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Is Diabetes Becoming The Biggest Epidemic Of The Twenty-first Century?

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 >>

Prevalence And Incidence Trends For Diagnosed Diabetes Among Adults Aged 20 To 79 Years, United States, 1980-2012

Prevalence And Incidence Trends For Diagnosed Diabetes Among Adults Aged 20 To 79 Years, United States, 1980-2012

Importance Although the prevalence and incidence of diabetes have increased in the United States in recent decades, no studies have systematically examined long-term, national trends in the prevalence and incidence of diagnosed diabetes. Objective To examine long-term trends in the prevalence and incidence of diagnosed diabetes to determine whether there have been periods of acceleration or deceleration in rates. Design, Setting, and Participants We analyzed 1980-2012 data for 664 969 adults aged 20 to 79 years from the National Health Interview Survey (NHIS) to estimate incidence and prevalence rates for the overall civilian, noninstitutionalized, US population and by demographic subgroups (age group, sex, race/ethnicity, and educational level). Main Outcomes and Measures The annual percentage change (APC) in rates of the prevalence and incidence of diagnosed diabetes (type 1 and type 2 combined). Results The APC for age-adjusted prevalence and incidence of diagnosed diabetes did not change significantly during the 1980s (for prevalence, 0.2% [95% CI, −0.9% to 1.4%], P = .69; for incidence, −0.1% [95% CI, −2.5% to 2.4%], P = .93), but each increased sharply during 1990-2008 (for prevalence, 4.5% [95% CI, 4.1% to 4.9%], P < .001; for incidence, 4.7% [95% CI, 3.8% to 5.6%], P < .001) before leveling off with no significant change during 2008-2012 (for prevalence, 0.6% [95% CI, −1.9% to 3.0%], P = .64; for incidence, −5.4% [95% CI, −11.3% to 0.9%], P = .09). The prevalence per 100 persons was 3.5 (95% CI, 3.2 to 3.9) in 1990, 7.9 (95% CI, 7.4 to 8.3) in 2008, and 8.3 (95% CI, 7.9 to 8.7) in 2012. The incidence per 1000 persons was 3.2 (95% CI, 2.2 to 4.1) in 1990, 8.8 (95% CI, 7.4 to 10.3) in 2008, and 7.1 (95% CI, 6.1 to 8.2) in 2012. Trends in many demograph Continue reading >>

The Best (and Worst) States For Diabetes

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 >>

The Global Diabetes Epidemic

The Global Diabetes Epidemic

Twelve years ago, my husband and I packed up all of our belongings and moved to Trivandrum — a steamy, tropical town at the southern tip of India in Kerala. At the time, I was a medical student interested in studying stroke. For the next six months I dressed in a sari and walked to work on jungle roads. At the hospital, I immediately began seeing a steady stream of young patients affected by strokes, many of whom were so severely disabled that they were unable to work. I initially suspected the cause was tuberculosis or dengue fever — after all, this was the developing world, where infections have long been primary culprits for disease. But I soon learned that my hunch was wrong. One of my first patients was a woman in her mid-30s who came in with a headache, vomiting and an unsteady gait. Her scan showed a brainstem stroke. Her blood sugars were very high. The underlying cause of her stroke was most likely untreated Type 2 diabetes. Here I was, halfway around the globe, in a vastly foreign culture, but I was looking at a disease — and the lifestyle that fostered it — that was startlingly familiar. Today, I am an endocrinologist, and diabetes has become a full-blown epidemic in India, China, and throughout many emerging economies. In the United States, diabetes tends to be a disease that, while certainly not benign, is eminently manageable. Just this month, federal researchers reported that health risks for the approximately 25 million Americans with diabetes had fallen sharply over the last two decades. Elsewhere on the globe, however, diabetes plays out in a dramatically different fashion. Patients often lack access to care and can’t get insulin, blood pressure pills and other medicines that diminish the risk of complications. As more and more people develop Continue reading >>

Half Of Americans Facing Diabetes By 2020: Report

Half Of Americans Facing Diabetes By 2020: Report

NEW YORK (Reuters) - More than half of Americans will have diabetes or be prediabetic by 2020 at a cost to the U.S. health care system of $3.35 trillion if current trends go on unabated, according to analysis of a new report released on Tuesday by health insurer UnitedHealth Group Inc. Diabetes and prediabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion -- up from an estimated $194 billion this year, according to the report titled “The United States of Diabetes: Challenges and Opportunities in the Decade Ahead.” The average annual health care costs in 2009 for a person with known diabetes were about $11,700 compared with about $4,400 for the non-diabetic public, according to new data in the report drawn from 10 million UnitedHealthcare members. The average annual cost nearly doubles to $20,700 for a person with complications related to diabetes, the report said. Complications related to diabetes can include heart and kidney disease, nerve damage, blindness and circulatory problems that can lead to wounds that will not heal and limb amputations. Diabetes, which is reaching epidemic proportions and is one of the fastest-growing diseases in the United States, currently affects about 26 million Americans. Another 67 million Americans are estimated to have prediabetes, which may not have any obvious symptoms. More than 60 million Americans are unaware that they have the condition, according to UnitedHealth. People with prediabetes have higher than normal blood sugar levels, but not yet high enough to be diagnosed as diabetes. Prediabetics often have other risk factors, such as overweight, high blood pressure and high cholesterol. The 52-page UnitedHealth report also focuses on th Continue reading >>

