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America’s Diabetes Surge

Diabetes in America. Type 2 is a symptom and a disease. Type 1 may have some new answers.

In this file photo, 7-year-old Ellie Clark holds her insulin pump, which also works with an implant to display blood sugar levels, Wednesday, Sept. 12, 2007, in Grandville, Mich. New treatments in diabetes care could allow patients like Clark to use artificial pancreas devices to better control their blood sugar levels and insulin intake. (AP)

In this file photo, 7-year-old Ellie Clark holds her insulin pump, which also works with an implant to display blood sugar levels, Wednesday, Sept. 12, 2007, in Grandville, Mich. New treatments in diabetes care could allow patients like Clark to use artificial pancreas devices to better control their blood sugar levels and insulin intake. (AP)

If diabetes were an infectious disease, the media would be going crazy over it.  Twenty-nine million American adults affected.  The numbers surging, up another nine percent since 2010.  Terrible risks:  stroke, blindness, kidney failure, amputation.  Cost to the US economy – nearly $250 billion a year.  But diabetes isn’t infectious.  Type 1, just five percent of cases, comes on in childhood.  Type 2 – the big numbers – is practically a lifestyle disease.  Poor diet, obesity, lack of exercise – and millions are at risk.  This hour On Point:  America’s diabetes boom, and what to do about it.

– Tom Ashbrook


Dr. Robin Goland, professor of clinical medicine and pediatrics at Columbia University. Co-director of the Naomi Berrie Diabetes Center.

Kelly Brownell, professor and dean of the school of public policy at Duke University.

Dr. Steven Russell, endocrinologist at Massachusetts General Hospital.

Edward Damiano, associate professor of bio-medical engineering at Boston University.

From Tom’s Reading List

Center For Disease Control: National Diabetes Statistics Report, 2014  – “During 2008–2009, an estimated 18,436 people younger than 20 years in the United States were newly diagnosed with type 1 diabetes annually, and 5,089 people younger than 20 years were newly diagnosed with type 2 diabetes annually. During 2008–2009, an estimated 18,436 people younger than 20 years in the United States were newly diagnosed with type 1 diabetes annually, and 5,089 people younger than 20 years were newly diagnosed with type 2 diabetes annually.”

Bloomberg: Best Bet to Stall Diabetes Remains Diet With Exercise — “Diet and exercise remain the best bet for staving off diabetes in patients at risk for the disease, according to a 15-year follow up on a landmark study that set lifestyle intervention as an effective approach. Study participants who lost weight and increased physical activity had a 27 percent lower rate of developing Type 2 diabetes, compared with 17 percent of those given metformin, a first-line drug to lower blood sugar. The research was reported today at the American Diabetes Association meeting in San Francisco.”

Boston Globe: Artificial pancreas offers hope to diabetes patients — “An artificial pancreas developed by Boston researchers shows considerable promise to dramatically change the treatment of type 1 diabetes, potentially enabling 2 million Americans to eat what they want without counting carbohydrates or calculating insulin injections, researchers announced Sunday. Investigators from Massachusetts General Hospital and Boston University developed the experimental device, which consists of an automated pump that releases the hormones insulin and glucagon and a glucose monitoring system controlled by an iPhone app.”

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  • hennorama

    Hey! Is On Point now using 12:01 AM Greenwich Mean Time as the time to post new show forums?

    (posted at 12:26 AM GMT Wednesday, June 18, 2014)

    • nkandersen

      We’re not sure why the new show posted so early…working on figuring that out.


      nick andersen
      web producer | on point radio

    • northeaster17

      Discuss is working out of their London offices for the summer.

  • Cynthia K

    Yes, I’m listening to a discussion on infrastructure. What’s up?

    • nkandersen


      Working on figuring out the flaws in our posting code here. Sorry for the gap!


      nick andersen
      web producer | on point radio

  • Human2013

    On a recent trip, I stopped and stayed at a hotel in Greenwich, CT.
    If you haven’t been paying attention, CT’s income inequality is starting to rival the undeveloped world and it shows.
    If I left my hotel and headed left on rt 1, the wealth was very apparent – well maintained streets, high end stores and plenty of healthy food options. If I left my hotel and went right, I was welcomed by fast food restaurants, dilapadated properties and low end retailers. I was struck by the proximity of these two extremes. Mean income in Greenwich is almost $1m and a mere $15k for places like Bridgeport. It starts to feel like the twilight zone, but then you remember, these extremes are the outcome of very deliberate policies.
    To bring it back to today’s show, remeber that when America was unequal in the early 20th century, many Americans were Farmers and could still grow their own food. Income inequality is disturbing for many reasons, but the food supply is particularly disturbing. At this rate, many Americans will continue to suffer fromType 2 diabetes as we have so much sugar masquerading as food.

    If we’re going to continue to on with this feudal system, just give me a small plot of land to farm and I will make my tribute to the king — oops, I mean Wall street.

    • Lawrence

      Yes, and it becomes racially unequal as well. We are selectively making sicker those in Bridgeport, and other similar communities. There is little offering of healthy food options and poor education on food, and other health options.

      Good nutrition should be available to all.

    • Don_B1

      If the threat of diabetes is not enough to motivate the obese to reduce weight, then the another organ that is affected, the liver, should help to increase the necessary motivation:


  • northeaster17

    Below is the link to todays Bittmam’s piece from the NYTimes. Basicly he is saying that lots of big Agri Companies will be in big trouble if we move towards healthier whole food diets. No added value there. Maybe Soylent Green will be able to pick up the slack.

    • HonestDebate1

      That was an interesting article but IMO the agri companies are like the government: we choose them; we give them their power.

      In our house we stay away from all of that.

      • Charles

        Agreed. Big Ag, like any other company, would adjust to the market if people would actually make responsible eating choices.

        Also, Bittman has some nice ideas, but he’s an alarmist with a taste for the spotlight. I wish we didn’t need ‘rockstars’ for causes, but alas…

        • northeaster17

          When fruit rollups are sold as fruit and soda is sold in schools it is about more than choices. It’s about a captive audience that graduates into life long customers. One choice that has to be made is how investers look at an agri giants and what they produce, as well as what we put in our shopping cart.

      • northeaster17

        For some it is easier than others to avoid them. I know how I ate until about ten years ago. Old habits and preconceptions can die hard.Part of the problem is that these companies have been selling garbage as good healthy food for generations. These big successful companies have become part of our lives and our economies. Getting junk out of the system will take time and effort.

