The Diabetes Epidemic Still Has A Disproportionate Impact On Some Americans
HuffPost joined The Forum at the Harvard T.H. Chan School of Public Health on World Diabetes Day to discuss the scope of the diabetes epidemic in the United States, including the disproportionate impact on communities of color, among pregnant women and in poor and underserved communities. Please follow along in the video below. Continue reading >>
Key facts The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 (1). The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014 (1). Diabetes prevalence has been rising more rapidly in middle- and low-income countries. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2015, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012**. Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the seventh leading cause of death in 2030 (1). Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications. What is diabetes? Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels. In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2015, diabetes was the direct cause of 1.6 million deaths and in 2012 high blood glucose was the cause of another 2.2 million deaths. Type 1 diabetes Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is charact Continue reading >>
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An American Epidemic
ON February 10th thousands of people crowded into a diabetes exhibit in Denver. They waited in lines to test the newest blood sugar meters. Matt Hoover, a star of the small screen, spoke about how he lost 157lb (71kg) and gained a wife. Representatives dispensed gewgaws. “It's an insulated bag,” explained one, “So if you've got a hot chicken...” No one had a hot chicken, though. The diabetic diet can be a Spartan affair. Over at the “Cooking Cardiologist” presentation, a dietician announced that people with diabetes should feel free to enjoy raisins—just not too many raisins. Not so many years ago such a scene would have been strange. Colorado is the kind of healthy, outdoorsy state where everyone seems to have a big dog and SUVs are splattered with mud. It has the lowest rate of obesity in the nation, and not coincidentally, about the lowest rate of diabetes. Just under 5% of Coloradans have been diagnosed with the disease. But that is not all that low. And the fact that it is one of the lowest in the country suggests the extent of the diabetes epidemic in America. The disease has become more than twice as common since 1980, and the rate is rising precipitously. According to the Centres for Disease Control and Prevention, 7% of Americans, roughly 21m people, have diabetes. At least 54m Americans have elevated blood sugar levels and are at risk of developing the full-blown disease. Rates are considerably higher among American Indians, African-Americans and Latinos. The economic costs of the disease were conservatively estimated at $132 billion in 2002, and the figure is rising. “If you look forward 10 or 15 years,” says Dr C. Ronald Kahn of the Joslin Diabetes Centre in Boston, “we really won't be able to afford the amount of health care this is goin Continue reading >>
Pets, Obesity And Diabetes: An Epidemic In 2016
If you’re like me, you’ve become used to hearing about the astronomical incidence of obesity and diabetes within the United States. And, predictions of how many of our children will ultimately develop diabetes is downright scary. Given this information, I wasn’t the least bit surprised to learn that two recent surveys demonstrate that the incidence of obesity and diabetes is also on the rise in our dogs and cats. Obesity survey Every year, the Association for Pet Obesity Prevention (APOP) conducts a survey that tracks the prevalence of obesity in dogs and cats. The 2015 survey, available on the APOP website, assessed 1,224 dogs and cats who received wellness examinations within 136 veterinary clinics. According to aaha.org, for every animal, a body condition score (BCS) was assessed and reported. This score was based on a five-point scale as well as the animal’s actual body weight. The animals were then classified as being ideal, underweight, overweight, or obese. The APOP survey revealed that approximately 58% of the cats and 54% of the dogs evaluated were overweight or obese. Wow, these percentages are striking! Based on body size alone, more than half of our pets have a significant health issue! The APOP defines obesity as an animal being 30 percent or more above ideal body weight. APOP board member, Dr. Steve Budsberg, notes that there is a lack of consensus amongst veterinarians about exactly how obesity is defined. “Our profession hasn’t agreed on what separates ‘obese’ from ‘overweight.’ These words have significant clinical meaning and affect treatment recommendations.”1 The APOP is pushing for the adoption of a universal pet BCS system. Doing so would allow veterinarians to more consistently and accurately assess their patients, report the Continue reading >>
