In a Gold's Gym, the day after Thanksgiving it is normal to find people who say they stuffed themselves over the holiday and are now trying to work it off.
"I keep a food journal every day. I track my blood sugar all the time," says Blake Tucker.
If Tucker's statement doesn't give it away, the pump on his hip will. He is diabetic and has been the past 14 years. This is not a man exercising out of guilt.
"At first it's like 'What did my body do? Did I do something bad to my body? Why is my body revolting against me? Why is it broken," says Tucker.
For Tucker, with Type 1 diabetes he can blame genetics.
However, 23.7 million have diabetes in 2009, but a new study released Friday by the University of Chicago predicts that by 2034, the nation's diabetes cases will double to 44.1 million, with the cost of treatment tripling to more than $336 billion.
The study cited two factors in particular: an aging population and an aging population that neither eats well or exercises right. It also found that a weight loss of as little as 10 pounds might make a difference.
"What this is really due to is the aging of the population and increased testing," says ABC News medical editor Dr. Richard Besser, M.D.
As Dr. Besser notes, the only bright side in this study is that is assumes American will remain as obese in the future as they are now, but education might change that. It certainly did for Tina Shinizu.
"I think about it because my parents have it," says Shinizu. And she knows that gym time reduces her odds. "Exercise will keep it off, I think."
In fact, many diabetes victims describe the disease as almost a reverse blessing that forces them to stay fit. Look for what it did for Tucker -- most 37 year olds don't look as fit.
"You get a different plus. It's maybe a little more subtle, but it's good," says Tucker.
Not that he would wish this on anyone else, and certainly not on 44 million people.