Interview with Dan Hurley

Diet Detective: Why focus on diabetes?

Diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations and nerve damage. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) reports that more than 23 million people, or nearly 8 percent of the U.S. population, have type 1 or type 2 diabetes, and both types are on the rise. Diabetes is a metabolic disorder affecting the way the body uses and digests food. The food you eat is broken down into glucose and circulated in the blood as sugar - the body's source of fuel. Once there is sugar in the blood, insulin (produced by the pancreas) moves the glucose/sugar from the blood into the cells. If you have diabetes, however, your pancreas produces less or no insulin. Then, according to the NIDDKD Web site: "Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose."
In his new book, Diabetes Rising, medical journalist Dan Hurley sheds some light on this mysterious disease. 
 
Diet Detective: Why focus on diabetes? 
 
Dan Hurley: I have had type 1, or “juvenile,” diabetes since 1975, and I simply got sick and tired of reading and seeing so much information that is outdated and/or dead wrong. The main message we hear over and over again is that diabetes is totally manageable if you just take care of yourself, so any problems that develop are your own fault. And that’s a terrible lie. Diabetics walk around feeling guilty for “screwing up” all the time. The truth is that diabetes is a nightmare to manage, and all a person can do is try his or her best. I’m not being negative; I’m just being honest.
 
Diet Detective: How big a problem is diabetes?
 
Dan Hurley: Huge and growing. Type 1 diabetes is now twice as common as it was in the 1980s, five times more common than in the 1950s, and 10 times more common than a century ago. It continues to increase at 3 percent per year. As for type 2, or what used to be called “adult onset,” it’s now projected that 33 percent of all boys and 39 percent of all girls born in the year 2000 will develop diabetes in their lifetime. With all the fuss over H1N1, only about 10,000 deaths around the world have been officially attributed to it so far, whereas 1.1 million people die of diabetes every single year.
 
Diet Detective: What are the two types of diabetes?
 
Dan Hurley: Cars run on gas; bodies run on glucose -- the sugar in your blood that supplies every cell with energy. But glucose can’t get into those cells without insulin, the hormonal key that unlocks the cell walls. In both kinds of diabetes, too much glucose is floating around in your blood with nowhere to go, causing what’s known as a high “blood-sugar” level. The causes of the two types of diabetes are very different. With type 1 diabetes, your body stops producing insulin because of an autoimmune attack in which white blood cells in the immune system target and destroy the insulin-producing cells in the pancreas. Type 1 diabetics must take insulin for the rest of their lives. With type 2, as your weight and age increase, your body develops resistance to normal insulin levels, and your insulin-producing cells slowly grow weaker and weaker. Many people can prevent or reverse the early stages of type 2 through diet or exercise. When that doesn’t work, pills are often necessary, and sometimes insulin.
 
Diet Detective: If diet, insulin or pills can treat diabetes, what’s the problem?
 
Dan Hurley: The treatments hold diabetes at bay, but they don’t “cure” you. Most diabetics still have higher blood-sugar levels on average than people without the disease. The result is serious damage to your eyes, the nerve endings in your feet, your kidneys and your heart. In fact, diabetes triples your risk of heart disease. Keeping your blood-sugar levels as near to normal as possible lowers these risks.
 
Diet Detective: Does eating sweets cause diabetes, as many people believe?
 
Dan Hurley: That is a terrible myth. Neither kind of diabetes is caused by sugar. It’s true that eating something sweet can raise your blood-glucose level quickly, but then so can eating a plate of french fries or even eating a banana. People get obsessed with the idea that if they just avoid sugar, everything will be fine. It’s far more important to watch your total calories, and in particular your total intake of carbohydrates.
 
Diet Detective: So why does type 2 diabetes occur?
 
Dan Hurley: There’s no question that the older and heavier you are, the greater your chances for developing type 2 diabetes. But there is also a strong genetic link, so if your brother or mother has it, you are more likely to get it. And studies have shown that exposure to common pollutants also strongly raises your risk.
 
Diet Detective: What are the most plausible theories for why type 1 diabetes is increasing, based on your investigation?
 
