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14 HEALTH • June 15, 2015 Cutting-edge research and patients' day-to-day decisions fight Type 2 together \\ By Emily Micucci D iabetes affects 29 million Americans, but perhaps even more stunning is the size of the population it threatens: The American Diabetes Association (ADA) estimates that about 86 million Americans have pre-diabetes and are at increased risk for developing the disease. According to the ADA, the vast majority of the cases — between 90 and 95 percent — are Type 2 diabetes, which typically develops in middle-aged adults who are often overweight or obese. But unlike many diseases that have causes that are difficult to identify and that cannot be reversed by lifestyle changes, Type 2 diabetics and pre-diabetics are lucky, according to several local health experts: To some extent, their fate is in their hands. DIGGING IN AGAINST DIABETES "An ounce of prevention is worth a pound of cure," said Dr. David Harlan, co-director of the Diabetes Center of Excellence, run by UMass Medical School and UMass Memorial Health Care in Worcester. Harlan has dedicated his career to helping patients with diabetes. He is chief of the diabetes division at UMass Memorial, and was inspired to delve into the specialty when he watched a documentary about the discovery of insulin back in 1986, when he was a physician in the U.S. Navy. He also liked that working with diabetes patients involved ongoing interactions. "They become friends and family," Harlan said. "It becomes a relationship, and I like that." Still, if he had his way, Harlan said diabetes would vanish from the face of the earth, and that's a goal he believes the field of medicine will one day realize through improvements in therapy for the disease. Eliminating diabetes? "I believe that someday, we will be able to eliminate diabetes," both Type 1 and Type 2, Harlan said, though curative therapies for the two types "will likely differ significantly." Harlan thinks the key to a cure may lie in cell trans- plants, which would provide patients with insulin- producing cells when their bodies have stopped pro- ducing it. But that technology is not market-ready, and until it is, Harlan said people with Type 2 diabe- tes should take every measure to reverse the disease if PHOTO/EDD COTE UMass Memorial's Dr. David Harlan urges his patients to take every measure they can to reverse diabetes, or stop its onset.