Diabetes Danger: What 200 Million Americans at Risk Need to Know.

Walter Bortz II, MD, has written three books--We Live Too Short and Die Too Long, Dare to be 100, and Living Longer for Dummies. Now, in this extraordinary new book entitled Diabetes Danger: What 200 Million Americans Need to Know, Dr. Bortz compares the diabetes danger facing America today with an out-of-control wild fire consuming both young and old and blacks and whites like a huge conflagration.

Dr. Bortz begins this insightful text with personal histories of his dad and oldest brother, who both perished early as a result of having diabetes. Through the description of his brother's illness, it is clear to see how the toll on personal caregivers is excruciating. His brother, Ford, passed on before his 49th birthday after spending his last 10 years sick and dependent on family members and friends.

The book consists of a forward by Governor Mike Huckabee of Arkansas who, himself, was diagnosed as diabetic in 2003 when he was about 300 pounds. After being told by his doctor that he was eating himself into an early grave, the Governor stopped eating potato chips, double cheeseburgers, and refined sugars and began an exercise program. He lost 110 pounds and just recently ran the Marine Corps Marathon, which was his second marathon finish in 2005.

In eight well-developed chapters, Dr. Bortz cites astonishing facts and figures. For example, there are 20 million diabetics in the U.S. today and by 2030, there may be as many as 30 million diabetic Americans. And diabetes shortens the life span by approximately 15 years.

Included in the first few chapters are a discussion of Body Mass Index and other ways to effectively measure obesity, the number one risk for type II adult onset diabetes, as well as other risk factors and a history of the disease. Dr. Bortz notes that the disease was recorded in 1552 B.C. and in 250 B.C., the word diabetes was first used. He also outlines the discovery of insulin.

Every book has a critical chapter and in this book it's chapter three. Entitled "You Can Prevent Diabetes," it discusses the importance of prevention versus treatment. Dr. Bortz covers in a point-by-point fashion the nuts and bolts of how to prevent diabetes. The message is simple--you must exercise and eat correctly--but following this advice can be extremely difficult in our advanced society.

The following chapter continues with the "prevention theme" and several large research studies are reviewed to show how diabetes affects the risk for cardiac disease and heart attacks. Additional information about therapy and proper preventions are presented.

In chapter five, "Supersize Me," Dr. Bortz talks about energy expenditure and how inactivity leads to diabetes. A better choice for a chapter title might have been "Proper Exercise to Avoid Diabetes" and it could have been combined with chapter six, which continues with the same points about inactivity.

Chapter seven returns to the analogy of the diabetes inferno and is superb.

Dr. Bortz links adult American productivity with health care costs; now we realize why General Motors is in such bad shape financially--health care costs! Caring for people with diabetes can amount to three million dollars for life. And what cost can be attached to the plummeting quality of life for an individual suffering from this disease?

In the final chapter, Dr. Bortz talks about changing behavior and the importance of providing education, opportunity, and incentives to help individuals avoid diabetes. His summary is again simple yet profound: "we eat too much," "we move too little," and "we live too fast." Education is key and a necessary first step. We must educate and urge all Americans toward incentives to avoid bad health practices.

In my opinion, Dr. Walter Bortz has once again produced a wonderful book on the state of America's health and I recommend it for any physician's or health care professional's library.

We should slow down, read this remarkably candid and accurate book about a very significant health problem facing America, then push away from our tables early and go out for a long brisk walk.

Diabetes Danger: What 200 Million Americans at Risk Need to Know by Walter Bortz II, MD. New York: Selectbooks, Inc., 2005, 156 pp. (ISBN Number 1-59079-103-7)

by Alfred F. Morris, PhD, FACSM 

Dr. Alfred Morris is the Health Improvement and Physical Fitness Director for a large federal agency in Washington, D.C., and a former marathon runner who still tries to practice eating in moderation and engage in daily aerobic exercise.