"You should be knocking at the pearly gates," a nurse said.
Until that moment, Clay, 49, had no inkling that she had Type 2 diabetes. Nor did she realize how much her weight was a factor. At 5-foot-6, she weighed over 200 pounds.
Over the last decade, the prevalence of diabetes in this country has jumped 40 percent - a leap that government health officials pin largely on America's piling on of pounds.
Today, more than 15 million Americans have Type 2 diabetes, and about 80 percent of them are overweight to some degree.
"Obesity is the main reason behind the dramatic and worrisome surge in Type 2 diabetes," said Allen Spiegel, director of the Diabetes Institute at the National Institutes of Health.
The rate of obesity - the most severely overweight - has jumped more than 50 percent in the last 10 years.
While many heavy people are healthy, particularly if they exercise, a person's medical risks escalate with weight.
"Obesity is not a cosmetic issue any more," said Ali H. Mokdad, a senior epidemiologist at the Centers for Disease Control and Prevention, which in 1999 declared the problem an epidemic. "It is a risk factor for several chronic diseases such as diabetes."
People with diabetes are two to four times more likely to develop heart disease and more than twice as likely to have a stroke.
And diabetes leads to about 86,000 lower-extremity amputations a year, 35,000 new cases of kidney failure, and more than 12,000 cases of blindness.
Propelling both obesity and diabetes - and making the twin epidemics hard to fight - is the way Americans now live.
People are barraged by food at every turn, enticing them to eat more. They also enjoy more energy-saving devices, guaranteeing that they move less.
As Helen Clay was to learn, making the changes that would keep her healthy meant doing battle with her surroundings every single day.
Living with diabetes
means changing a lifestyle
