Like many uncured diseases, the effects of diabetes can be softened by some relatively simple lifestyle changes. However, one of these is something most Americans struggle with --- overweight. For years, physicians recognized that losing weight had a huge impact on the long-range prognosis for most diabetics. Unfortunately, they never communicated the magnitude of this relationship to their patients until quite recently. Being overweight and other lifestyle issues can cost diabetic patients years of life.

And the medical community wants you to be scared of diabetes -- but not too scared. Diabetes is a serious condition that can lead to blindness, limb loss, kidney failure and early death. Yet new research shows that more than half of new diabetes cases can be prevented and/or controlled with some fairly simple lifestyle changes, such as losing a few pounds.

After years of reassuring diabetics that the disease is one they can live with and manage, doctors and health workers are struggling with how to also send the message that diabetes is a deadly, terrible disease -- so that more people will be motivated to take steps to prevent it. American Diabetes Association as part of its "Weight Loss Matters" campaign is trying to spread the word that people have to lose only a little weight to dramatically lower their risk for diabetes. (www.ada.com)

The problem is how do you convince people to lose weight without scaring them. An estimated 16 million people are on the verge of developing diabetes.

“That’s the nub of the problem facing us. It's much harder to get people's attention who are just overweight," says Christopher D. Saudek, director of the Johns Hopkins University School of Medicine Diabetes Center in Baltimore. In the past, the medical community has learned it must walk a fine line when educating people about a disease as ubiquitous as diabetes, which afflicts 17 million people in the U.S. Experts believe 16 million more Americans are on the verge of developing diabetes.

The trick is to warn people of the dangers of the disease without making those who already have it feel hopeless. Several years ago, a frightening public-awareness campaign featuring Uncle Sam as a diabetic amputee prompted so many complaints it was quickly shelved, notes Dr. Saudek. Adult onset or Type 2 diabetes is the most common form of diabetes. Experts believe it is usually triggered by poor diet, obesity, lack of exercise and genetics.

A sufferer’s body is unable to process insulin effectively and can't make enough insulin to keep blood-glucose levels normal. Insulin is important because it promotes the storage and use of all nutrients, including sugar. Once full-blown diabetes occurs, the body’s cells are unable to absorb blood glucose and it accumulates in the bloodstream. Most often children and young adults whose pancreas doesn't produce enough insulin develop Type 1 which isn’t preventable.

Doctors don’t fully understand how diabetes damages the body isn't entirely understood. Some theorize that all the excess sugar in the blood stream triggers a process similar to rusting -- the sugar begins to stick to things and damage blood vessels, kidneys and nerves. What most doctors know is that diet, losing weight and exercise can add years to a diabetics life.

Today, doctors want people to know about the tragic consequences of diabetes. They point out that the leading cause of death from diabetes is heart attack and stroke, and about 40% of all heart attacks are caused by diabetes. Blindness, kidney failure, impotence and amputations are also the results of poorly maintain diabetic regimens. Doctors estimate that diabetes steals five to seven years from your life expectancy.

David M. Nathan, Harvard professor and director of the diabetes center at Massachusetts General Hospital led a three-year clinical trial studying 3,000 people who weren't diabetic, but were overweight with higher-than-normal blood-glucose levels. The study found that participants who made lifestyle changes lowered their risk for developing the disease by 58%. What was required included walkng about 30 minutes, five evenings a week and losing about 7% of their body weight -- only about 15 pounds each. The impact of the lifestyle changes was even greater among people over age 60, where the risk of diabetes was reduced by 70%.

"But if you live with diabetes for 10 to 15 years, you can end up being pretty sick. It's not a nice way to die,” he said. But since the results of the landmark 2001 Diabetes Prevention Program study were released, diabetes experts have remained frustrated at how difficult it has been to get the word out to both doctors and patients. "We know there is this enormous gap between what we know to do and how it gets done," says Dr. Nathan. "Forget about patients listening -- doctors don't even listen."

A new Small Steps Big Rewards campaign was launched earlier this year by the National Diabetes Education Program. Other channels are being used to reach potential sufferers as well. The goal is to simply get more people to ask their family doctor about diabetes. It isn't always obvious who is at risk. Being over 45 and just slightly overweight -- by 15 or 20 pounds -- puts you at higher risk for the disease. A simple blood test can help determine if your blood-sugar levels are above normal, putting you at high risk for developing diabetes over the next 10 years.

"It's long been a concern that people don't take Type 2 diabetes very seriously," says Martha Funnell, past president of health care and education for the American Diabetes Association. "It's been our attempt to soften the message to not frighten people, and in so doing, we perhaps have not conveyed the seriousness well enough."