Experts Say Diabetes Help Can Be Found on Many Fronts
Rates of diabetes, fueled by obesity and sedentary lifestyles, have risen unchecked in the US. About 7 percent of the population is affected, translating to about 20 million adults and children, according to the American Diabetes Association (ADA).
Estimates show that by 2050, some 48 million Americans will have type 2 diabetes.
And the disease will bring with it complications such as blindness, hearing loss, kidney disease, nervous system disorders, and amputations of extremities.
"Studies have suggested that for the first time in history, the generation of people born in 2000 is probably going to have a shorter life expectancy than their parents," says Dr. Sue Kirkman, vice president of clinical affairs for the ADA.
"That's attributable to obesity, diabetes, and heart disease. Is that what we want for our children?"
What is worse, one of the most promising medicines for treating type 2 diabetes - Avandia® - now appears to increase a person's risk of heart attack and heart failure, according to recent studies.
Still, medical experts say the fight against diabetes can be won - if everyone decides to do what is best for themselves and their families.
The finding on Avandia calls into question the safety of the entire class of medications known as thiazolidinediones. For now, Avandia - and other thiazolidinediones such as Actos® - remain on the market.
But last year, the US Food and Drug Administration (FDA) mandated stricter labeling, including "black box" warnings, for the medications.
A black box warning is the most serious warning that can be required by the FDA to be placed on a prescription medication, indicating that the medication carries more risks than most other prescription medications.
Medical experts recommend that each person discuss with their physician the risks and benefits of using Avandia.
"Every patient is different," says Dr. Kirkman. "Every patient has different risk factors. Every patient has reasons why one medicine might be better for them than another."
But medications are only part of the solution.
A better response would be drastic changes to American lifestyles, starting with improved diets and more exercise, to avoid type 2 diabetes in the first place.
"The statistics are pretty gloomy, but we also know people who are at risk for diabetes can do a lot to prevent it from coming on," explains Dr. Kirkman. "There's a lot people can do to try and control their fate."
The most common form of diabetes, type 2, or what used to be called adult-onset diabetes, occurs when either the body does not produce enough of the hormone insulin or the cells ignore the insulin.
The body needs insulin to transport sugar in the blood to cells for energy. Being overweight, an unhealthy diet, and lack of exercise are common contributors to this form of the disease.
Type 1 diabetes, usually diagnosed in children and young adults, occurs when the body is not capable of producing insulin.
Researchers reviewing data from the National Health Interview Survey found that from 1990 to 2005, cases of diabetes increased 4.6 percent each year.
They rose from 26.4 cases per 1,000 people to 54.5 per 1,000 people in the most recent year available.
Expert Martha Funnell, a certified diabetes educator (CDE), says health care costs are expected to soar as more people with diabetes complications fill doctors' offices and emergency rooms.
Even the US economy will be affected as potentially healthy people find themselves unable to work. "You're losing folks in the prime of their years, and that has an impact on society and our economy," says Funnell.
She says people can make healthy lifestyle choices and help pass those choices along to their children.
"The messages are those same old 'eat healthy and exercise,' and we hear those to the point where we think, 'Yeah, yeah, yeah, everybody knows we need to do these things,' " comments Funnell.
However, even small measures - standing more often during the day or walking during a lunch break or eating an apple instead of ice cream - can help make a difference.
The ADA recently "sounded the alert" about diabetes.
It was a one-day "call to action" to encourage those at risk for developing type 2 diabetes or those with loved ones at risk to take the Diabetes Risk Test and, if they score high, to schedule an appointment to see their health-care provider.
Always consult your physician for more information. |
Diabetes affects an estimated 20.8 million people in the US (90 percent to 95 percent have type 2 diabetes) - 14.6 million have been diagnosed, but 6.2 million are unaware they have the disease.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the American Diabetes Association (ADA), those affected include:
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9.7 million US women (8.8 percent of all women)
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10.9 million US men (10.5 percent of all men)
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176,500 people under age 20
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10.3 million adults over age 60
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3.2 million African Americans (13.3 percent of all African Americans)
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2.5 million Hispanic/Latino Americans (9.5 percent of all Hispanic/Latino Americans)
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13.1 million Caucasian Americans (8.7 percent of all Caucasian Americans)
According to the most recent statistics, diabetes was the sixth leading cause of death, and the fifth leading cause of death from disease. Diabetes costs $90 billion annually in direct medical costs. Diabetes costs $40 billion annually in indirect costs (loss of work, disability, loss of life).
Certain ethnic groups tend to be more susceptible to developing type 2 diabetes. Several risk factors contribute to this pattern, including the following:
genetic background
Certain racial groups tend to share a common genetic factor that may affect their insulin secretion and insulin resistance.
For example, African Americans, Hispanic Americans, Asian Americans, and Pacific Islanders may share a "thrifty gene" left over from their ancestors, which enabled them to survive during "feast and famine" cycles.
However, with those cycles phasing out, that same gene may make a person more susceptible to developing type 2 diabetes.
impaired glucose tolerance (IGT)
Impaired glucose tolerance, when blood glucose levels rise higher than normal after meals, may be more prevalent in certain groups. IGT may be an early stage of diabetes.
gestational diabetes
Women who develop gestational diabetes during pregnancy may have a 50 percent chance of developing type 2 diabetes within 20 years of the pregnancy. The prevalence of gestational diabetes is higher among certain groups.
hyperinsulinemia and insulin resistance
Hyperinsulinemia, or higher than normal levels of fasting insulin, may lead to diabetes. Certain ethnic groups tend to have higher insulin levels.
obesity
Obesity is a major risk factor for type 2 diabetes. Obesity is more prevalent in certain races.
physical inactivity
Lack of physical activity can lead to diabetes. Certain groups have higher levels of physical inactivity than others.
Always consult your physician for more information.
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