BROOKSVILLE - Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to manage the disease and lower the risk of complications.
23.6 million Americans have diabetes — 7.8 percent of the U.S. population. Of these, 5.7 million do not know they have the disease.
Each year, about 1.6 million people ages 20 or older are diagnosed with diabetes.
The number of people diagnosed with diabetes has risen from 1.5 million in 1958 to 17.9 million in 2007, an increase of epidemic proportions.
It is estimated that 57 million adults aged 20 and older have pre-diabetes. Pre-diabetes is a condition where blood glucose levels are higher than normal but not high enough to be called diabetes. Studies have shown that by losing weight and increasing physical activity people can prevent or delay pre-diabetes from progressing to diabetes.
Type 1 (previously called insulin-dependent or juvenile-onset) diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes.
Type 2 (previously called non-insulin-dependent or adult-onset) diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents
Racial Breakdown
Non-Hispanic Whites represent 14.9 million; 9.8 percent of all non-Hispanic whites aged 20 and older have diagnosed and undiagnosed diabetes.
African Americans represent 3.7 million; 14.7 percent of all non-Hispanic blacks aged 20 and older have diagnosed and undiagnosed diabetes.
Non-Hispanic blacks are about 1.8 times more likely to have diabetes as non-Hispanic whites aged 20 and older.
Hispanics/Latinos represent 10.4 percent of Hispanics/Latinos ages 20 or older have diagnosed diabetes. Among Hispanics/Latinos, diabetes prevalence rates are 8.2 percent for Cubans, 11.9 percent for Mexican Americans, and 12.6 percent for Puerto Ricans.
American Indians and Alaska Natives represent about 16.5 percent aged 20 years and older who are served by the Indian Health Service have diagnosed diabetes. Diabetes rates vary -- among Alaska Native adults (6.0%) to American Indians in southern Arizona (29.3%).
Asian Americans and Pacific Islanders represent 7.5 percent who are diagnosed with diabetes. However, prevalence data for diabetes among Pacific Islanders is limited.
Complications caused by Diabetes
Diabetes is the seventh leading cause of death listed on U.S. death certificates.
Cardiovascular disease is the leading cause of death among people with diabetes — about 68 percent die of heart disease or stroke.
The overall risk for death among people with diabetes is about double that of people without diabetes.
Diabetes can lead to serious complications, such as blindness, kidney damage, cardiovascular disease, and lower-limb amputations, but people with diabetes can lower the occurrence of these and other diabetes complications by controlling blood glucose, blood pressure, and blood lipids.
Many people with type 2 diabetes can manage their blood glucose by following a healthy meal plan and exercise program, losing excess weight, and taking oral medication. Some people with type 2 diabetes may also need insulin to manage their blood glucose.
The Legacy Effect
The United Kingdom Prospective Diabetes Study (UKPDS) was a groundbreaking study in people with newly diagnosed type 2 diabetes that ended in 1997. This study established that blood glucose control could reduce the risk of microvascular complications (eye disease, kidney disease, and the neuropathy that can lead to limb amputation) in type 2 diabetes. Unlike patients with diabetes of longer duration, in these patients, there was no increase in CVD related deaths during the early treatment period.
Ten years later, the UKPDS Follow-Up Study found participants in the intervention group who achieved blood glucose control as close to normal as possible during the original UKPDS had a lower risk of heart attack than those in the control group who had less well-controlled blood glucose. The intervention group also showed continued risk reduction in microvascular disease.
This "legacy effect" indicates that the benefits of blood glucose control that is as close to normal as possible in the early years after diagnosis can lead to a lasting impact on health risks over a long period of time.
Furthermore, a 27% reduction in the risk of heart attacks was seen in those who were overweight and managed their diabetes with blood glucose goals as close to normal as possible when using the common drug, metformin.
This "legacy effect" underscores the importance of early detection of diabetes. If diabetes is diagnosed, working toward early blood glucose control as close to normal as possible can result in long term benefits.
Total health care and related costs for the treatment of diabetes run about $174 billion annually.
Of this total, direct medical costs (e.g., hospitalizations, medical care, and treatment supplies) account for about $116 billion.
The other $58 billion covers indirect costs such as disability payments, time lost from work, and premature death.
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