You’re driving through the Serengeti and a herd of elephants come charging toward you- danger seen. The apartment next door to yours is on fire and you can see the smoke entering your front door- danger seen. A car zooms past you on the interstate and slams into a tractor-trailer spinning out of control- danger seen. Microvascular changes diabetes is causing damage to your eyes, kidneys, and heart – danger unseen. 

The body’s reflex mechanisms perform actually pretty well when presented with threatening situations. For instance, your heart rate rises, you start to sweat, and cortisol levels go up in anticipation of the fight or flight response. I’m sure you recall that sensation if you remember that first encounter with the school bully or being chased by a vicious appearing dog in your neighborhood.   

However, if I could reconfigure human anatomy, I would design our brains to also react to the less than obvious signs of danger like obesity, hypertension and diabetes. Those same physiological changes that occur in the aforementioned examples would also occur when we ignore early warning signs of certain diseases.   

In the US, more than 72 million people are obese. Obese patients spend a little over $1,400 more on medical costs than individuals with normal weight. Currently, no state has an obesity rate less than 15 percent, which is the national goal.   

How did this happen? One component of the problem is related to the increase in dietary intake of sugars and processed foods in addition to the lack of physical activity. And let me be clear, it is not fat-shaming to bring attention to the health hazards of obesity. No, everyone is not supposed to be skinny, but having a weight proportional to your height is appropriate and it is recommended for optimal wellness. 

Therefore, in my imaginary world, every time the scale started tipping toward a body mass index (BMI) of 30, an internal alarm would fire with a message similar to the emergency broadcasting alert: “Warning: you are in danger! Seek assistance immediately!” 

Medical students who rotate through my office are often overwhelmed by the sheer magnitude of the number of patients with hypertension. Unfortunately, because of the obesity epidemic among children, the students also see a lot of young patients with high blood pressure as well. One out of every three American adults has high blood pressure, roughly 70 million people. Only half of those individuals have their blood pressure under control. Days missed from work, medications to treat high blood pressure, and the medical services needed all contribute to the $46 billion this nation spends yearly on hypertension. 

Blood pressure should be checked regularly and for the majority of adults, normal is 120/80 or less. Extra weight, smoking, lack of physical activity, alcohol, and high-salt foods can cause blood pressure to rise. A person who has on more than one occasion a blood pressure of 140/90 or more is considered hypertensive. But again, in my imaginary world, when blood pressure reaches 130/90, the alarm sounds: “Warning, you are approaching danger.  Seek assistance immediately!” 

Per the CDC, every five minutes, two people die from diabetes-related complications and 16 adults are newly diagnosed. Diabetes can cause symptoms like increased thirst, increased urination, fatigue, and frequent vaginal infections. However, it is not uncommon for patients to present to the doctor for a totally different reason and incidentally be diagnosed with diabetes. It has occurred in my practice on many occasions and blood sugars during those times were in the 400s-500s. 

The damage that ensues with diabetes may not be appreciated initially. You could be asymptomatic until that first heart attack or stroke. At that point though, the destruction is done. Future care is aimed at preventing the next medical catastrophe. Intervention obviously needs to happen prior to such events. I am suggesting the lighthouse approach with the flashing lights and bullhorn: “Warning: you are in danger! Seek assistance immediately!” 

I realize my fictitious remedy will probably not come to fruition, but there are some simple things that can be done before negative outcomes occur.  

  1. Get regular check-ups and blood work
  2. Maintain a healthy weight
  3. Exercise regularly
  4. Listen to your doctor and follow his/her recommendations
  5. Instead of spending hours watching mindless TV or reading Facebook posts, go online and read about diabetes or hypertension.

Yours in Service,

Denise Hooks-Anderson, M.D.

Assistant Professor

SLUCare Family Medicine

yourhealthmatters@stlamerican.com

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