David Panofsky, 35 of Madison, Wis.; Doug Bursnall, 31, of Wales; and



Katherine Bradt-Wells, 30, of Victoria, British Columbia, Canada, climbed

to the summit of Aconcagua last year. And they have a lot more in common than mountain climbing. They all have Type I, or insulin-dependant diabetes, and they are all vegetarians. In fact, everyone on the 26-member Team International Diabetes Expedition Aconcagua 2000 (IDEA 2000) has Type I diabetes.

For people with this disease, the pancreas does not release sufficient amounts of insulin, a protein hormone necessary for the body to regulate the metabolism of sugar and certain carbohydrates. Diabetics may require insulin injections and blood testing -- as often as eight times a day. Untreated, the disease can cause blindness, nerve damage, cardiovascular disease and kidney failure.

Panofsky, Burnsall and Bradt-Wells are also members of the Diabetes

Exercise and Sports Association (DESA), an international organization made up of amateur and professional athletes whose mission is to help people with diabetes achieve their athletic goals. The team's success at Aconcagua served as a statement against the stereotypes that tend to define diabetics: that their activities must be restricted because they can become quickly incapacitated. And for Panofsky, Burnsall and Bradt-Wells, the trek to the summit was also a way of dismantling one of the myths about nutrition, meat and muscle power. A vegetarian diet, says Brandt-Wells, "Is much easier to digest to get important nutrients and vitamins - especially at high altitudes like 20,000 feet, where the altitude interferes with digestion." Food poisoning is also avoided, points out Brandt-Wells, because vegetarian fare is much less likely to spoil than meat.



Most diabetics suffer from Type II diabetes, a non-insulin-dependent disorder that tends to develop in overweight adults and is often preventable. Type II diabetes can be caused by poor diet, excessive weight and a sedentary lifestyle. It is more easily treated than Type I diabetes, according to Stephen Clement, M.D., director of the Georgetown University Diabetes Center in Washington, D.C., mostly through oral medication or insulin injections, diet and exercise.

To reduce weight and increase insulin sensitivity -- making insulin work better and thus reducing dosages -- ''eat less, exercise more,'' said Marion Franz, a registered dietician and former director of Nutrition and Professional Education at the International Diabetes Center in Minneapolis, Minn. Reducing food intake, being selective about what they eat and exercising help keep diabetics in fit condition.

Speaking at the DESA annual conference held this month in Washington, D.C., Franz emphasized the benefit of eating smaller portions of lean meat -- or replacing meat altogether with peas, beans, lentils, soy protein, whole grains, fruits and vegetables.

Last year, the Physicians Committee for Responsible Medicine, a health-advocacy organization based in Washington, D.C., and Georgetown

University Medical Center Department of Endocrinology published the

results of a study on the effectiveness of a vegetarian diet for

diabetics. In conjunction with the Diabetes Action and Education

Foundation in Arlington, Va., the Physicians Committee compared

''fasting'' glucose levels -- the blood-sugar levels that result in the

absence of food for 12 hours -- and weight loss of Type II diabetics,

using two types of diets for a period of three months. The pilot study had

13 participants; a follow-up study begins this year at The George

Washington University Medical Center with 60 participants.

''We compared two different diets,'' said Mark Sklar, M.D., an associate professor at Georgetown University Hospital's Department of Endocrinology, ''one, a high-fiber, low-fat, vegetarian diet that contains no animal products; and the other, a more common American Diabetes Association (ADA) diet, which contains meat and dairy products.''

''The vegan meals were made from unrefined vegetables, grains, beans,

and fruits, with no refined ingredients, such as vegetable oil, white flour, or white pasta,'' said Neal Barnard, M.D., president of the Physicians Committee. ''These meals averaged just 10 percent fat (as a percentage of calories), 80 percent complex carbohydrate and 10 percent protein. They also offered 60-70 grams of fiber per day and had no cholesterol at all.''

The comparison (ADA) diet contained more plant-based ingredients than

the average American diet but still relied on the conventional chicken and

fish recipes. This diet was 30 percent fat and 50 percent carbohydrate. It

provided about 30 grams of fiber and 200 milligrams of cholesterol per day.

REDUCED INSULIN DOSAGES AND BETTER CONTROL

The fasting blood sugars in the vegetarian group decreased 28 percent,

whereas the ADA group's blood sugars dropped only 12 percent. The

vegetarians needed less medication to control their blood sugars, whereas

the ADA group needed just as much medicine as before.

While the ADA dieters lost an impressive 8 pounds on average, the vegetarians lost nearly 16 pounds. Cholesterol levels also dropped more in the vegetarian group, compared to the ADA group.

Study vegetarian dieters said they were pleased with the weight loss

and the reduction or elimination of insulin injections or oral medication.

''Being able to take control of my diabetes has been a wonderful thing,''

said Scott Johnston, 34, a business consultant from Arlington, Va. ''Had I

known that this diet would have such a powerful effect, I would have

adopted it years ago.''

''In the beginning, it's not an easy diet,'' said Sheldon Berman, 62,

of Washington, D.C. ''But I managed to lose 17 pounds. I'm no longer on

medication for diabetes, and I am no longer on medication for blood

pressure. ... The overall mental outlook on how I feel about myself as a

diabetic is much more hopeful now, as I am self-sufficient with a diet

that makes sense for me.''

Worldwide, more than 125 million people have either insulin-dependent

or non-insulin dependent diabetes, according to Stuart Sundem, a senior

community health specialist at the International Diabetes Center in

Minneapolis, Minn. And that number is expected to skyrocket to more than

300 million by 2025, as Asian countries adopt Westernized lifestyle patterns of high consumption and sedentary activity, he said.

Francine Kaufman, M.D., president-elect of the American Diabetes

Association and chairman of Children's Hospital Endocrinology Division in

Los Angeles, cites ''fast food laden with fat and lower levels of activity'' as the culprits for approximately 25 million cases of undiagnosed diabetes worldwide.

This month, the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases released the results of their own Diabetes Prevention Program study, showing that Type II diabetes can be prevented.

The study maintains that two different approaches -- diet and exercise

therapy, and the administration of a diabetes medication, metformin --

were both effective. Just 30 minutes of daily exercise coupled with a

low-fat diet increases insulin sensitivity and reduces weight, possibly

eliminating the need for insulin injections altogether, according to the

report.

Christopher D. Saudek, M.D., president of the American Diabetes

Association and a principal investigator says ''the Diabetes Prevention

Program conclusively proves that Type II diabetes is not inevitable for

people at high risk of developing it.''

The DPP is the first study to demonstrate that prevention strategies

can work across the broad spectrum of racial and ethnic diversity. Both

lifestyle and medication interventions worked with those of Caucasian,

African, Latino, Native American, Asian and Pacific Islander origin.

Judith Ambrosini, another DESA member, has lived with diabetes for more

than 40 years. Currently a food columnist and caterer in Boston, Massachusetts, she became a vegetarian 20 years ago while living in Italy. ''I

would go into town to the butcher shop,'' she said, ''but by the time I

got there, all that was left were brains, intestines and hearts.''

She opted for the traditional Italian fare of pasta and vegetables when

she realized that she had better ''make friends with this thing

(diabetes) -- it will be with me for the rest of my life.''

Mothers worldwide tell their children to eat their vegetables. This advice

may very well hold the answer to combating diabetes.

WEB-LINKS

Bruce Andrew Peters: http://www.GreatWriteUp.com

DESA: www.Diabetes-Exercise.org

IDEA 2000: www.IDEA2000.org

Physician Committee for Responsible Medicine: www.PCRM.org

International Diabetes Center: www.idcdiabetes.org