        • HonestDebate1

          I agree with you but isn’t confronting unhealthy habits and not falling prey to pre-conceived notions a necessary part of maturing and evolving to a better life? I just think many people don’t catch on to the gravity of personal choice until way too late in life.

          • Ray in VT

            I also think that many people’s food options are limited by either local availability of healthy foods or the economic inability to pay for a healthier diet in many cases.

          • Don_B1

            A big part of the problem is that a lot of the products that are not good for health are subsidized through the federal farm program and other sources.

            A good description of the whole problem is in the book, Salt Sugar Fat by Michael Moss:


            Too much of the U.S. population lives in s (healthy) food desert, and that goes beyond the inner city where the term originated.

          • Ray in VT

            There’s definitely a role there. I think that some of this also gets driven by our on the go lifestyle, and a lot of convenience stores and such don’t stock fresher or healthier alternatives, I think in part because of the very limited shelf lives of some of those foods.

          • Don_B1

            In the past (and maybe still) even the big grocery stores had supply lines that were at least 2 weeks long. Some stores now have programs to buy a lot of their vegetable (and even some meat) supplies locally, which probably shortens that “waiting” time.

          • Ray in VT

            Could be. There has also been the nice re-emergence of farmer’s markets in some areas, which gives growing a place to sell and buyers a place to go other than convenience or grocery stores.

          • geraldfnord

            Yes, but we should not be content with the presence of those whose raison d’être semingly is that people not do so? Everybody bears a large measure of responsibility for their own acts, but if presumably marketeers and advertisers weren’t capable of somewhat dependably producing N dollars’ marginal revenue in exchange for M≪N dollars’ expenditure by their clients, they’d have gone out of business.

            Persons have some degree of free will that makes it fair to assign them some level of responsibility…including moral responsibility when they at least believe that they can dependably manipulate people in the aggregate.

          • northeaster17

            “Falling prey” is what I have a problem with here. The fact that Multi level corporations can pedal as much garbage as they want, call it food, and the consumer, the most gulible being children, have to sort whats good and bad from sophisticated marketing programs. That’s not right.

      • jimino

        “agri companies” and “the government” are partners, for good or ill, and I expect the number of informed eaters likely mirrors the number of informed voters. In other words, a small percentage.

    • AC

      maybe big Ag owns stock in insulin manufacturers? it is removed from cattle or pig pancreas, right? ranching and farming are often combined…
      – finally i came up with my own conspiracy theory!! someone find a link, it would be scandalous

      • northeaster17

        You may be on to something there. Wink

      • geraldfnord

        Sorry, but these days it’s mostly (nigh-entirely) insulin as close to human insulin as the yeast-tailors can make it, which is ‘almost identical’…though they also often stick on a lipid or acidic tail that keeps it from being used immediately, the tail degrades over time and this produces a much less spikey effect.

        If you want to keep your theory, look for the big food firms’ getting a piece of the industry pre-{c. 1986} and still using it for your favourite Nefariius Purpose.

  • http://www.facebook.com/profile.php?id=32606540 Brian Belgard

    Ou, Diabetes. I’m curious to see what the breakdown of discussion of type 1 vs 2 is. As a 21 year Type 1 (My DIabetes Can Drink Legally!) I’ve noticed that supplies and equipment (glucose monitoring esp) almost alwats geared towards type 2. Makes sense in terms of numbers (1mm vs 30mm), but frustrating none the less.

    • Don_B1

      Type I diabetes is usually though of as occurring in children (it has been called “juvenile diabetes”) but it can occur at almost any age. Elaine Stritch (actress, singer, known for her version of “Ladies Who Lunch”) was diagnosed at the age of 56.

  • AC

    can you discuss which gene sequence variants are common among people with diabetes and whether or not it is an automatic diagnoses or just a risk factor?

  • Lawrence

    That’s all we need to do. Take drugs, pop a pill, get a new pancreas instead of having the willpower to stop stuffing our faces with junk food and sitting all day on social media and mind numbing TV.

    • AC

      i’m not sure how to tell you this, but this statement is incredibly uninformed. while a percentage of diabetes can be avoided due to the behaviors you mention, it is an auto-immune disease and usually develops regardless of your lifestyle habits. many are born with it or present because of age. you are being prejudiced and sound self-righteous by making statements like this, so be careful…

      • geraldfnord

        Three brothers who looked almost as twins when young. One very overweight, never cooks, eats junk-food, doesn’t exercise much; one overweight, but less than the U.S. average, cooks or is cooked-for, never eats junk-food, exercises moderately, the third exercises more, eats a little junk-food. Guess which one doesn’t have diabetes?

        True, you can improve your odds, but here as in other areas, too many have an absolute mania for believing that this world were ‘just’, so everybody gets what they [sic] deserve and deserve all they get. It’s a world ruled by some god or another, named ‘God’ or ‘Allah’ or ‘the Market’ or ‘healthy eating’ or ‘History’ or….who makes all just and right so noöne need bestir themselves to reduce suffering, since all suffering is deserved…with the exception of theirs and that of people they like, whose problems are due to Satan under one name or another, e.g. ‘Satan’, ‘The Gummint’, ‘the immigrants’, ‘the Space Masons’, ‘the wealthy’, ‘the moochers’ or ‘bad habits’.

        Again, it’s smart to play the percentages, but wise to remember that probabilities are all that they are….

        And then again, some people are just gluttons for punishment—other people’s.

        • Don_B1

          So true unfortunately!

          I don’t remember this much self-centeredness in people when I was growing up; maybe I was just naïve or less interested in the politics that existed outside my inner world.

          But it does seem that the culture has moved to a meaner spirited, with vindictive attitudes dominating the talk in the public square.

          I hope it is merely a correlation, but the rise of fundamentalism seems to have some relationship with this trend. I saw an article showing some incredibly harsh comments on the signs outside some fundamentalist churches.

          The rise of these attitudes also coincides with the administration of Ronald Reagan.

          But he was only the tool of the real reactionary forces that began working to oppress workers right during and after President Franklin Delano Roosevelt established the New Deal.

      • Don_B1

        What you are mainly describing is Type I diabetes, although it does apply, though to a lesser degree, to Type II. Many diagnosed with Type II have been able to go into “remission” if they lose enough weight, though far from all.

    • LinRP

      You need to get educated about Type 1 Diabetes. ENTIRELY different situation than Type 2. You are born with it, and those people need a bionic pancreas. Seriously, learn the difference and stop judging.

  • Jim

    it is given… country is quasi prosperous. food is “relatively” cheap compare with other countries. and working class people know they must make end meet. where can you find time to workout when children come in the equation?

