People sometimes ask how I became interested in nutrition, wellness, and prevention. Truth be told, it was my patients who taught me. After I had been practicing medicine for a few years, I noticed something odd. Most of my recently diagnosed diabetic patients belonged to a select group of new patients — spouses of my other diabetic patients. I had learned in medical school that the tendency to develop diabetes is genetic. No one said anything about spouses. Yet here it was. One after another, the spouses of my diabetic patients were being diagnosed with diabetes. What did they have in common? Not their genes. It was their eating patterns.

I started to look at how, what, and when they ate. They kept food logs, and checked their blood sugars before meals, after meals, even in the middle of the night once or twice. They brought me nutrition labels. Then they began to make changes.

There is more to this story. A few years later, I, like all of America, watched the people of New Orleans struggle to survive in the aftermath of Hurricane Katrina, the first in a decade of similarly devastating storms. I stared, horrified, at one particular news photograph of a blanket-covered, wheelchair-bound body, flattened over itself as if tying its orthopedic shoes for eternity. My physician’s eye could see a second, deeper layer of tragedy below the surface, but what? I realized that it symbolized to me the awful consequences of uncontrolled diabetes.

For the individual in the photograph, Katrina was likely the last in a long series of humiliations. The disease’s destructive course speeded up by the storm, there was no alternative ending. Diabetes stole their ability to regulate fluids, monitor sugars, stand and walk. Diabetes destroyed their ability to adapt to environmental change. And then came the storm. Unable to adjust to heat, dehydration, starvation, and immobility in that awful place from which there was no escape, they died.

The tragedies of Katrina and diabetes became linked in my mind. As harsh a blow as these storms are, diabetes makes it even more difficult to survive. No matter what your circumstances, diabetes always makes everything harder. Katrina didn’t make diabetes more destructive, but it did show how profound that destructiveness is — and how urgent is the need to prevent it. After that storm, I became more committed than ever to preventing diabetes.

Annual diabetes costs in the U.S. are devastating our economy. Diabetes is devouring our healthcare dollars, felling our workforce, and exhausting the resources of millions of families. The costs are not sustainable. Diabetes affects 21 million Americans, an estimated 6 million of whom have not yet been diagnosed. It is the number one cause of acquired blindness, non-traumatic leg amputation, and end-stage kidney disease (dialysis). Two-thirds of diabetics die from heart attacks; diabetics are up to four times more likely to have a heart attack or stroke than non-diabetics.

To optimize our overall health as a nation, to direct public health resources most effectively, and to be in the best possible shape to prepare for that next emergency if and when it occurs — and it will, we must learn to nourish ourselves better, to be kinder to ourselves, to learn to tell real food from manufactured calories.

My goals are a little different from yours. I want to keep your sugars and blood pressure normal, prevent kidney damage, update immunizations and cancer screenings. But you have just one goal — to live a long healthy life, and perhaps even to dance at your grandchildren’s weddings. To your good health!