Diabetes is one nasty disease. Not only is it the sixth leading cause of death in the U.S., it is a major risk factor for cardiovascular disease. It is a leading cause of non-traumatic amputations, blindness, end stage kidney disease, and neural defects. It costs $132 billion annually in medical and related costs.

The number of cases of type 2 diabetes is rising dramatically and the rate of growth nationally and globally is projected to double by 2050 and 2025, respectively. Type 1 diabetes accounts for only 5 or 10% of the total. It generally is first seen in children or young people, and may be due to genetics, autoimmune factors, or possibly infections or other environmental factors. We are discussing type 2 here. Type 2 diabetes used to be called "adult onset, " but so many kids are getting it now, the name is no longer used. Type 2 is largely a lifestyle disease.

Pharmaceutical firms are busy developing drugs to treat type 2 diabetes. These can be useful and are required when the disease progresses too far. However, it's better to not get the disease in the first place. Among the risk factors for type 2 are obesity and physical inactivity. In fact, these may account for the dramatic rise in numbers of cases. Aerobic exercise has been shown to prevent development of diabetes better than medication does. Even in the early stages, diabetes is often treated, and controlled, just by diet and exercise.

So if you're obese and/or have a family history of diabetes, start right now working to head it off by doing regular aerobic exercise. Walk (or run, bike, skate, swim) at least 150 minutes a week. This can be half an hour 5 days a week or an hour every other day (or 10 minutes 3 times a day). (Exercise at least every other day.) Resistance exercise is important too, but at least start with aerobic activity. It may seem like a lot of trouble now, but you don't want to regret not doing it if you eventually develop the disease and they're trying to decide whether to cut your foot off.