The Paunch: an inevitable and yet ultimately innocuous fact of life eventually facing most men in the world, you might think. But as you notice that slight thickening of the waist and dimpling around the kidneys, a chemical process is underway with the potential to change your life, if you ignore it.


Although you don’t know it yet, that spreading midriff is poisoning your metabolism and may, by the time you hit your mid-forties, have set you on the road to a premature death from the irreversible complications of the world’s current invisible epidemic: type-2 diabetes.


This is just a warning. It is not meant to alarm, merely cause you to take note – and action. If what you are about to read causes concern – and it should – then console yourself with the knowledge that you can do something about it before it happens. The thing to remember with diabetes is that, perhaps more than any other disease, it’s down to you.


Have you noticed you’re buying jeans with a bit more room? The first signs are relatively mild. A 37-inch waist or more and you could be joining the ever-swelling ranks of diabetics – now an unnerving two hundred and fifty million, with many of them undiagnosed. About 80 percent will die from heart attacks or strokes, thousands a year will go blind, while many will suffer kidney failure.


By 2025, the World Health Organization predicts the number of diabetics worldwide will reach 400 million. Each year, the disease claims more lives than breast cancer or Aids, and is the fourth most common cause of death in developed countries. It is without doubt the world’s most alarming – and yet ultimately preventable – health crisis.


So what is happening? As your nascent gut gradually expands, toxic fatty acids (that’s beer and burgers) radiate from within, lowering ‘good’ HDL cholesterol levels and materially changing the structure of arteries, which can contribute to high blood pressure. What’s more, your burgeoning midriff is among the causes of ‘insulin resistance’, where the hormone fails to properly convert blood glucose into energy, leaving levels dangerously high.


The pancreas goes into overdrive to produce more insulin. Already, 10 years before your type-2 diabetes is diagnosed, you are displaying four of the defining characteristics (obesity, low HDL cholesterol, high blood pressure, insulin resistance) of ‘metabolic syndrome’ – the condition that puts you at risk of developing the world’s fastest-growing illness. Then, as you age, the continual assault of toxic compounds on your pancreas reduces its ability to produce enough insulin – known as ‘insulin deficiency’.


As you near 45, it stops and pancreas cells begin to die. Although diabetes can often be prevented, it remains incurable despite vast medical resources. Most money goes on managing the illness with tablets or self-injected insulin, regular monitoring for deterioration, hospital aftercare for those who have ‘hypos’ (dangerously low blood sugars) and surgery when things go wrong.


A pioneering treatment – islet cell transplantation – is now available, in which insulin-producing beta cells from a donor are injected into a (type-1 only) diabetic’s liver. However, this is only suitable in certain cases and the potential side effects (including deterioration of kidney function) mean it is recommended only for seriously ill patients.


The problem is that the tell-tale symptoms of this silent epidemic often go unnoticed until it’s too late. Tiredness, thirst, frequent urination and infections as the glucose levels in your blood rockets are all indicators. You don’t bother going to see a doctor because, as a typical man, you don’t want to make a fuss. But by the time you do, your body has been ravaged by an invisible disease for a decade and the damage has been done.


Frightening, isn’t it? Well, yes; but it needn’t be – not if you follow the simple steps to protecting yourself. They involve a more sensible diet and exercise regime – it’s that easy. And if you’re unlucky enough to develop diabetes despite taking these steps, it needn’t ruin your life. The boxer Sugar Ray Robinson was diabetic, as are cricketer Wasim Akram, the golfer Jack Nicklaus and ex-Bafana Bafana striker Shaun Bartlett. Britain’s greatest ever Olympian, Sir Steve Redgrave, still managed to pick up a few gold medals despite being a sufferer.


Type-2 diabetes is caused by many malfunctions, imbalances and deficiencies, a lot of which can be attributed to modern living. The only treatment is a change in lifestyle. You can treat type-2 diabetes with lots of exercise and no tablets or insulin at all – so, if you’re fit, you can make much better use of the small amount of insulin you actually have. If that insulin is not really working and your blood sugars are high, and then you add exercise, they will come back to normal. Exercise is the treatment and the prevention.



Exercise also helps keep diabetes at bay or under control by regulating glucose levels and preventing blood pressure from rising. Diabetics should get advice from a doctor about precisely the kind of exercise that is best for them before starting any exercise program. Light running, swimming and walking are all heartily endorsed. As is spreading your activities out over the week – half an hour every day is far more beneficial than one three-hour sweat session once a week.

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