Dan Hurley: Decades of research have established that type 1 is an autoimmune disease. Figuring out why it’s increasing means asking what could be triggering the autoimmune response. One possible trigger is that kids who develop type 1 diabetes seem to be, on average, slightly taller or heavier than kids who don’t develop it ­ not obese; just a little bit bigger than average. That surprises many people, so let’s be clear: Nobody is saying that weight “causes” type 1; plenty of thin kids get it, too. But some researchers do believe that our overall trend toward increasing size over the past century is linked to the rising rate of type 1. Another possible factor is our low levels of vitamin D, the “sunshine” vitamin, because we all spend so much less time outside than people did years ago. Yet another possible factor is feeding infants baby formula rather than breast milk. Kids who were given formula with cow’s milk or soy milk in the first six months of life seem to have a slightly increased risk of getting type 1. (“Highly hydrolyzed” formula, available at most stores, avoids this risk.) All these theories are being aggressively investigated.
Diet Detective: Can you explain this part of the subtitle, "How a Rare Disease Became a Modern Pandemic"?
 
Dan Hurley: Since ancient times, and as recently as the Civil War, diabetes was so rare that doctors could go their whole career without seeing more than one or two cases. When insulin was discovered in 1922, doctors thought it was a cure. But the number of people diagnosed with the disease, and dying due to it, has continued rising ever since. Type 2 has now reached epidemic levels in almost every country in the world, which is why doctors now call it a “pandemic.” It’s especially troubling when you consider that rates of every other major disease, including cancer and heart disease, have been slowly but steadily dropping.
 
Diet Detective: Can a person cure type 2 diabetes by following a good diet?
 
Dan Hurley: It’s possible, but difficult. We’re living in what I call a “diabetic nation,” where it’s easy to snack and eat junk food, and hard to find the time to get out and be active. And let’s get real: People who were couch potatoes for the first 40 years of their lives are going to find it hard to change their ways. You can usually hold type 2 diabetes at bay for a while by going on a modest diet and getting more active. But long term, it will just keep getting tougher and tougher. That doesn’t mean you shouldn’t try. But it’s important to recognize what you’re up against.
 
Diet Detective: So are you saying that many people do not take their diabetes seriously enough?
 
Dan Hurley: My experience is just the opposite ­ most people with either type 1 or type 2 diabetes get consumed with worry and guilt. They try and try ­ and feel like failures. We need to stop putting the blame on individuals and start working together as a society. To prevent type 2 ­ and improve our overall health ­ we need to change our communities, make sure sidewalks and bike lanes are available, put well-lit, inviting stairways in malls, offices and airports so that exercise becomes part of our normal lives. If healthy food were as cheap and convenient as fast food, more people would eat it. Throwing pills at type 2 diabetes is not going to fix it. We need a lifestyle revolution.
 
Diet Detective: Meanwhile, is there a diabetes cure coming? Or is management our only hope in the next five to 10 years?
 
Dan Hurley: If you have ever heard the sports term “winning ugly” you’ll understand what I mean when I say that, right now, there are some “ugly” cures for both kinds of diabetes. As drastic as it sounds, bariatric surgery on the intestines has been shown to “cure” type 2 diabetes in a matter of days or weeks, even before the person loses weight. It’s not for everyone, but for some it beats a lifetime of pills and struggling. And for type 1, researchers have now developed an electronic “artificial pancreas,” an external device the size of an iPod that senses your blood-sugar level and automatically gives you only as much insulin as you need. I participated in a clinical trial of this device last year, and it’s totally amazing. FDA approval of at least a preliminary version of the artificial pancreas is expected in the next two years.
 
Diet Detective: You mentioned that vitamin D and exposure to sunshine might lower the risk for type 1 diabetes. Should we be taking supplements? Baking in the sun? Please explain.
 
Dan Hurley: Studies have shown that the closer you live to the equator, the lower your chances of developing type 1 diabetes. And children are more likely to get diagnosed with type 1 in the winter, when there is less sun than in the summer. So if anyone in your family has had type 1 diabetes, vitamin D supplements are something to consider, in consultation with your physician. As for sunshine, it’s always healthy to get out in the fresh air.
 
Diet Detective: What is the biggest secret that health care professionals are not telling us about diabetes?
 
Dan Hurley: The biggest secret is how hard diabetes is to control. Doctors act like you’re just being naughty and willful if your blood-glucose level goes high. But I know from personal experience that watching every bite of food you eat is a real pain and drives us diabetics crazy.
 
