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A few years ago, I was with a friend at Camp Zama powerwalking around the football field. Normally, this was an easy fitness schedule to maintain. We were both attempting to control our weight and lose weight. Gradually, my walking partner began feeling increasingly fatigued, more thirsty than usual, he was becoming more irritable, and needed to make more stops at the restroom. No one likes to be analyzed, but, in graduate school I studied Rehabilitation Medicine. Then the “Big Aha” moment: We have a problem, Houston.

I suggested a quick blood test and minor health check. Sure enough: Hypoglycemia, or low blood sugar. It happens when the level of sugar or glucose in your blood drops too low to fuel the body. My friend had many of the warning signs of diabetes. "Many people can just fool themselves and say, ‘I don't have it’,” says Marilyn Ritholz, a psychologist at the Joslin Diabetes Center at Harvard University. Like many sturdy cowboys, my friend was in total denial.

Diabetes is the seventh leading cause of death in the U.S., affecting more than 6 percent of Americans. Currently, medical care is aimed at controlling blood sugar, blood pressure and lipids, to reduce vascular complications. Smoking cessation, healthy eating and adherence to prescribed medications are important behavioral aspects of diabetes management, according to Psychology Today.

Chronic diabetes is split into Type 1 or Type 2. Type 1 diabetes is an autoimmune reaction that attacks cells in your pancreas that produce insulin and is caused by inherited genetics or environmental elements. Type 2 diabetes happens when your body becomes resistant to insulin and is associated with genetics and lifestyle choice. Type 2 diabetes accounts for 90 percent of diabetes in the U.S. and is associated with increased age, obesity, and a sedentary lifestyle. More than 80 percent of individuals with Type 2 diabetes are overweight.

Prediabetes and gestational diabetes are other related conditions but could be reversible. Prediabetes is a precursor to diabetes and occurs when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes. Appropriate measures are required to prevent prediabetes from progressing. Gestational diabetes occurs during pregnancy but may resolve after the baby is delivered, WebMD reports.

My friend’s hypoglycemia diagnosis meant giving up three packs of cigarettes a day, adios to double cheeseburgers with bacon and fries and a six pack of beer a day. At the hospital I asked: “Do you want to be healthy or sick? Do you want to live longer or die sooner?”

I did not have his lifestyle habits, but he needed guidance if he was to live a healthy lifestyle. However, focusing on diabetes prevention may be more effective than focusing solely on treatment. Changing people's behavior is key. In fact, Finnish researchers found that subjects who shed just 10 pounds and increased their physical activity by approximately 30 minutes per day reduced their risk of Type 2 diabetes.

The return drive from Yokosuka Hospital was a somber 54-kilometer ride to Camp Zama. Several studies suggest that changing behavior can affect diabetes risk. In the Finnish Diabetes Prevention Study, 522 middle-aged overweight adults with impaired glucose tolerance were counseled for diet, physical activity and weight change, leading to a 58 percent reduction in risk of developing diabetes. Overweight individuals who are at risk for diabetes should work to achieve modest weight losses and gradually increase their physical activity. I asked my friend the risk-to-reward for modifying his behavior or correcting bad habits.

After a few quiet kilometers, we began discussing food fixes. None of the ideas he liked, but the goal was eating for nutrition, not comfort-food eating while watching television and reducing sugar.

Changing our diet is a better alternative to relying on medication, Richard A. Anderson, a lead scientist for the USDA suggests. For this, my friend’s shopping list would have to change. We added tea like black, green or oolong, since these contain polyphenols which boost insulin activity. We added cinnamon as half a teaspoon daily has shown benefits in increasing sugar metabolism in fat cells. Buckwheat, like that used to make soba noodles, was another one on the list because it contains chemical compounds that reduce blood sugar levels. Cherries, which contain anthocyanins which increase insulin production, guava, which lower blood-sugar levels and cocoa, which decreases insulin resistance, all went on the list as well.

My friend made the decision to live longer. On his desk and in his car, photos of his wife and three kids were a reminder. He went from a size 40 waist to a size 36. He lost 35 pounds and is still losing weight and getting fit. Now, he calls me, asking about the risk-reward of maintaining my health; “forcing” me to join his power-walks and going to the gym. Before, I just suggested walking, then he added the gym. Grrr.

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Hilary Valdez is a retiree living in Japan. He is an experienced Mental Health professional and Resiliency Trainer. Valdez is a former Marine and has worked with the military most of his career and most recently worked at Camp Zama as a Master Resiliency Trainer. Valdez now has a private practice and publishes books on social and psychological issues. His books are available on Amazon and for Kindle. Learn more about Valdez and contact him at www.hilaryvaldez.com or at InstantInsights@hotmail.com.

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