    • Don_B1

      It is true that as a percentage of the family budget, the cost of food has dropped from just above 18% to somewhere around 10% (maybe a bit higher). That would seem to say that families could spend a bit more for better food, but there are other factors in modern life that mitigate against that.

      1) Family incomes in the lower 60% have not been rising while the costs of rent and clothing have.

      2) Part of the drop in food costs has been that some food is subsidized; e.g., corn, soy, wheat, beets. Note that two of those subsidized foods are sources of sugar.

      3) Healthy foods do not have a big lobby to get equivalent subsidization.

  • AC

    that’s the insurance companies brainwashing people into persecuting sick people….

  • J__o__h__n

    Stop subsidizing corn.

  • X Y & Z

    Kyrgyzstan Initiates 100% GMO Ban for 5.5 Million Population


    Don’t look for any similar move in the US, particularly since Obama appointed ex Monsanto lobbyist Michael Taylor, to be the Deputy Commissioner for Foods at the FDA.

    • Ray in VT

      Do you have some information linking GMOs to diabetes?

  • Teresa Vaughn Osborne

    It is imperative to set up this discussion from the outset with a clear definition of Type 1 versus Type 2. There is so much confusion about this. Type 1 is absolutely NOT a “lifestyle” disease.

    With so much media attention on Type 2 and no media responsibility to clearly define the very critical differences between these two separate diseases, Type 1 diabetics are very unfairly stigmatized, further complicating an already difficult physical and psychological existence with an all-day, every-day, life-threatening chronic disease.

    Let’s also be clear about treatments. An artificial pancreas solution will help (not cure) Type 1s, but not necessarily Type 2s. And insulin is not a cure for Type 1s. It does allow them to survive, but it is an extremely complicated and dangerous regimen.

  • brettearle

    Thirst, frequent urination….

    You can have those symptoms when the disease is mild.

  • Stephen706

    Stop the madness!
    Stop allowing people to get on disabiltiy because they have become SO fat!
    Make them exercise!
    Stop giving EBT and food stamps and actually give the “right” foods
    Stop giving welfare for this
    Stop using medications for the after effects except for over the counter!
    Bottomline–stop enabling with secondary and tertiary prevention and FORCE the cheap option of defintive weight loss for survival

    • hennorama

      Stephen706 — Yes!

      And if people don’t lose weight, just cut it off them!

      • AC

        i just avoided this (stephen706) – i couldn’t take in the ugliness of it….
        ‘cut it off’, lol

      • Don_B1

        Merchant of Venice ! Go Shylock !

    • Human2013


  • atakemoto

    Let’s start labeling our foods and beverages as increasing our risk for diabetes the way we label cigarettes? Oh, right, because the producers of these foods that are killing us have powerful lobbies.

  • Grant Ingle

    My doctor kept warning me that my increasing blood sugar levels would make me a diabetic soon if I didn’t lose weight. Despite a level of regular aerobic exercise considered excessive by many of my friends, if I couldn’t lose weight. Three years ago I experience digestive problems (bloating, gas, cramping) that my doctor could not diagnose. After considerable research I eliminated wheat from my diet, felt better and lost five pounds in the first week. After I turned to gluten-free products I bought at Whole Foods, my symptoms and weight gain returned within a month. After more research I learned that most gluten-free foods are made with GMO ingredients (corn, soy, canola oil, cottonseed oil and sugar from sugar beets). Within a month after eliminating these GMO ingredients all my symptoms disappeared and within two months I lost 20 pounds while actually eating more. At my next physical, my blood sugar was normal for the first time in more than a decade. I have met many other people who have had the same experience. There are several theories about why eating wheat and GMO food ingredients might have similar negative digestive and blood sugar effects, but many of us know from personal experience that eliminating these food ingredients will lower weight and blood sugar, often dramatically. Based on our experience, most of us are also strong advocates of mandatory labeling of GMO food ingredients.

    • ThirdWayForward

      It is very hard to argue against better food labeling — it seems like such a no-brainer — greater transparency enables better choices, even if people are slow to take advantage of the knowledge to make changes.

  • AC

    i already tried to calm the people ready to hang you…i have lupus myself and it’s failing battle. people with chronic diseases will be persecuted…..they don’t care; it’s your fault automatically, it costs them money & drives up healthcare costs.
    it’s called ignorance and mob mentality. not that i don’t think some people need the lifestyle changes, but i can’t believe onpoint is giving a voice to the people looking for any excuse to hurt others…..

  • creaker

    Recently read Pandora’s Lunchbox, which delves into the manufacture of food – processed food is only food in the sense that you can digest it. It’s really more and more chemicals manufactured and created from (mostly) biological sources. But mostly things you’d never be able to create in your own kitchen.

  • http://earthasset.com Melissa

    Dr Joel Fuhrman wrote a book called The End of Diabetes–which has clinically notated and documented experience as a physician showing the ability to reverse and eliminate type 2 diabetes through nutritional intervention–regardless of genetics. No medication needed. This should be common knowledge in the medical community, but there is no financial incentive in the pharmaceutical industry to render their products obsolete.

    • ThirdWayForward

      It should be common knowledge within the medical community, the type 2 patient community AND the general public.

      Nutritional control can have very immediate and profound effects on metabolism and insulin resistance. Benefits can be seen within a few days.

      It is truly appalling how bad our patient education systems are — it is one of the reasons for the high inefficiency and cost of American health care.

  • Swalker

    Please be careful about differentiating between type 1 and type 2 diabetes. Everything said so far on the show only applies to type 2, but is framed under the general diabetes term, which is a disservice to the albeit less common form of diabetes: type 1. As a type 1 for more than 18 years I can tell you that they constitute completely different disease.

  • creaker

    Here’s a simple diet – no processed foods, no foods created from white powders. I’ve lost almost 30 pounds since the beginning of the year.

  • Kate

    The focus on not eating the right foods, dieting, And not exercising enough, distracts from real problem, which is that we, as Americans, often eat for reasons other than hunger. We eat because we’re bored, because we’re sad, because were angry at our partner. we lose touch with our bodies, such that we are unable to determine when we actually need food. The focus on dieting and exercising confounds the problem by making certain foods taboo and, thus, more appealing. In my humble opinion, the solution to the obesity epidemic is to shift the focus away from food, exercise, and instead focus on what feeds us as whole people. in so doing, we will stop eating when we’re not hungry, finish when our bodies are full, and find ways to heal ourselves in ways other than eating.