Diet Detective: You suggest that focusing on "personal responsibility alone has not stopped, and will never stop, the rise of diabetes. ..." Can you please explain?
 
Dan Hurley: I don’t mean to say you should do whatever you want and ignore the risks associated with diabetes. I jog, I watch my weight, I test my blood-sugar levels frequently ­ I do everything I can to stay healthy, and I encourage every other diabetic to do the same. But we’re all in this diabetic nation together. Blaming the victim only adds insult to injury. It’s time we worked together to make our communities healthier places, so that living well becomes the default option.
 
Can you tell us a bit about your health habits?
 
Diet Detective: What’s your favorite healthy ingredient?
 
Dan Hurley: Raw asparagus. It’s not as expensive as it used to be, and it’s so healthy and refreshing ­ as crunchy as potato chips.
 
Diet Detective: If you could eat one unhealthy food whenever you wanted without gaining weight, what would it be?
 
Dan Hurley: My wife’s pecan pie is to die for. Heaven help me, resistance is futile!
 
Diet Detective: What’s your favorite “junk food?”
 
Dan Hurley: Sometimes I buy a box of Goobers at the movie theater. At least it’s dark, so nobody can see!

 

This was interesting.  I'm curious as to how many  T1's out there were slightly taller or heavier than the average.  I know my daughter was on the slim side and not overally tall at all.  Plus,  how do you factor in the athletes who come down with T1.  We also live in the Gulf Coast region and my kids are always outside and or swimming.   Just some thoughts that crossed my mind when reading this.

 

Lots of good info.

 

Kim

Dan Hurley also did an interview on NPR.  The link  http://www.npr.org/templates/story/story.php?storyId=122250567 takes you right to the interview.  There is a transcript of the interview as well.  It's about 30 minutes long, but well worth the time.

We have the book at home right now and my husband and I are frantically trying to read it before it is due back at the library.

Thanks for posting this. I posted a link about his new book a couple of weeks ago, not knowing anything about him or his ideas. Some people on here seemed very upset about the thesis that slight weight gain could lead to T1. I still have no opinion on it b/c I haven't seen any actual studies, but I'm glad to see here that: 1) this guy has T1 himself and 2) he is trying to step away from the "blame the victim" mentality that many in our society (and some endocrinologists) have.

I am curious to see what he thinks is causing this "pandemic" as he calls it.  We are super healthy at home.  Have never been a family that eats junk food.  We don't do fast food, we pretty much make everything we eat from scratch.  I breast fed all my children, my youngest (dx'd dec 09) I breast fed the longest, never gave any of them cow's milk until they were 1 yr old.  I'm also curious to see what he says we need to do about it.  My daughter weighed 50 lbs at diagnosis, so weight is not an issue for her.  I'm very curious. 

Stanca,

I too breastfed my children, and we eat healthy foods and get exercise. My son, dx'd at 3.5 yrs is tall for his age but thin, but my husband and I are tall and thin. My personal interest/hypothesis is the Vit. D link. We live in northern WI, so there are long stretches of the year where the most outside time is going from the house to the car. And then in the summer, I was being a 'good mom' and slathering high SPF sunscreen on him. This to me seems the strongest track, because I know that breastfeeding rates are on the rise particularly compared to the 50/60s, but no one used sunscreen 'religiously' until the 90s, and now we are seeing increasing rates. Our family has started taking Vit D supplements (several 1,000 IU depending on age).

I also have had to examine my beliefs about doing the healthy things, like eating right and breastfeeding, they don't ELIMINATE the risk, only lower it. So there is still a chance that you can get it, that's life. But, the healthy lifestyle does make managing it easier, if you do unfortunately develop it.

The Vitamin D hypothesis is what stands out to me as well. Looking back, we didn't spend much time outside when Brandan was a baby. Then again, I feel there are several things I could have done differently to at least postpone the development of diabetes.

