Exercise Improve Diabetics’ Quality Of Life JACKSONVILLE, FL -- January 14, 2000 -- Richard A. Dickey, MD, FACP, FACE, President of the American Association of Clinical Endocrinologists (AACE), states that, "AACE has long been an advocate for exercise and its many benefits, especially for the diabetes patient, the overweight or obese patient and other people with the insulin resistance syndrome." In the AACE Patients First Diabetes Public Initiative in October 1999, besides 13 to 15 million Americans with diabetes, AACE stated that 60 million Americans are overweight or obese and at risk for diabetes. More than half of these will face cardiovascular disease and such complications as heart attack, stroke or sudden death. The study, published in the January 12th issue of the Journal of the American Medical Association (JAMA), examines what role insulin resistance and elevated insulin levels play in cardiovascular disease. Most obese patients have increased insulin levels due to an insulin resistant state. About one quarter of them are likely to develop diabetes. These patients can benefit from exercise, which can help lower their weight and blood pressure, help maintain their loss of weight, reduce their insulin resistance and insulin levels, and lower their risk of strokes and heart attacks by lowering their PAI-1 antigen level. Exercise may lower cardiovascular risk through a reduction of insulin level and PAI-1 level. The study showed that non-diabetics (people with the insulin resistant state) with increased insulin levels also have elevation of PAI-1 antigen, as do patients with diabetes mellitus. PAI-1 antigen reduces the body's ability to dissolve clots. Higher insulin levels, associated with overweight and obesity where an insulin resistant state is usually present, may cause an increase of PAI-1 antigen levels. This increases the risk for heart attack and stroke. "We can avoid a costly Type 2 diabetes epidemic in the 21st century if patients are taught the importance of proper nutrition, physical activity, and the use of new drugs, medical devices and applications of genetic research," said Dr. Dickey. Also, Dr. Dickey stated that, "AACE recently published its diabetes guidelines, 'AACE Medical Guidelines for the Management of Diabetes Mellitus: The AACE System of Intensive Diabetes Self-Management - 2000 Update,' which recommends that Type 2 diabetes patients be taught intensive diabetes self-management. The AACE guidelines state that in type 2 diabetes, nutrition and exercise can help maintain near-normal blood glucose and optimal lipid levels, achieve desirable weight, and improve physical condition. "The guidelines further state that these interventions, control of blood pressure and use of appropriate medication including new insulin sensitizing drugs have been inadequately emphasized, and patients have not adhered to physician recommendations. The guidelines recognize the relationship between diabetes and cardiovascular disease and that most diabetics die from cardiovascular disease and rather than diabetes. The guidelines were written by an AACE task force headed by Stanley Feld, MD, FACP, MACE, which included such noted endocrinologists such as Om Ganda, MD, FACE of the Joslin Diabetes Center in Boston.
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