    • http://www.openeyesvideo.com/ Glenn C. Koenig

      What you’re describing is what I sometimes call “recreational eating” where you eat something not for nutrition but for an activity that feels good short term, like an addiction to pretty much anything else. You eat to console yourself and avoid troubling aspects of your life.
      So, yes! I agree with what you’re point out. Our actual challenge here is perhaps an entire culture that is moving ourselves toward more isolation, inactivity, and fear. Fear is a great tool for advertisers to sell products. And the side effect is recreational eating. Our antidote, so to speak, is connection, community, physical activity, mutual support and love, in the face of fears.
      But, as is often the case, in our current society where we have intense money and power behind a materialistic culture, there is no one to “make a profit” from love and support or strengthening community.
      To bring about better community, we are challenged to turn our attention away from “making a profit” or “making a lot of money” or “striking it rich” in terms of money and material possessions, and steer out interest back toward connecting with each other.

      • ThirdWayForward

        “Anxious eating” or “addictive eating” is more like it. Nothing recreational about it — those who do it do not freely engage in it.

      • The poster formerly known as t

        To me, people concerned with isolation and the degree of social interaction that everyone has are very extroverted and extroverts tend to prefer the close-knit small community thing and assume that everyone will thrive in such a situation. They don’t pay attention to how selective and discriminating, small, close-knit communities are. People tend to be “connected” in small, close-knit communities because differences, are suppressed and or expelled. I’ve realized that one of the good things about stratified and hierarchical societies is that the individual has ,for better or worse, the option to determine how connected he/she remains with whom he/she wants and can express themselves more freely because of the heterogeneous nature of stratified societies.

  • http://www.openeyesvideo.com/ Glenn C. Koenig

    When I wanted an ice cream or a candy bar, my mother told me to “eat a piece of fruit.” Great idea but terrible marketing!! “A piece of fruit?!?!!” What a unappealing way to present it!! I wish we could say “A nice jucy orange” or “a nice crisp apple” or “some fresh sweet blueberries”
    The big companies have it all over us, pushing sugar which is truly addictive, just like nicotine or opioids.

    • northeaster17

      There is no money in fruit. Ice cream. That’s another story.

      • The poster formerly known as t

        There’s no money in anything healthy. Healthy people are resilient and don’t depend on large corporations, and federalized governments for subsistence. Politicians and capitalists gain their power and status from creating situations of dependency. Dependency is vaguely alluded to with words like “demand” “support”, and “loyalty.”

  • LWG

    Thank you Kris. I am an adult with T1D and was getting very frustrated with this show so far because both Tom and the drs continue to just use “diabetes” as a catch-all term. I commented as well and hope it makes a difference!

  • Teresa Vaughn Osborne

    On Point: you are spreading dangerous misinformation when you continue to reference “diabetes” and “diabetics” without noting which type you are discussing with each and every mention. This is not just semantics.

    • AC

      a few people have tried to call them out on it. they don’t care.

    • http://www.facebook.com/profile.php?id=32606540 Brian Belgard

      I agree (As a Diabetic) that distinction between the two is hugely important, however the fact that Type 1 is getting any coverage at all is an improvement.

      • ThirdWayForward

        For most of the last century, beginning with the discovery of insulin, Type 1 diabetes was the focus of virtually all research on diabetes.

        An excellent book on the history of diabetes research is Cheating Destiny by James S. Hirsh (2006). Mostly it’s about the history of Type I diabetes.

        Type 1 and Type 2 diabetes are really two very different diseases, despite common symptoms (hypoglycemia) and some common therapies (insulin).

        The increased focus on Type 2 diabetes is a relatively recent phenomenon, due in part because of the rising number of people with the condition.

        It has only been since about 1990 that “metabolic syndrome” and the problems of insulin resistance have been widely recognized within the medical community. it took another decade for these concepts to make it into the wider medical community and patient education (which is still in a very rudimentary state).

        Our current level of ignorance about the causes of both types of diabetes is truly shocking. Complacency is our biggest enemy — we spend $100 billion/year putting soldiers in the Middle East ($1 million per soldier per year), whereas the whole NIH budget is about $30 billion per year, and they spend about $1 billion of that on diabetes research.

        While we squander blood and treasure on pointless military ventures, our people are dying of diseases that can be tamed and cured if we do the research. Roughly 70,000 Americans deaths are attributed to diabetes each year.

        • http://www.facebook.com/profile.php?id=32606540 Brian Belgard

          Did not realize the whole type 1/2 dynamic was a contemporary situation. Thanks for the info!

    • adks12020

      They aren’t being clear enough but I think the major point is that Type II is the major problem, the one that is expanding exponentially and is effecting more people. Far fewer people have Type I.

      • ThirdWayForward

        Type 2 diabetes is a major epidemic, but Type 1 diabetes is a MUCH more severe (dangerous, debilitating, demoralizing) illness for those who have it.

    • Kris

      I agree Teresa, in fact if you look at the On Point web page for this broadcast they show a picture of a little girl holding her insulin pump and then summarize the broadcast. If you read it – it is all about type 2 and leads a person that does not know the difference to think that lifestyle causes all “diabetes”. So sad and unfair. I have two children with type 1 and people say all the time “huh, there not even fat!”.

    • ThirdWayForward

      It was a bad sign that On Point was trying to deal with the two diseases in one program.

  • ClimateDesperate

    ¡¿Dieticians?! Why are the associatioins of dieticians so badly coopted by the toxic processed/high-sugar-fats industries? Many dieticians in our institutions seem to be part of the problem in peddling unhealthy food. What can be done about it?

    • http://batman-news.com Patti

      The “dietician” who ran the cafeteria in my highbrow prep school in the 1970′s – 80′s drank coke all day and smoked.

    • Don_B1

      Here is one link that proves your point:


      and somewhere there is another article on a recent conference where the agribusiness dominated, with McDonald’s providing snack food.

  • Teresa Vaughn Osborne

    Thank you, Kris! It’s so important and the media just simply refuses to take the time and effort to convey accurate information.

  • brucegirl

    You might mention one of the easiest and low tech, personal responsibility factor in early detection: PAY ATTENTION TO YOUR BODY’S SIGNALS! I was concerned about burning in my feet before a planned hiking trip to Hawaii… and thought it was my old plantar fasciitis kicking in. The podiatrist ordered a blood test and found I was at elevated risk for type II… “That’s good news,” he said “beacuse it’s in your power to change this immediately!” and I did and my levels are nromal. Pay attention to your own signals. Know thy phyisical self!