Rising Global Temperatures Could Be Contributing To Worldwide Diabetes Epidemic
Growing global temperatures may be playing a part in the rising numbers of people developing type 2 diabetes, suggests new research from the Leiden University Medical Center and the Delft University of Technology, the Netherlands. The prevalence of type 2 diabetes is increasing rapidly worldwide. In 2015, 415 million adults globally were suffering from diabetes, and expectations are that the prevalence will rise by almost 55%, up to 642 million cases by 2040. In high-income countries, 91% of adults affected by diabetes have type 2 diabetes. Interestingly, it was recently shown that acclimatization of patients with type 2 diabetes to moderate cold for only 10 days already improves insulin sensitivity. Physiologically, cold exposure activates brown adipose tissue (BAT) that has been identified to combust large amounts of lipids to generate heat. Previously, it has been shown that BAT activity is negatively associated with outdoor temperature. A research team headed by Leiden University Medical Center Professor Patrick Rensen set out to investigate if global increases in temperature were contributing to the current type 2 diabetes growth by negatively impacting on glucose metabolism via a reduction in BAT activity. “In the present study, we aimed to assess the association between outdoor temperature and glucose metabolism on a countrywide as well as a global scale,” Prof. Rensen and co-authors said. “We specifically hypothesized that diabetes incidence and prevalence of glucose intolerance increase with rising outdoor temperatures.” The researchers used data on diabetes incidence amongst adults in 50 US states and three territories (Guam, Puerto Rico and Virgin Islands) for the years 1996 to 2009 from the National Diabetes Surveillance System of the Centers for Dis Continue reading >>
Epidemiology Of Diabetes Mellitus
Prevalence (per 1,000 inhabitants) of diabetes worldwide in 2000 - world average was 2.8%. no data ≤ 7.5 7.5–15 15–22.5 22.5–30 30–37.5 37.5–45 45–52.5 52.5–60 60–67.5 67.5–75 75–82.5 ≥ 82.5 Disability-adjusted life year for diabetes mellitus per 100,000 inhabitants in 2004 No data <100 100–200 200–300 300–400 400–500 500–600 600–700 700–800 800–900 900–1,000 1,000–1,500 >1,500 Globally, an estimated 422 million adults are living with diabetes mellitus, according to the latest 2016 data from the World Health Organization (WHO). Diabetes prevalence is increasing rapidly; previous 2013 estimates from the International Diabetes Federation put the number at 381 million people having diabetes. The number is projected to almost double by 2030. Type 2 diabetes makes up about 85-90% of all cases. Increases in the overall diabetes prevalence rates largely reflect an increase in risk factors for type 2, notably greater longevity and being overweight or obese. Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the more developed countries. The greatest increase in prevalence is, however, occurring in low- and middle-income countries including in Asia and Africa, where most patients will probably be found by 2030. The increase in incidence in developing countries follows the trend of urbanization and lifestyle changes, including increasingly sedentary lifestyles, less physically demanding work and the global nutrition transition, marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats, sometimes referred to as the Western pattern diet). The risk of getting type 2 diabetes has been widely found to be associat Continue reading >>
Diabetes Epidemic Looms In The United States
