Diabetes mellitus affects about 17 million people in the U.S., and it is thought that only half know that they have it. Diabetes refers to the problem of having too much glucose in the blood, either because the pancreas cannot make insulin or produces too little (Type I), or the body cells fail to use the insulin although sufficient amounts are being produced (Type II).

The most common form of diabetes (about 90 percent) is Type II, sometimes referred to as "adult onset" diabetes because it usually shows up after 40 years of age. Seniors over 65 are at heightened risk of developing Type II diabetes. Many of us are close to being symptomatic. Others are "pre-diabetic," with blood-glucose levels slightly higher than normal, but who have not yet been diagnosed as diabetic.

The symptoms of Type I (which tend to occur suddenly) are: extreme thirst or hunger; frequent urination; dramatic weight loss; persistent tiredness or irritability; nausea and vomiting.

The symptoms of Type II (which occur more gradually) are: any of the symptoms listed for Type I; recurring skin, gum, or bladder infections; slurred vision; tingling or numbness in hands or feet.

November is Diabetes Month, a reminder that, with the holiday season ahead, the temptations to "cheat" with too much "forbidden" food will be greater than ever for diabetics and dieters alike. All of us, especially seniors, need to beware of cheating to excess, even during the jolly holidays from October to December. Delightful days of celebratory eating with our loved ones can turn into weeks of eating sweet and empty calories. Too many of us find ourselves making New Year's resolutions in January, carrying 10 or more extra pounds, thanks to our well-meaning friends and family, who are, no doubt, in the same predicament.

Short of turning into antisocial grumps or following in the footsteps of St. Augustine, who apparently believed that "perfect abstinence" is easier than moderation, we can get through the coming holiday parties and protect ourselves from developing or worsening diabetes.

Dr. Mike Nichols of the TempusClinic in Los Gatos tells his patients that it's OK to enjoy special occasions as long as it's kept within boundaries. He suggests one meal per week. Sometimes patients will plan a depraved feast of all their forbidden foods.

"But," Dr. Nichols says with a knowing grin, "there's a rather interesting reward." In as little as two weeks on the doctor's food plan, his patients come to realize after one of these binges that they feel much better when they're eating well. Temptation is less of a problem for the recovering diabetics at TempusClinic; Dr. Nichols and his staff easily recognize when this has happened for their patients.

"They're clear-eyed," he says. "Their ability to be fully present for others is visible." And TempusClinic does it all without medications.

Ann Coulston is a speaker for the American Diabetes Association and one of the authors of a new book about women dealing with diabetes entitled Help! My Underwear is Shrinking! She urges that everyone learn his or her glucose levels. The number to remember and stay below is 110 mg/dL. Coulston also believes that the creeping weight gain of later years is not normal aging.

"Excess weight is a risk factor for diabetes," she warns, "and calories count." She points to the calculations made by using Body Mass Index in the ADA brochure "Could You Be at Risk for Diabetes?" in which weights of 162 pounds at 5 feet 5 inches or 193 pounds at 5 feet 11 inches are considered risky.

Dr. Nichols agrees with Coulston that weight can be a factor, but he does not rely on the BMI-calculated weight charts. More important, he thinks, is body composition—the amount of fat compared to amount of muscle. People with a high BMI but with good body composition can be healthier than those who boast a low BMI, because muscle weighs more than fat. He is also concerned about the type as well as the number of calories that his patients ingest.

This November, Dr. Nichols will submit to the American College of Sports Medicine an interesting study conducted at the TempusClinic. In the study, 25 subjects were asked to eat no starchy or sugary foods, to eat every three hours, to rotate their source of protein (for example, seafood, beef, poultry, or nuts), and to exercise (using a simple regimen) for one hour, three times per week. The 20 men and five women were tested for metabolic parameters at baseline and after six months, and the results were impressive. Important markers for diabetes, heart disease, stroke, and so on, were greatly improved—some to a degree that no known medication could achieve. One of those markers is, according to Dr. Nichols, "the best indicator of longevity."

The bad news is: exercise and good nutrition are essential to avoid illnesses that can lead to early death. The good news is: exercise and good nutrition will keep us seniors healthy all of our days.

For more information about ADA brochures, call 1-800-diabetes or visit http://diabetes.org; for more information from TempusClinic, call 408-354-0801 or visit http://www.tempusclinic.com.