Imagine sitting in your doctor's office 
and being told you have type 2 diabetes. Maybe it takes a few seconds to sink in. Then, your mind is flooded with fear, confusion, and questions. So many questions, but where do you begin? And the one thing you know is that your life will never be the same again. This is the experience reported by countless people who have been diagnosed with type 2 diabetes. "I never heard anything the doctor said, after she said the word diabetes. The next thing I knew, I had a handful of pamphlets and was told I needed to schedule a follow-up visit," said Kathy Stender, 48, the mother of four who has type 2 diabetes. But, even with such a life-altering diagnosis, there is hope through simple lifestyle changes than can turn the tide against type 2 diabetes. And Beachbody has joined the fight with Kathy Smith's Project:YOU! Type 2™.
Type 2 diabetes and pre-diabetes
Type 1 diabetes is outside the scope of this article. Type 1 diabetes has no cure, and despite healthy lifestyle changes and medication, a person with type 1 diabetes has a very unclear future.
Type 2 diabetes, on the other hand, can be prevented, and even reversed, through healthy lifestyle changes. Type 2 diabetes used to be a disease that was associated with much older people; in fact, it was referred to as adult onset diabetes. Now, there are kids as young as 8 who are being diagnosed with the disease. Currently, 24 million people in the United States have diabetes. Almost 95 percent of them have type 2, which can be managed by making healthy lifestyle choices—exercising, eating right, handling stress, and, in some cases, taking medication.
There is also a third diagnosis: pre-diabetes. The 57 million Americans diagnosed with pre-diabetes are already headed toward developing type 2. But there is hope for those with pre-diabetes, and type 2 diabetes, and there are choices available that can help reverse the trend. "I know any kind of diabetes can be difficult, but I get mad sometimes at people who have type 2," said Jack Lopez, 22. "I have had type 1 since I was 4 and I don't know if I will live to have grandchildren, or if I'll lose my eyesight, or a leg. People with type 2 have choices; they have control. They can do something about their diabetes, and I can't," he concluded.
The long trip to type 2 diabetes
The long trip to type 2 diabetes is silent. There are no symptoms, not even ones that can be recognized in retrospect. Routine glucose tests can't detect the problem. For many people, when they start gaining weight in their late teens and 20s, their body chemistries change and their cells become increasingly insulin-resistant.
When someone is insulin-resistant, the beta cells in his or her pancreas produce plenty of insulin, but the cells throughout his or her body don't respond normally to it. To maintain homeostasis, the pancreas makes more and more insulin. This works temporarily: the extra insulin compensates for the cells' insensitivity, so blood glucose remains normal. That's why the condition is silent.
Over time, however, the beta cells become exhausted and can no longer sustain their abnormally high insulin production rate. Why this happens is still not completely understood, but the assumption is that multiple factors are at work. Some of these factors are linked to obesity: the beta cells may be damaged by excess fat deposited within them; other hormones released by visceral fat may interfere with the function or even the survival of beta cells. Additionally, a person's genetic heritage and early life probably play important roles, since these factors help determine how the beta cells develop and how robust they will be later in life.
Despite getting medical checkups and normal test results, an abnormal process begins, without the doctor even realizing it. After many years, the beta cells began to falter. Insulin production drops and blood glucose levels begin to rise.
Diagnosing diabetes and pre-diabetes
Blood glucose fluctuates throughout the day. Because of these fluctuations, it's best to perform routine blood glucose tests—the kind used to screen apparently healthy people after an overnight fast. Fasting blood glucose under 100 milligrams per deciliter (mg/dl) is considered normal; 126 mg/dl or higher signifies diabetes. Sometimes, blood is checked over the next 1 to 3 hours after a person drinks a liquid that contains a fixed dose of glucose. This is called an oral glucose tolerance test. If blood is tested this way—or if it's simply checked at a random time over the day, rather than after an overnight fast—a level of 200 mg/dl or greater indicates diabetes.