Diabetes is considered one of the most expensive chronic conditions in the United States to treat in terms of total dollars spent, and it is becoming increasingly common. It was the seventh leading cause of death in the U.S. for 2015, according to the federal Centers for Disease Control and Prevention (CDC). Approximately 30.3 million Americans (9.4% of the population) have diabetes, and an estimated 84.1 million people (33.9 % of the population) were prediabetic in 2015, according to the National Diabetes Statistics Report 2017, a new report released by the CDC. In 2013, more than $101 billion was spent in the U.S. to diagnose and treat diabetes, according to research by the Institute for Health Metrics and Evaluation. And the CDC estimates that one in three U.S. adults are pre-diabetic. The report says that 90 percent of people in the U.S. with prediabetes have not been diagnosed, so they do not know that they have the condition. As a result, they are not aware of the potential health risks posed by diabetes. If untreated, diabetes can result in many other health issues, including: Heart disease Stroke Kidney failure Vision problems including blindness Poor blood circulation Leg or foot amputation About 95% of cases are Type 2 diabetes, also known as “adult onset” diabetes. Type 1 diabetes is also known as “juvenile diabetes.” The CDC report says diabetes prevalence varies significantly: Among adults with less than a high school education, 12.6% had diabetes. Among those with a high school education, 9.5% had diabetes, and among those with more than a high school education, 7.2% had diabetes. People who are prediabetic can prevent or delay the onset of diabetes through exercise and better nutrition, says a new campaign by the American Diabetes Association (ADA Continue reading >>
The Great Diabetes Epidemic
In the past few months, there have been two deaths from Ebola in the United States, and half a dozen patients with the disease have been transferred from West Africa to specialized U.S. facilities for treatment. Americans are panicking about a U.S. Ebola epidemic, which has evoked a loud call for public health action — and generated efforts focused on prevention and vaccine development. Now compare that response to the lack of public outcry about the 281,400 deaths in 2010 from a different epidemic: Diabetes mellitus! That number is about the population of Toledo, Ohio, but the nation has not yet truly mobilized to address this very real threat. In 1994, the head of the Centers for Disease Control and Prevention’s (CDC) diabetes program declared that diabetes had reached epidemic proportions and should be considered as a major public health problem. Yet, in the last 20 years, we have failed to apply a dedicated and focused public health approach to diabetes; as a result, Type 2 Diabetes’ incidence has tripled, and deaths and serious complications have skyrocketed. As of 2012, almost 30 million people in the U.S. were thought to have Type 2 Diabetes — more than 9 percent of the population.1 Over one-quarter (27 percent) of those individuals have not been diagnosed and are not in treatment.2 An additional 86 million have pre-diabetes and are at-risk for developing diabetes (up from 79 million in 2010); of these, 90 percent are unaware of their condition, and 5 to 10 percent will progress to full diabetes annually.3 Diabetes occurs when the body either does not make enough insulin or cannot use it effectively. Type 2 Diabetes is the gateway to many serious complications, as the excess blood sugar (hyperglycemia) results in progressive damage to large and small bloo Continue reading >>
Diabetes And Its Drivers: The Largest Epidemic In Human History?
Abstract The “Diabesity” epidemic (obesity and type 2 diabetes) is likely to be the biggest epidemic in human history. Diabetes has been seriously underrated as a global public health issue and the world can no longer ignore “the rise and rise” of type 2 diabetes. Currently, most of the national and global diabetes estimates come from the IDF Atlas. These estimates have significant limitations from a public health perspective. It is apparent that the IDF have consistently underestimated the global burden. More reliable estimates of the future burden of diabetes are urgently needed. To prevent type 2 diabetes, a better understanding of the drivers of the epidemic is needed. While for years, there has been comprehensive attention to the “traditional” risk factors for type 2 diabetes i.e., genes, lifestyle and behavioral change, the spotlight is turning to the impact of the intra-uterine environment and epigenetics on future risk in adult life. It highlights the urgency for discovering novel approaches to prevention focusing on maternal and child health. Diabetes risk through epigenetic changes can be transmitted inter-generationally thus creating a vicious cycle that will continue to feed the diabetes epidemic. History provides important lessons and there are lessons to learn from major catastrophic events such as the Dutch Winter Hunger and Chinese famines. The Chinese famine may have been the trigger for what may be viewed as a diabetes “avalanche” many decades later. The drivers of the epidemic are indeed genes and environment but they are now joined by deleterious early life events. Looking to the future there is the potential scenario of future new “hot spots” for type 2 diabetes in regions e.g., the Horn of Africa, now experiencing droughts and f Continue reading >>
