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Diabetes: Sugar-Coated CrisisAthens, GA
Diabetes: Sugar-Coated Crisis
David Spero, RN.
Publisher: New Society Publishers, Gabriola Island, British Columbia,
Canada. Date of Publication: 2006. Price: $16.95
Have you ever thought of diabetes as a social disease? David Spero wants you to consider that option in his book, Diabetes: Sugar-Coated Crisis—Who Gets It, Who Profits and How to Stop It. The author builds the case that type 2 diabetes is not as much a genetic disease but a reflection of the toxic environment that produces the stress, inequality, powerlessness, and hopelessness that keep people from adopting and maintaining good health practices. He feels that this toxicity explains why certain minorities and lower socioeconomic groups have been inordinately affected by diabetes. Mr Spero attempts to show that "the quality and difficulty of a person's life influences his health" and that only by joining forces in a social movement to change these social ills will diabetes and other chronic diseases be conquered. The book is ostensibly written for people who are personally affected by diabetes, but it definitely provides a unique viewpoint for health care providers to consider. It could also be a valuable resource for educating political and community leaders about the health and social issues affecting the most vulnerable segments of our population. Using a persuasive writing style, the author argues that current diabetes research and treatment are often misdirected. Instead of focusing on building communities and programs that promote empowerment and self-care, billions of dollars are spent on studying the genetics of diabetes, developing new drugs, and providing heroic interventions when diabetic complications occur. What does Mr Spero recommend instead? He proposes a diabetes wellness movement. In this movement, health care providers would serve as consultants to groups of people affected by diabetes and their communities. These people would support and educate each other at group medical appointments, diabetic support groups, and physical activity sessions with the assistance of trained community health workers. They would find healthy ways to relieve stress and depression without resorting to high-fat, high-sugar comfort foods, cigarettes, television, or drugs. They would also work with local political leaders to get community gardens and farmer's markets, where they would get fresh food and develop strategies to make neighborhoods safer for physical activity. In other words, these individuals would develop self-efficacy, which would allow them to take charge of their lives and decide on their own treatment. Unfortunately, Mr Spero believes the current culture promotes social isolation, excessive material consumption, and a belief that asking for help is a sign of weakness, which make these societal changes difficult. Besides addressing the sociologic issues related to diabetes management, the author, who personally has dealt with multiple sclerosis for many years, also devotes 2 appendices to his own recommendations for diabetes self-management and a listing of diabetes resources. The author says up front that these suggestions are based on his own experience and research and not necessarily the recommendations of mainstream diabetes organizations and can be ignored if they do not suit the reader's needs. The book also has a detailed index and list of references. The author firmly believes that many of the problems with diabetes prevention and control could be eliminated, or at least minimized, if social problems such as food insecurity, inadequate transportation, housing, and crime were eliminated or at least minimized. Some will argue that stress and social problems have been around much longer than the current diabetes epidemic, but with the incidence of diabetes only going up, we may need more books like this one to stimulate new ideas and interventions because clearly our current efforts are not working.
Books submitted for review may be sent directly to the Book Review Editor. See Information for Authors at www.diabeteseducator.org.
The Diabetes Educator, Vol. 33, No. 6,
916-920 (2007)
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