Hallym University Sacred Heart Hospital

- Expert opinion on the causes and the latest medical treatments
- Life style & inheritance account for 70% & 30%, respectively, of cause of diabetes
- The earlier, the better: You have to take medicine and change your life-style

*Drs. Byung-Wan Lee, Eun-Gyoung Hong and Per-Ola Carlsson(from left) discuss diabetes in Seoul.

The prevalence of type 2 diabetes (over 30 years old) is about 10%. Many call it 'A Diabetes Crisis.' On the other hand, that of Sweden is only 3~4%. Moreover, this value hasn't changed for years. Hallym University held an International Collaborative Symposium with Uppsala University, Sweden on October 9 in Seoul, to which Dr. Per-Ola Carlsson, a specialist of diabetes in Uppsala University, was invited. Drs. Byung-Wan Lee and Eun-Gyoung Hong, faculty of Hallym University College of Medicine, shared their views on the latest information on diabetes.

• The development of diabetes made by inheritance and life-style = Even though the western meals mainly cause diabetes, why do the Swedish people have much less prevalence of diabetes than Koreans?

Dr. Carlsson said, "I think there is a genetic variance. The western people have been used to eating meat and high-calorie, high-fat meals for hundreds of years. On the other hand, the Oriental people, who have had low-fat meals, switched suddenly to high-fat meals, which constitutes a cause for such a sharp rise in prevalence of diabetes." Not only a fragile genetic background (DNA) of Koreans, but also an unfamiliar life-style has lead to an increase in diabetes.

"The Sweden government held an anti-smoking campaign and kept a smoking rate under 10% among the Swedish population, decreasing the prevalence of diabetes in Sweden," he added.

Western Samoa shows the highest prevalence of diabetes. 80 to 90% of the whole population has type 2 diabetes as their food-intake and obesity population have suddenly been increasing. Dr. Carlsson calls it 'A Disaster."

He also emphasized, "If there is a diabetes patient in one's family, everyone needs to help change his or her life-style to have traditional meals and do more exercise."

Dr. Lee said, "About 70% of the cause of diabetes comes from a life-style, and about 30% comes from one's genetic background."

• You have to take medicine at the early stage of diabetes = In the past, when people got diagnosed as a diabetes, they were asked to change their life-style. When a glucose level was not be regulated, even after two months of life-style modification, then patients were asked to take medicine. And insulin was the final step.

Dr. Hong said, "Such a previous medical treatment has helped an insulin secretary function of a pancreas eventually exhaust not in a long-time, making the glucose level hard to regulate, and the percentage of getting diabetic complications increase. With this evidence, taking medicine actively from the start is a recent way to cure diabetes." The American Diabetes Association (ADA) also recommended in 2006 that patients change their life-style and to take diabetic medicine upon learning the examined results.

Dr. Lee advised, "In every 2 or 3 months, you'd better check hemoglobin A1c, and if it cannot be lowered than 6.5%, take a metformin, sulphonylurea (insulin secretagogue), glitazone (insulin sensitizer) and insulin injection."

• If you hope for longevity, you have to prevent cardiovascular complications = Diabetes is a manageable disease, and if you are keep of some important points in mind, you may expect a long life. Quitting smoking, moderation in drinking, weight reduction, regular exercise and routine health examinations are among them.

The first mortality cause of diabetes is a cardiovascular disease. "A diabetes patient can suffer from a cardiovascular disease, such as myocardial infarction, 3 to 5 times easier than a normal glucose tolerant person," said Dr. Hong. "The percentage of getting an ischemic heart attack (25~30%) is higher than getting an ischemic cerebral attack (10~20%)." The reason why a diabetic cardiac disease is fearful is that it cannot be detected by a routine examination. Therefore, preventing it is the best way.

"You would better usually eat brown bread (whole grain bread) or hard bread which has a low glycemic index, and do a glycemic control and keep a blood pressure within a rage of 130/80, and keep taking anti-lipid, anti-coagulants," Dr. Carlsson advised.

By Seung-Kyu Oh, Int'l Operations Team, HUMC