Diet or Die

The U.S. death rate from diabetes is still going up and has been going up alarmingly since 1900. The death rate for 1940 is three times as great (27 deaths per 100,000 population) as it was 40 years ago, and last week the Census Bureau reported it was still rising. Even more striking: the diabetes death rate is now 68% higher than in 1922, when insulin was discovered by Toronto's late Sir Frederick Banting and diabetics were presumably given a new lease on life.

The disease has risen from 27th to 10th place among causes of death, and it is now killing more older women than tuberculosis. From 2% to 3% of all living Americans will eventually die of diabetes.* What is the explanation? Why are more & more people unable to use or store the sugar in the food they eat? To a very slight degree this rise is a statistical illusion. In the last 40 years more people have been going to doctors, and more doctors have begun looking for diabetes. In the past diabetes was sometimes overlooked as a cause of death, but statistics have become increasingly reliable.

Even so, Dr. Elliott Joslin of Harvard, probably the No. 1 U.S. diabetes expert, and Statistician Louis Dublin of Metropolitan Life Insurance Co. warn that the rise in diabetic death is real. For insulin neither cures nor prevents diabetes. It has saved the lives of most diabetics under 45, prolonged the lives of those over 45. But insulin, observes Dublin, does not confer immortality. Sooner or later diabetes becomes complicated with other diseases like pneumonia, cancer, hardening of the arteries, etc. Diabetics are especially susceptible to gangrene (the tiniest infections are dangerous) since their blood vessels are often blocked with deposits of fat.

Diabetes usually sets in after 40. Since 1900 child mortality and deaths from infectious diseases have dropped steadily, so that more people survive into middle age. In 1900, 23.4% of the population was over 40 years. In 1940 the proportion reached 33.2%. Thus, by an irony of medical progress, more potential diabetes victims exist.

Diabetes also increases as the standard of living rises. Labor-saving machinery relieves more & more people of heavy food-burning physical work, and food itself becomes more abundant. Large amounts of food (especially sugar) burden the pancreas. This organ secretes insulin to burn up and store carbohydrates, which have been digested to sugars. If an individual inherits a tendency toward diabetes, his hard-pressed pancreas may slow down or stop producing insulin. Out of every 20 diabetics more than 40 years old, 17 were overweight before the disease appeared.

Says Dr. Robert Loeb of Columbia: "When overnutrition is abolished in a community, the incidence of diabetes is decreased." Thus the U.S. diabetes death rate slumped in 1918-19 when sugar was scarce, but sugar consumption alone is by no means responsible for the diabetic death rate (see chart). Diabetic deaths dropped dramatically in Germany from 1917 to 1924--starvation's silver lining.

Tragic fact is that the rising death rate from diabetes is by no means inevitable and is needlessly high. Many sufferers can forestall a diabetic death by following a diet prescribed by a physician. It is significant that diabetic doctors die of the disease only one-fourth as often as diabetic laymen.

* Diabetes is more than twice as common among Jews as among Gentiles. Reasons: 1) the incidence of heredity is higher among them, 2) Jews tend to be fatter than other peoples.

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