Pre-diabetes is diagnosed when fasting blood glucose is elevated but not high enough to be considered diabetic: between 100 and 125 mg/dl after an overnight fast, or between 140 and 199 mg/dl at the 2-hour point during an oral glucose tolerance test. As previously stated, more than 57 million Americans have pre-diabetes. Sometimes doctors refer to this as borderline diabetes, or they call it "glucose intolerance," when it's diagnosed via an oral glucose tolerance test, or "impaired fasting glucose" if a fasting glucose test was used. By any name, the diagnosis should serve as a loud warning signal. Studies have shown that, each year, about 10 percent of people with pre-diabetes will develop type 2 diabetes.
Diabetes Prevention Program study
We know that lifestyle changes can prevent type 2 diabetes, even in people who have already begun the march toward the disease. The Diabetes Prevention Program (DPP) study proved this. This investigation, which began in the mid 1990s, was the single most important study ever conducted in diabetes prevention.
Three groups were set up. The first group received metformin, a medication that makes cells more sensitive to the insulin naturally produced by the pancreas. If insulin sensitivity could be improved in people with pre-diabetes, the investigators reasoned, perhaps diabetes could be prevented altogether. The second group was given a placebo, a pill that contained no active ingredients. This part of the study was blinded, which means that neither the participants nor the investigators knew who received the real medications. Members of both groups were also given printed information on diet and exercise.
The third group, with more than 1,000 high-risk participants, received no pills at all. Instead, they underwent extensive training with lifestyle coaches, who taught them how to alter their lives to lose weight and to become more physically active. The coaches counseled them about diet and exercise. They learned how to set goals and keep track of their success. Group members were expected to eat less fat and fewer calories overall and to exercise for a total of at least 2-1/2 hours per week. The coaches led problem-solving discussions to help participants deal with lapses. Members of the lifestyle-change group also attended classes on healthy eating, physical activity, and behavioral topics. In addition to all this, they participated in special events, such as group walks or competitions. Meanwhile, those in the other two groups simply took their pills and went about their usual lives.
At the end of the 3-year study period, 29 percent of the participants who received only a placebo had developed diabetes. Those who took the medications fared better—just 22 percent of that group developed diabetes. But the people in the lifestyle change group enjoyed the most success of all; only 14 percent developed diabetes during the 3 years of the study. What's more, they lost an average of 12.3 pounds.
Diabesity and alarming statistics
Dr. Fran Kaufman was president elect of the American Diabetes Association (ADA) in 2001. She, along with U.S. Health and Human Services Secretary Tommy G. Thompson, was part of a press conference to announce the findings of the DPP study. Dr. Kaufman said, "It was thrilling to learn conclusively that each of us has it within our power to reverse diabesity (diabetes caused by [being] overweight or [obese . . . .]" The term diabesity, from diabetes and obesity, is synonymous with type 2 diabetes.
Currently, more people die of diabetes than die of AIDS and breast cancer combined. And diabetes complications include illnesses such as heart disease—people often die because of these secondary illnesses linked to diabetes. Additionally, diabetes is the leading cause of blindness and amputations. With one in three children born after 2000 predicted to get diabetes, diabetes is growing at a phenomenally rapid rate. But we don't have to watch 300 million people worldwide develop diabetes by 2020, as is presently projected. We have the opportunity to set a new course and stop the epidemic.
The Beachbody solution: Kathy Smith's Project:YOU! Type 2
Beachbody, the ADA, and Kathy Smith joined together to create a simple, comprehensive program to help people with pre-diabetes and type 2 diabetes learn how to lead healthy lifestyles. Project:YOU! Type 2 is the healthy approach to managing type 2 diabetes and, if you have pre-diabetes, to preventing it.
The ADA has called this program "revolutionary" because it includes eating tips, exercise, journaling, and support all in one inclusive package. This is the first time the ADA has recognized a total lifestyle solution program. The ADA's mission, to prevent and cure diabetes and to improve the lives of all people affected by diabetes, is shared by Beachbody. Additionally, a portion from the sale of each Project:YOU! Type 2 program will be donated to the ADA. Read more about Project:YOU! Type 2.
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