Hi,JDVsMom,I wish I would could go back in time and everything they even think...might lead to or cause Type1-I would try to avoid or do right.It's enough to drive a parent nutty :) Especially the mom because we carry and give birth to them.Then the parents have to raise them-no way to do everything right...Then if your child get's type 1-it's not enough that your heart breaks,stupid remarks come to add salt to the wound.If people could only expereince one minute of a parents feelings on the whole type1 issue-They would beg for forgiveness...I did not breastfed,but neither did my side of the family or my husband's side-we both come from large families.I made sure my kids played outside-I am from the South and we get many pretty days-Our diet,no I am no Rachael Ray,but we did no worse than any American diet.I would have eaten out less if I could go back...My child was not overweight,just cute,fun,outgoing,more friends the better kid.Was she taller-maybe so-a little,but her friends caught up with her.The Sunscreen-used that on pool days only.I knew kids needed the sun for vit.D-so I was in line with the thought not to block too much,But on the news you were told over and over to block your children..if not a burn in early could  cause skin cancer later in life.I also made sure my kids played in the dirt-Batt's brought this up one time on here-She was right-I have a book that backs it up.There are things that are needed in the soil and playing in it takes care of that.But today,parents have to question what is in that dirt my kids are making mud pies with.What if the soil has persticides...I am thankful that everyone is looking for the answer-may be more than one answer for the cause of Type1-but in the meantime I will always wonder what I did right or wrong that could have lead to this.Like I said my husband and myself  both come from  large families.All the kids that my brothers and sisters raised  or all the kids his brother or sisters raised..None Have Type 1,just my baby who has turned 18 and I am now starting to see that even though she has put on a positive outlook on this the best she could--The cracks are now becoming visable and I see this is taking a toll on her emotions.The doctor told us both in 10 years there would be a cure-Where is it ? The AP news has been the only thing that has raised her spirits lately and mine.Thanks JDVs mom for pointing out some things that were on my mind and I needed to talk about :)

 

Meme, I was breastfed by my Mom for ... well, much longer than most kids. I also never even tried candy or junk food. Once I got the D and couldn't candy, I was bitter at my Mom for never having the chance, lol. I think a lot of this data is general statistics, so we can beat ourselves up about it, but in reality, there's nothing we can do to cause or prevent it.

I'll admit, I now give my son a multi-vit w/ vit D. I also breast-fed him, but started giving him cow's milk and yogurt at 12 months even though some T1 Moms wait on the cow's milk for much longer. But, I'm philosophical that, while I'd be devastated if he got T1, I did my best with the information I have and now I just have to hope for the best. Obviously, by myself, I can't prevent all the chemicals that these terrible companies have put into our environment!

I doubt this really helps, just my thoughts...

:) It helps alot !!! Thanks Sarah :)

I'm not taller or heavier.  In fact, for first Holy Communion I got to the fist boy in the procession because I was the shortest!

I have my own theory as to why Type 1 diabetes is more prevelant now than ever.  The invention of insulin.  It has enabled people like me who without it would have died at the age of 19 and not had any children.  Since I was able to get insulin I had 2 children.  One had diabetes.  One does not. 

The gene is more prevalent because more people with it are able to reproduce.  Sort of the anti-survival of the fittest.

That's my theory anyway.

My daughter is short!  Only 25 percentile in height and weight...she is a little shrimp...like me--I am barely 5 ft tall. 

DDrumminMan,The nuns back then dressed in full habit-and they were tough ! :)

Good observation.  Most

t1's did not have long lifespans or good quality of life.   Something to think about.

 

Kim

Big Dan Hurley foot in mouth again. Half truths and personal pain abound...and another book sells.

[quote user="DDrumminMan"]

I'm not taller or heavier.  In fact, for first Holy Communion I got to the fist boy in the procession because I was the shortest!

I have my own theory as to why Type 1 diabetes is more prevelant now than ever.  The invention of insulin.  It has enabled people like me who without it would have died at the age of 19 and not had any children.  Since I was able to get insulin I had 2 children.  One had diabetes.  One does not. 

The gene is more prevalent because more people with it are able to reproduce.  Sort of the anti-survival of the fittest.

That's my theory anyway.

[/quote]

I love your theory. Thanks. :)

BTW, Brandan isn't tall or heavy either. He's just now up to 40th percentile.

I think DDrrumminMan is on to something.I have never thought of this being a reason ...

Hi sjwprod,I need to do my homework,because I only just heard of him because he is being brought up on Juvenation...[quote user="sjwprod"]

Big Dan Hurley foot in mouth again. Half truths and personal pain abound...and another book sells.

[/quote]