    • Rick Evans

      Sounds good. How long did it take to restore your levels to normal and what did you do?

      • brucegirl

        My primary care physician gave me three months before re-ordering the hemoglobin A1c test and I brought myself to acceptable levels within that time frame. I stopped the sugar binge, which included heavy portions of dried fruit, tropical juices on top of sweet treats I have always had trouble resisting. I cut each meal to about 35 carbs, served on small plate or in a cup, using a diabetic-style meal plan for guidance (half plate is non starchy veggies, quarter plate is protein, quarter plate is starchy veggie) and increased my exercise to at least a half hour a day – mostly walking. Although I did my best to completely eliminate the sugars in my diet, I allowed myself a small piece of dark chocolate every week. I lost weight, feel fantastic and am keeping the numbers down.

  • creaker

    A big part of this issue is the idea that you can just consume whatever you want and be sedentary until you have weight, blood pressure, blood sugar issues – and then you change your lifestyle. But by then you’ve done tons of damage and developed decades of bad habits.

    • ThirdWayForward

      The problem I have with this attitude is that it encourages a fatalistic attitude about the damage done that discourages change. We cannot change the past, but we CAN change the future.

      I think the attitude is not only counterproductive for change, but also false.

      A great deal of the damage associated with Type 2 diabetes/metabolic syndrome can be undone rather rapidly (with significant improvements within a few weeks) if one is able to reduce caloric intake (including, but not limited to, carb reduction) and to increase exercise.

      For many Type 2 diabetics, where insulin resistance is the problem rather than lack of insulin, simply managing one’s diet can have dramatic, almost immediate effects on insulin requirements. This point is almost never emphasized in the public discourse.

      Further benefits come from substantial weight loss, which is a longer term and ongoing struggle, but given the immediate effects, there is no reason not to try to take control of what you eat and to get more active RIGHT NOW.

      It escapes me why health insurance companies don’t better support weight loss and lifestyle change (to be successful, those trying to lose weight do need psychological support if they are to succeed in their efforts — insurers pay out $300 to have an 8 minute office visit with a specialist, and lots of money per month for diabetic meds and supplies, but won’t pay for Weight Watchers or some other kind of similar program that would reduce those expenses — why is that?) — it would seem like such a no-brainer that this would pay off in the longer run.

      But if you think about it, part of the structural problem with our health care system is that health insurance companies don’t have much of an interest in curbing longer term costs that will mount in a decade or more — there is no assurance that any given patient will be in their system over the long haul.

  • m turn

    My brother did his phd in the 90s on insulin synthesis and talked incessantly at the time about the quiet rise of type 2 that was happening even then. Much of it is diet, much is the continued rise in tv and internet use, much is our sedentary lifestyle, and much of it is cultural. Companies that profit from pushing unhealthy foods will continue to do so, but until the health consequences of our lifestyle choices are decoupled culturally and socially from our current stigmas surrounding weight, this issue will continue to be difficult to address on the individual level.

    On another topic: an idea for a future show. Peter Galbraith, son of historian John Kenneth Galbraith and a Vermont state senator, wrote a prescient account of the pitfalls and inevitabilities surrounding the Iraq War. Written in 2006, it’s called The End of Iraq and he’d be a great guest to have on the topic of the current conflict there.

  • Stephen706

    type 2 first half, type 1 is going on now–chill

    • Kris

      Yes thank you, I’m on hold now!

  • Lisa Vaas

    One point not being discussed is the culpability of nutritionists—I speak here even/especially of nutritionists who work out of Joslin Clinic, one of the most, if not the most, pre-eminent diabetes research and treatment centers in the world—who are still passing on scientifically dangerous advice. Endocrinologists, nurse practicioners and nutritionists alike are still passing on advice about curbing calories. This is dangerous advice. Curbing calories causes famishment, which leaves to people failing at dieting, whereas curbing carbohydrates does not. Curbing carbohydrates means you’re going to rely on fat-rich food, including nuts and cheese, for example. Those foods are calorie rich, but because they are low-carbohydrate, they don’t trigger the production of insulin. Insulin, of course, stimulates the appetite and causes people to crave more food. That, in fact, is the biochemistry behind the reason why we crave more food after we eat American-Chinese food, for example: white rice and sugary sauces create a gush of insulin, which causes hunger.

    We will have truly turned a corner when Joslin Clinic begins to preach low-carbohydrate diets, not calorie restriction.

    • creaker

      I’ve been doing this for months – kind of a modified paleo, and it’s the first diet that’s worked for me. I’m not limiting how much I eat, just what I eat. Once I got past carb withdrawal, it’s been odd learning to eat when hungry rather than being constantly driven by carb addiction (where I was always hungry).

      • Lisa Vaas

        Congratulations! I’m glad to hear you’ve broken the carb addiction. Lord knows it can be hard. Atkins preached going cold turkey, then progressing in phases to slightly more carbs, and I realize the wisdom of that: The sooner you turn off insulin production, the sooner you cut that carb addiction.

        You know, since I read about the artificial pancreas for Type 1s (that’s me), I’ve been musing about being able to eat whatever I want. And I think that there will be, in fact, a period of splurging in my diet. There are these little chocolate, ganache-filled mice and penguins the Burdick’s makes… oh lord, yes!

        But then, I predict, I will go right back to low-carbohydrate eating. There are plenty of health reasons besides diabetes control: maintaining a healthy weight, cholesterol count, blood pressure, for example, as well as keeping a lid on highly oxygenated blood, which is a product of eating carbohydrate and which leads to rapid proliferation of potentially cancerous cells.

        Besides, it just feels so much better to live in a body that’s gone low-carb. I’m sure you know what I mean.

    • Don_B1

      Carbohydrates that contain high amounts of fiber prevent the quick absorption of sugar and thus avoid the “insulin-rush” you mention.

      A lot of agribusiness-produced food is stripped of its original fiber content to make it last longer in storage, much like they add preservatives.

      It is really important to know the difference between various “carbohydrates” and here is where “natural” when the term is used correctly, helps a lot. But check out the fiber content of the food you eat.

      Until recently Asians were not obese and ate mostly a vegetarian (carbohydrate) diet. The Mediterranean diet contains a lot of vegetables.

      • Lisa Vaas

        That’s true, foods high in fiber are absorbed more slowly. But if they’re also high in carbohydrates, they’ll still cause insulin production, albeit at a lower rate. So those who are looking to lose weight, or to maintain weight loss, are still better off looking for low-net-carb foods (i.e., carbohydrates minus fiber = net carbs).