The Best (and Worst) States For Diabetes
TIME Health For more, visit TIME Health. The United States is experiencing a diabetes epidemic. Since 2008, the number of Americans with diabetes has risen by 2.2 million people, and the rate has increased rapidly with growing obesity. Yet some states appear to be faring better than others. On Wednesday, Gallup and Healthways released a new report ranking states and communities on incidence of diabetes for 2015. The new report shows Utah, Rhode Island and Colorado have the lowest incidence of diabetes in the United States. In each of those states, less than 8% of the population has diabetes. That’s significantly different than the rates reported in other states. For instance, Alabama and West Virginia have the highest number of people with diabetes in their state, with over 16% of the population with a diabetes diagnosis. TIME Health Newsletter Get the latest health and science news, plus: burning questions and expert tips. View Sample Sign Up Now The researchers cite the obesity epidemic as one of the greatest contributing factors to the high rates of diabetes in the U.S. More than a third of American adults are obese. “While not all people with diabetes are obese, and not all who are obese develop diabetes, research shows that about 54% of middle aged Americans who are obese and have not yet developed diabetes will do so in their lifetime,” the report authors write. The study authors also looked at specific communities within states for a deeper picture on what regions of the nation are doing well, and which communities need some work. They found that Boulder, Colo., Bellingham, Wash., Fort Collins, Colo., and Provo-Orem, Utah report the lowest incidence rates out of cities nationwide. Boulder is especially low with less than 5% of people in the city diagnosed w Continue reading >>
Half Of Adults In The U.s. Have Diabetes Or Pre-diabetes, Study Finds
A national wake up call to intensify efforts to control the obesity crisis with added focus on diet, exercise and monitoring blood sugar According to a study published online in JAMA today, nearly 50% of adults living in the U.S. have diabetes or pre-diabetes, a condition where a person already has elevated blood sugar and is at risk to develop diabetes. Diabetes, a condition where blood sugar is elevated, may reflect lack of production of insulin to lower blood sugar (Type 1) or insulin resistance (Type 2), generally the result of obesity, poor diet or lack of exercise leading to the metabolic syndrome. Diabetes is a costly disease in the U.S, racking up an estimated 245 billion in 2012, related to consumption and utilization of health care resources as well as lost productivity, according to the researchers in the study. Diabetes can damage blood vessels, the eyes and kidneys, also resulting in poor wound healing and devastating soft tissue infections. And nearly 71,000 persons die annually due to complications associated with diabetes, based on recent statistics from the American Diabetes Association. Investigators in the study defined undiagnosed diabetes as those persons having a fasting blood sugar greater than 126 mg/dl or a hemoglobin A1C > 6.5 %, a measure of long term glucose control. Pre-diabetes was defined as having a fasting blood sugar 100-125 mg/dl, or a hemoglobin A1C of 5.7-6.4%. Researchers evaluated 5,000 patients who were part of a national survey designed to assess the prevalence of diabetes and explore trends in different subgroups and ethnicities. Results from the study indicated that in 2012, between 12% and 14% of adults had diabetes, the most recent data available. The majority of these diabetics are type 2, the result of poor diet, obesity an Continue reading >>
Perspectives In Renal Medicine Epidemic Of End-stage Renal Disease In People With Diabetes In The United States Population: Do We Know The Cause?
Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause? The number of individuals initiating renal replacement therapy in the United States population grew exponentially over the past two decades. Cases of end-stage renal diseae (ESRD) attributed to diabetes accounted for most of this increase. In this report we examined factors that may account for the increase to determine whether it truly represents an epidemic of ESRD due to diabetes. We reviewed time trends in data of the United States Renal Data system, the Diabetes Surveillance Program of the Centers for Disease Control and Prevention, and diabetes literature. Recent growth of the number of individuals with diabetes accounted for less than 10% of the increase in the number of diabetes-related ESRD. Instead, most of it was due to a threefold increase in risk of ESRD in people with diabetes and, therefore, qualifies as an epidemic. Curiously, this epidemic occurred despite widening implementation of effective renoprotective therapies. Individuals with type 2 diabetes, regardless of gender, age, or race, experienced the greatest increase in risk. There is no evidence that diabetic patients have been surviving longer, so the increased risk was not attributable to the high risk associated with long duration diabetes. We hypothesize that an epidemic of ESRD has occurred in people with diabetes in the United States population over the last two decades. The nature of the factor responsible for the epidemic and the reasons it affects patients with type 2 diabetes particularly are unknown. Research efforts to identify the putative factor deserve high priority, as does a commitment of resources to provide care for the burgeoning number of patients with ESRD and type Continue reading >>
- Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes United States and Puerto Rico, 20002014
- Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study
- India’s Diabetes Epidemic Shifts to Poorer People in More Affluent Cities
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If Not Us, Who? Curbing The Diabetes Epidemic Requires A Person-centered Approach
I know from personal experience how challenging it can be to navigate the health care system. My mother was diagnosed with diabetes at an early age, and as the oldest daughter in a large family, it was up to me to coordinate her care that included frequent hospital stays. I often was frustrated with the fragmented system we found ourselves in, particularly as her condition continued to worsen. The experience convinced me that something had to be done. My mother passed away from complications related to her diabetes. She would have been proud knowing I — along with my colleagues — am fighting for innovative solutions to chronic health conditions. As the seventh leading cause of death in the United States,1 and the leading cause of kidney failure, adult blindness and lower-extremity amputations,2 there's no question that diabetes is a serious public health issue. According to the Centers for Disease Control and Prevention, 29 million Americans, or 9.3 percent of the adult population, live with diabetes. Together, the direct and indirect costs of diabetes and related complications exacted a toll of $245 billion on our nation's economy in 2012, according to the latest five-year study by the American Diabetes Association. The recent upward trend in diabetes cases is also startling. Since the disease first emerged in the 1980s as a major threat to public health, the number of adults with diabetes has nearly quadrupled. Although much can be attributed to significant advances in diabetes research and treatment, equally important is the role health care providers, community organizations, employers and policymakers have played in addressing several underlying causes of diabetes — socioeconomic conditions such as race, income and level of education. We must continue to take Continue reading >>
Is Diabetes Becoming The Biggest Epidemic Of The Twenty-first Century?
Diabetes is a major public health problem that is approaching epidemic proportions globally. Worldwide, the prevalence of chronic, noncommunicable diseases is increasing at an alarming rate. About 18 million people die every year from cardiovascular disease, for which diabetes and hypertension are major predisposing factors. Today, more than 1.7 billion adults worldwide are overweight, and 312 million of them are obese. In addition, at least 155 million children worldwide are overweight or obese. A diabetes epidemic is underway. According to an estimate of International Diabetes Federation comparative prevalence of Diabetes during 2007 is 8.0 % and likely to increase to 7.3% by 2025. Number of people with diabetes is 246 million (with 46% of all those affected in the 40–59 age group) and likely to increase to 380 m by 2025. The comparative prevalence of IGT is 7.5% in 2007 and likely to go up to 6.0 by 2025. The number of people with IGT is 308 million in 2007 and likely to be 418 m by 2025. (1) Almost 80% of the total adult diabetics are in developing countries. The regions with the highest rates are the Eastern Mediterranean and Middle East, where 9.2 % of the adult population is affected, and North America (8.4%). The highest numbers, however, are found in the Western Pacific, where some 67 million people have Diabetes, followed by Europe with 53 million. India leads the global top ten in terms of the highest number of people with diabetes with a current figure of 40.9 million, followed by China with 39.8 million. Behind them come USA; Russia; Germany; Japan; Pakistan; Brazil; Mexico and Egypt. Two major concerns are that much of this increase in Diabetes will occur in developing countries and that there is a growing incidence of Type 2 Diabetes at a younger age in Continue reading >>