RALEIGH — Joe Gosselin of Raleigh is working hard to avoid becoming one of the 643,000 people in North Carolina with diabetes.
Three years ago when Gosselin was 61, his doctor at SAS, where he works as a computer programmer, told him he was overweight and pre-diabetic. The condition, marked by elevated levels of sugar in the blood, afflicts tens of millions of adults in the U.S., including an estimated 376,000 in North Carolina.
It is among the leading lethal consequences of obesity.
Gosselin, who weighed 230 pounds at 5 feet 10 inches tall, was grateful for the early warning of trouble ahead. Actually, research shows, a lot had already gone wrong inside his body over a long time, although scientists are only beginning to understand and identify some of the earliest indications of problems.
Researchers in North Carolina and elsewhere hope that earlier detection of type 2 diabetes could save lives and money. In North Carolina alone, the disease leads to 8,400 deaths a year and $5.3 billion in medical expenses. Especially at the stage of Gosselin's high blood sugar, diet and exercise can restore health.
As they delve into the origins of diabetes, scientists at UNC-Chapel Hill, Duke University and East Carolina University are following different paths, forging beyond the starches and sugars most often considered the bad actors in diabetes. Instead, they are finding that gobs of fats and proteins appear to instigate many of the early cellular malfunctions associated with diabetes, particularly when combined with little or no exercise.
The problem is excess. Even in the Atkins diet, which emphasizes eating fats and proteins over carbohydrates, calories are restricted. So a day that starts with sausage biscuits, includes a biggie burger and fries for lunch and ends with a big plate of lasagna for dinner would need to be accompanied by a similarly huge amount of exercise to balance out.
"We're living sedentary lifestyles, eating Western diets high in fat and animal protein, and it's the worst combination of things," said Dr. Svati Shah, a cardiologist at Duke who is examining early markers that signal distress in the metabolic system. "That could be explaining some of the explosion of diabetes in America."
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