  • Kris

    They did spend a few minutes on type 1 diabetes, but unfortunately they put me on hold then picked up and said they were out of time for callers and hung up.

  • Lynn

    Looks as though my first post didn’t go through. Recap:
    I’m from a family that tends to be active, thin, maybe too thin, but who, most of us, develop Type II diabetes in our 60s. Not a member of any of the high risk groups mentioned. Sensitivity to carbohydrates doesn’t always manifest as weight gain. I’m 100 lbs and pre-diabetic.

    • Lisa Vaas

      Have you heard of the term TOFI? Thin on the outside, fat on the inside. The documentary “Fed Up” did a good job of looking at this in a family where one brother was obese/diabetic and others were thin. They put the thin brothers in an MRI and found that they did, in fact, have fat collecting around their internal organs. Eating an extremely carbohydrate-restricted diet is the answer for avoiding either type of fat accumulation, whether it be on the inside or outside of the body, visible or not. And, of course, avoiding the Type 2 diabetes that both thin and obese people can develop.

  • Lisa Vaas


  • http://hammernews.com/ hammermann

    What I want to know is EXACTLY how eating alot of sugar causes diabetes- the latest accepted wisdom from doctors, elected officials, and pushers of the nany state who are trying to ban soda pop, sugar, everything sweet in life. I’m frankly dubious- can’t help comparing to the 40 year successful campaign to ban saturated fats that caused us to all use margerine or unsat oil- then- “Oh, whoops, sorry-we were wrong, the breakdown by-products of healthy clean unsaturated oil are MUCH worse than saturated” (which I always wondered as a chemist, since they are far more reactive). I think the anti-sugar campaign is fueled by the same arrogance, superiority, and desire to meddle into the deep pleasurable zones of our lives. You vant to take away MY SUGAR???? Actually I’m using 80% artificial tablets/20% sugar to sweeten tea + homemade lemonade/cold coffee drink (which I always thought were garbage- banned cyclamate, an oddity of US, it isn’t in Europe, is almost indistinguishable from sugar in proper mix w sacharine) because I partly believe the propaganda against sugar. Haven’t listen yet- I will comment on my comment.

    • pm05

      It’s carbohydrates, including sugar, and is well know. So, no, you can’t be in denial about it.

    • Don_B1

      You might try watching this video from Dr. Robert Lustig of UCSF:


      He has several more recent YouTube videos out with later data, but this should give you a good foundation.

      He has a new book out also, and has been on the book tour circuit of talk shows, but he is a serious scientist.

    • youngfeminist

      Sugar is a kind of carbohydrate. And it is carbohydrates that are the problem. This includes starchy foods like potatoes, white bread etc. Eating the sugar in cookies, for example, is only part of the digestion process that will affect blood sugar levels-these kinds of foods also most likely contain refined white flour that will also affect blood sugar levels. Cutting sugar (but if you balance your diet you can still eat SOME sugar) and switching to whole grain and reducing starchy foods will help bring most people’s blood sugar level down. But this needs to be consistent, every day vigilance, not a here and there thing.

  • Julie T.

    If you really want to reverse pre-diabetes and control diabetes, buy Diane Kress’s book “Diabetes Miracle”. Diane is a RD and CDE. She is also a Type 2 diabetic who takes no insulin or meds for her diabetes. She has developed a 3 step plan to totally control this condition. Why haven’t you heard about it? Because, it doesn’t involved big pharma! Such a shame that these companies are banking on us staying in the dark about how to fix this!

  • pm05

    RE: the story of the man who got rid of his cases and cases of soda – he gave it to his brother!!! There is one of the problems! He should have thrown it out….

    • Don_B1

      Couldn’t have it go to waste!

      But maybe it could have been used as a household cleaner?

  • Jessica Nugent Rammos

    It’s too expensive to be healthy in this country! When being heathy is not a luxury than there won’t be 21 million with type 2 diabetes!!

    • tbphkm33

      With a little knowledge of how to shop and how to cook, it is cheaper to live healthy than on processed foods. It is a myth that it costs more to live healthy. It might if you go to health food stores and Whole Foods type places. If you go to farmers markets and regular groceries, you can spend 2 to 3 times less on a healthy meal than a frozen pizza (etc.).

      • warryer

        Indeed. It’s more likely a matter of the “cost” of time to make said healthy meals.

  • Susan

    The diabetic-industrial complex will ensure that the rates will continue to rise. There is too much money at stake in “managing” the disease, not even counting the junk food industry

  • Richard Jablonski

    An unrecognized factor contributing to obesity and diabetes is the difference in physiology among individuals. It is easily observed that many individuals have big feet, long noses, or short arms, even though the rest of their bodies fall within norms for weight and BMI; but in other individuals, the dimensions of the colon’s length, diameter, or both, are suspected to be disproportionately large. The consequence is that the GI tract is super-efficient, delivering excess glucose to the bloodstream whenever it is fed carbohydrates. The ever-present glucose output subsequently results in obesity followedby diabetes in my opinion.

  • youngfeminist

    I have been listening closely to this conversation and whereas I agree that lifestyle is a major contributor to diabetes, I would like to offer a personal anecdote to highlight that not everyone will be able to prevent diabetes through lifestyle changes alone. I have always been athletic, running track, cross country and on swim team. As a grad student and at 30 now, I easily run 30 mile a week, go to yoga, bicycle and hike and have taken up Thai chi. I also do a little weight lifting and cross training. After my father was diagnosed with diabetes a few years ago, I consulted nutritionists and dietitians and re-vamped my eating habits to be diabetic friendly. And yet, my blood sugar levels continue to climb towards unhealthy levels. What hope is there, or what research is being done for those people who are seemingly doing everything right but whose lifestyle is already healthy, or already modified to prevent diabetes?

    • http://earthasset.com Melissa

      You must read The End of Diabetes by Dr. Joel Fuhrman. Often dietary recommendations don’t go far enough to be effective. I know of no cases where his haven’t worked to reverse full-blown type II diabetes. It’s great you’re addressing this now, and that all it’s going to take is some dietary tweaking to get it in the bag!

  • ELKennelly

    For Type 2, it’s so simple: watch the hit documentary “Forks Over Knives” on-demand on-line http://www.forksoverknives.com and be inspired to follow a whole-food plant-based diet. It works, as Doctors Dean Ornish, Neal Barnard, John McDougall and Joel Fuhrman demonstrate time and time again with their patients, and as I’ve witnessed in friends’ reversals of their disease.