An American Epidemic

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 >>

Diabetes Epidemic Looms In The United States

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 >>

How Diabetes Became An Epidemic

How Diabetes Became An Epidemic

It is estimated that almost 8 percent of Americans have some form of diabetes. What's even more worrying is that the number of people with diabetes is on the rise not just in the United States, but all over the world. Scientists have been working to find out why more people are developing diabetes and looking for strategies to help reverse this trend. Diabetes in the United States In the United States, diabetes has become increasingly prevalent in recent years. In 1980, 5.8 million people were diagnosed with diabetes, compared with 17.9 million today. Diabetes is expected to rise significantly in the near future. It is estimated that one in three Americans living today will eventually develop diabetes, and that the number of cases will increase in this country by 165 percent by 2050. Researchers believe that the following factors play a role in the increase: The baby-boomer population is aging, and your chances of developing diabetes increases with age. The Hispanic population is one of the fastest-growing segments of the United States population, and Hispanics are at increased risk of developing diabetes. Americans are becoming increasingly overweight and physically inactive, both known risk factors for diabetes. The Worldwide Diabetes Epidemic Diabetes is now a problem that affects people everywhere. There is evidence that 246 million people worldwide have diabetes. If current trends continue, this number is projected to reach 380 million within the next 20 years. Diabetes affects developed and developing countries alike. In fact, the largest increases in diabetes prevalence in the years to come are projected to take place in developing countries. According to the International Diabetes Federation, India currently has the highest concentration of people with diabetes, Continue reading >>

Diabetes And Aging: Meeting The Needs Of A Burgeoning Epidemic In The United States

Diabetes And Aging: Meeting The Needs Of A Burgeoning Epidemic In The United States

Abstract—In the United States, one out of every four adults over the age of 65 has diabetes and one half of all adults in this age group are prediabetic, placing them at high risk for developing the disease. Beyond the United States, many other countries are also facing aging populations and high obesity rates that contribute to a staggering global diabetes epidemic. The care of the older patient with diabetes is frequently challenging, due to the accumulation of diabetic complications, extensive comorbidities, and functional impairments. Compounding this challenge is the lack of directly available evidence to guide management and care in this population. Though the global community shares in the epidemiologic burden of diabetes, there are large disparities across health systems and nations in the allocation of resources to the prevention, diagnosis, and treatment of the disease. Yet there is a consistency across many countries in the sub-optimal glycemic control and health outcomes for a majority of diabetics. This article reviews the context in which health systems provide diabetes care for the elderly and provides a framework for policy makers to support comprehensive diabetes care in the older adult. Nearly half of global diabetes expenditures occur in the United States, where only 6% of the world's diabetics reside. This article focuses on how to improve diabetes care in the United States, given its disproportionate contribution to global diabetes expenditures. Many of the recommendations presented, however, may be adapted and applied to other health systems. Continue reading >>

The Great Diabetes Epidemic

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: America's Newest Health Epidemic (infographic)

Diabetes: America's Newest Health Epidemic (infographic)

As one of today’s fastest growing health challenges, diabetes has become increasingly prevalent in the United States. In fact, the number of Americans diagnosed with diabetes has risen from 10.4 million people in 1998 to 21 million people today, according to the CDC, and the number is expected to rise even more in the near future. The American Diabetes Association projects that one in three Americans living today will eventually develop diabetes, and that by 2050, the number of diagnoses will increase by 165 percent. As we recognize American Diabetes Month during November, let’s take a closer look at why more people are developing the disease and what our UnityPoint Clinic providers say we can do to reverse this trend. The Rise of Diabetes in the United States The number of people living with diabetes isn’t just up in the United States, but all over the world. While diabetes is now a problem that affects people everywhere, the CDC estimates that as many as 29.1 million Americans have diabetes (21 million who are diagnosed and another 8.1 million who are undiagnosed). This means that over 9 percent of the United States population has some form of diabetes. The rise in diabetes incidence across the United States is largely linked to the following three factors: More Americans are becoming overweight or obese and increasingly physically inactive – both known risk factors for diabetes. A person’s chances of developing diabetes increases with age. Now that the baby-boomer population is aging, more people from this generation are being diagnosed with the disease. Type 2 diabetes is especially common among African Americans, Latinos, Native Americans and certain Asian populations, which are all growing populations in the United States. Diabetes Complications Type 2 D Continue reading >>

Rising Global Temperatures Could Be Contributing To Worldwide Diabetes Epidemic

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 >>

Pets, Obesity And Diabetes: An Epidemic In 2016

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 >>

Perspectives In Renal Medicine Epidemic Of End-stage Renal Disease In People With Diabetes In The United States Population: Do We Know The Cause?

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 >>

Diabetes And Its Drivers: The Largest Epidemic In Human History?

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 >>

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