  • Kestrel

    Thanks for mentioning this very important point. I would also argue that our 8-5 work culture which makes it VERY hard for people to find time and energy to exercise is also a culprit. Wouldn’t it be far more civilized to allow people a two hour break in the afternoon to take a walk/ride a bike or whatever their choice of exercise is? How about a 6 hour work day as the norm? America has a deadly work ethic; give me the lifestyle of many European countries with shorter work days, work weeks and work years any day. If only I were in charge of the world…..

    • Stacy Dorris Proctor

      Hi Kestrel ~ I agree with you! Other contries, I am thinking of Denmark in particular, work less hours per day/week leading to a more efficiently work style. They value a rich and active life outside of the office. And, their productivity is very similar to ours. They also support a more even society – where men and women share in childcare and in home life…all things that can help us redistribute how we spend our time so we can make it a priority to exercise.

  • Kestrel

    I see a lot of people have had trouble with the way the program was presented, but I thought it was very clear when they were talking about the two different diseases. Maybe we need to re-name type II diabetes.

  • kenrubenstein

    The cause of increased diabetes and related increases in obesity have been the subject of numerous studies that link them to decreased diversity in the gut microbiome (all the bacteria that live there). In fact, Tom had a program featuring Dr. Martin Blaser of NYU who’s written a book, Missing Microbes, that presents a cogent theory behind all this. And he’s not alone. I haven’t listened to more than half this program, but I’m very surprised that none of the authorities have pointed to overuse of antibiotics in childhood and their killing of friendly gut bacteria in causing these problems. Diet and exercise, sure, but there appears to be something much more subtle and sinister going on here.

  • Stacy48918

    The first caller – Teresa – doesn’t understand the difference between gestational diabetes and Type II diabetes. Gestational diabetes is primarily the result simply of BEING pregnant. The hormone progesterone is an insulin antagonist. Yes, there are certain population groups/ages/etc that are even more prone to it but EVERY woman simply by being pregnant could potentially have gestational diabetes, no matter the diet.

    • RC

      Not true I got my GD and high blood sugar by changing my diet and exercising.

  • TJPhoto40

    Come on, Dr. Goland, tell it like it is. “It’s really hard” to make the changes in eating and lifestyle, she says, to avoid or resolve Type 2 diabetes. No, doc, it’s really hard to live with diabetes and its other health consequences! If you can’t convince your patients that health depends on good choices, and they don’t want to change to avoid the horror of disease, then you’re not an effective doctor and your patients are weak-willed fools. The callers and posters here who point to proper diet are correct. For most people who are prone to Type 2 (formerly called adult onset) diabetes or already have it, proper diet will forestall the disease or cure it so that there’s no need for daily drugs, injections, etc. It’s just about that simple, and anyone who tells you differently, Dr. Goland, probably has a vested interest in patients being sick because that’s what pays the doctors and pharmaceutical companies who like it that way.

    • CC

      You are assuming Type 2 Diabetes is always diet related. They are finding now that heart disease might not be so simple as Cholesterol levels. The healthiest food in this country is the most expensive. The most affordable food in this country is pre-packagd garbage. That is the real crime. We also don’t know what affect environmental toxins have on our bodies. Wonder if something as simple as DDT in our bodies alters the genes/hormones expressed? Before you blame diabetes solely on lifestyle choices (so you can just malign poor people), you should maybe take a step back. I can’t believe its just “junk food.” That sounds way too simple. There could be numerous factors at work here.

      • TJPhoto40

        No, CC, I specifically used the phrase “for most people” diet is the key. I’m not maligning poor people, I’m saying virtually everyone who chooses a bad diet is setting themselves up for health problems, and diabetes is one possible outcome. Look up “metabolic syndrome,” which is the medical term for the condition that leads to various health disorders. As for the cost of food, that’s a typical false claim. Some healthy food is more costly than junk, some isn’t. But the long-term cost of eating poor diet is much greater, including all the costs of health care such as treatment for diabetes. It’s nonsense to say that poor people can’t afford quality food. But subsidizing bad food, as the government does now, is something we should definitely object to, don’t you think?

  • Lisa Vaas

    It’s not excessive calorie consumption that’s to blame. It’s excessive carbohydrate consumption. Limiting calories, unfortunately, entails limiting dietary fat. That’s unproductive and besides the point. Dietary fat doesn’t translate into body fat on a low-carbohydrate diet, because it doesn’t trigger insulin—a crucial hormone for the body to store fat.

    Nor is it productive to blame people who overeat. They are victims of decades of bad advice regarding just this issue: getting more exercise and cutting calories. Were they to have been advised instead to cut carbohydrates, many people well might have broken the carbohydrate addiction that causes people to have excessive appetites.

    It’s not the total calorie intake that matters; it’s the type of calorie that matters. They’re not all the same. Different types of calories have markedly different effects on the body. The most relevant effect is whether calories stimulate insulin production.

    Fat does not. That’s why so many people have success on some version of low-carbohydrate eating, whether it’s Atkins, Paleo or what have you.

    Fat satiates (thereby keeping people on the diet, since they’re not famished) without triggering the insulin production

    that stimulates appetite.

    The best book I’ve read on this is the exhaustively well-researched work “Good Calories, Bad Calories,” by Gary Taubes.

    It’s time to stop blaming people for obesity. It’s a malady that they’ve been pushed into by those preaching low-fat diets, by TV ads promoting processed food, and by the food manufacturers. The obese are not necessarily slothful nor lacking in discipline.

    They might be addicted to carbohydrates, but many can, and many have, broken the cycle of addiction.

    • Marilyn Archibald

      I respectfully disagreem And I am not calling anyone names. I just think it’s time to stop blaming, TV, advertising, fast food, and all the usual suspects, and plain old cut down on calories. Noone eats more carbs than I do, to be honest, or enjoys them more (I also like fat!). I just don’t eat too many or too much. People who lose a lot of weight do it in a lot of different ways, but it all involves cutting back–significantly, on calories and portions. Everybody wants to latch onto a “thing,” whether it’s paleo, gluten-free, grapefruit diet, or whatever the fad of the moment. Eating a bit of everything, not too much of anything, and enjoying a nice balanced diet as we go through life–it’s really a pretty good approach but isn’t sexy or “theme-y” enough, I know.

      • CC

        There is an evolutionary reason why people would crave carbohydrates. Our ancestors certainly weren’t offered a daily buffet of anything they wanted to eat while lounging around. Its not surprising however, how most of the comments here are just about diet and exercise, as if that’s the only factor at play.

  • Lisa Vaas

    Tracee, I’m type 1 as well. FWIW, I found the book “The Diabetes Solution” by Dr. Richard K. Bernstein to be extremely helpful and informative with regards to how a low-carbohydrate diet can help alleviate the complications of both Type 1 and Type 2. I’ve managed to greatly reduce my A1C numbers since reading it and adopting his recommendations.

  • Lisa Vaas

    Two good books that i recommend to everybody: “The Diabetes Solution” by Dr. Richard K. Bernstein, and “Good Calories, Bad Calories” by Gary Taubes. There are tons of book recommendations in this comment section, but these two in particular I found very helpful in understanding the physiology of nutrition and how our bodies react to different types of calories.

  • http://eau.tumblr.com Colleen Williams

    Uh… Type 2 can’t be “cured.” And I’m thin, eat very well and exercise regularly. I have Type 2, diagnosed only a few months ago and I’m only 34 because it runs in my family. I’m sorry we’re not good enough for you, but we’re all in a big FAT glucose mess together. I’ll have this for the rest of my life & my meds keep me alive too. Get some empathy, jeeeeeeeez.

    • http://earthasset.com Melissa

      Colleen, check out Dr. Joel Fuhrman’s book, The End of Diabetes–He’s been practicing for 20 years and has successfully reversed all cases of Type 2 with nutritional excellence (with no medication)–but not the same nutritional approaches by other physicians. Anyone reading the book can do it with some necessary monitoring at first to adjust insulin. Good luck.

      • CC

        My grandmother got Type II in her 60s. Unfortunately, the damage to her pancreas was already done, so no amount of diet and exercise was going to help her. Please stop propagating the idea that type II is the same for everyone and if people just buy a book and follow the diet, they will be magically cured. Perhaps early on, but not so for everyone.

        • http://earthasset.com Melissa

          HI CC, so sorry to hear about your grandmother. Here’s a quote from a resource you may find helpful, and that hopefully addresses your point. I should have said ‘majority’ of patients, you’re right. This sentence comes from the enclosed link to a brief essay describing Fuhrman’s approach to treating and reversing type 2 (with case studies from both Type 1 and Type 2–a very, very hopeful approach): “For a Type 2 diabetic, this approach results in complete reversal of the diabetic condition for the majority of patients.”

          And here’s the link. Anyone with diabetes in their family should check it out, it is very credibly cited and written: http://www.drfuhrman.com/disease/Diabetes.aspx

  • http://www.mistertwilight.com mrtwilight23

    The government can do two things. Stop subsidizing corn, wheat and soy agriculture. Tax the food that is driving these chronic diseases to the edge of oblivion. Maybe a third thing is subsidize real whole food.

    • Art Myatt

      And there’s a fourth thing – publicize and prohibit the environmental causes of diabetes, such as the “Agent Orange” used so extensively in Vietnam. Decades later, the Veterans’ Administration recognizes Type II Diabetes in Vietnam veterans as a service-connected disability. The active ingredient, as I understand it, was dioxin, which is still being pumped into our air by incinerators and other sources. There’s no question diet and exercise is important, but it’s a complex condition with many contributing causes.

  • Joe D’Agosto

    Great topic of our day, diabetes. Love to learn more.
    1. Have the miracle preservatives in western food that extend shelf life
    for years been studied on their effect on diabetes? Are there still people on earth that have not been exposed and what are their incidence of diabetes?
    2. Have the hormones we feed our cows for milk production and the gene splicing we use to make our crop produce antibiotics for pest control, been studied for long term effects, for example, on diabetes (and breast cancer.)
    3. Does weight reduction really cure diabetes or is this a myth? Many people that have morbid obesity do not have diabetes. Weight reduction seems like a common sense strategy but where is the science that it cures or prevents diabetes. Chewing gum in class was thought to give you cavities, and butter we all know is bad for you, both have been proven false.
    4. Juvenile Diabetes was lethal, only a generation ago. As the type one diabetic raises a family, is there room for genetic counseling. The children may not have diabetes, but they may carry the gene. As more and more people are carriers, there would be an exponential effect in their offspring, as we are indeed seeing.
    5. Where is the incentive to cure diabetes? The pharmaceuticals certainly would lose. A vial of insulin is over $100. The new artificial pancreas with glucometer and pump is close to $8000. The status quo is very profitable (as are AIDS drugs). The United States awarded $100,000 for the invention of anesthesia in 1846 to prevent the pain and suffering to the casualties of the Civil War. Can the U.S. sponsor a Manhattan like project for Diabetes? Wouldn’t this pay for itself? Canada invented insulin, maybe the USA can find the cure to diabetes.

  • anon

    I live in Kuwait, and the younger generations have a completely different lifestyle from that of their grandparents… and diabetes has become VERY common. I don’t know if anyone can pinpoint the exact factor or factors, but certainly the entire sedentary, junk food lifestyle seems to bring diabetes with it.

    • Lisa Wallace

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  • Hillary Wright

    I called in to this show to offer my two cents, my point being we really need to change this conversation to one that helps people understand what’s going on with their body so they understand what they can do to change things. People have become numb to the “lose weight and exercise” message. This is what I try to do in my prediabetes book. I refuse to accept that people are too dumb to understand this, they just need it explained in a way they can comprehend.

    • Lisa Wallace

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  • Lisa Wallace

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  • Puchika Theany

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  • Lisa Wallace

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Sep 2, 2014
U.S. Sen. Mitch McConnell, R-Ky., talks with Mark Wilson, event political speaker chairperson, with his wife Elain Chao, former U.S. Secretary of Labor, at the annual Fancy Farm Picnic in Fancy Farm, Ky., Saturday, August 4, 2012. (AP)

Nine weeks counting now to the midterm elections. We’ll look at the key races and the stakes.

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Confederate spymaster Rose O'Neal Greenhow, pictured with her daughter "Little" Rose in Washington, D.C.'s Old Capitol Prison in 1862. (Wikimedia / Creative Commons)

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Pittsburgh Steelers outside linebacker Jarvis Jones (95) recovers a fumble by Carolina Panthers quarterback Derek Anderson (3) in the second quarter of the NFL preseason football game on Thursday, Aug. 28, 2014 in Pittsburgh. (AP)

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This Friday, Aug. 22, 2014 photo shows a mural in in the Pullman neighborhood of Chicago dedicated to the history of the Pullman railcar company and the significance for its place in revolutionizing the railroad industry and its contributions to the African-American labor movement. (AP)

On Labor Day, we’ll check in on the American labor force, with labor activist Van Jones, and more.

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