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Diabetes Epidemic United States

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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 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 >>

Epidemiology Of Diabetes Mellitus

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).[1] Diabetes prevalence is increasing rapidly; previous 2013 estimates from the International Diabetes Federation put the number at 381 million people having diabetes.[2] The number is projected to almost double by 2030.[3] Type 2 diabetes makes up about 85-90% of all cases.[4][5] 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.[1] 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[1] including in Asia and Africa, where most patients will probably be found by 2030.[3] 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).[1][3] The risk of getting type 2 diabetes has been widely found to be associat 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 >>

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 >>

Diabetes: Biggest Epidemic In Human History

Diabetes: Biggest Epidemic In Human History

Remember back in history class, when they talked about the Great Diabetes Epidemic of 1665? Of course you don’t; there was never any such thing. Certainly, there have been many epidemics throughout history. These could be enormously destructive; killing millions, toppling empires, depopulating entire landscapes.1 But diabetes as a mass killer? That’s something new. But that is exactly where we are today. Epidemiologists are warning that the Great Diabetes Epidemic is upon us – right now. The result of the combination of obesity and type 2 diabetes (“diabesity”) is likely to be the biggest pandemic in human history.2 Perhaps the word “epidemic” sounds overly dramatic to some ears. But the Centers for Disease Control (CDC) explains that “epidemic” simply refers to an increase in the number of cases of a disease above what is normally expected in a population in a given area. Relatedly, “pandemic” refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people.3 And so CDC refers quite specifically to the diabetes “epidemic” that currently affects almost 30 million Americans, which is forecast to rise to nearly 55 million people over the next decade.4, 5 This chart illustrates the growth in diabetes in the U.S. through the year 2030: Regarding the spread to other countries, the World Health Organization estimates that the number of people with diabetes grew by nearly 300% from 1980 to 2014, to 422 million worldwide.6 That number is also predicted to rise, to 642 million people living with diabetes worldwide by 2040.7 Altogether, taking into account both the number of people it will affect, and what it will cost to treat, one researcher has gone so far as to predict that type 2 diabetes is on t 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 >>

Diabetes Epidemic - Diabetes Data

Diabetes Epidemic - Diabetes Data

Diabetes is a national epidemic and is especially prevalent in the South. The Diabetes Belt, identified by the Centers for Disease Control and Prevention (CDC) in 2011, spans counties in most of the Southern states and reaches up through Appalachia. It's been growing since then, according to the CDC, new counties are being added; the CDC has let out the belt another notch yet it cannot contain the strain. The geographic area affected closely mirrors the "stroke belt," and its population generally is more prone to developing not only diabetes but also other chronic diseases. Nationwide, diabetes rates have nearly doubled in the past 20 years – from 5.5 percent in 1994 to 9.3 percent in 2012. In 2015, North Carolina had 10.7 percent of adults living with diabetes. Diabetes is the seventh leading cause of death in the United States and is a serious health condition that increases a person’s risk of heart disease, stroke, kidney disease, blindness, and amputation of the legs or feet. Carolinas HealthCare System is working to reverse the diabetes trend in our community by focusing on prevention, identifying effective treatments and improving medical care. Our clinicians are sharing best practices so we can continue to see improvement in the more than 100,000 diabetic patients under our care. In 2015, our clinicians effectively managed 74 percent of patients with diabetes and helped them keep their blood sugar under control, and 77.3 percent of patients had their blood pressure or hypertension under control. Our efforts compared to national bench marks show we are performing in the highest percentiles in several key areas including: Continue reading >>

The Diabetes Epidemic Still Has A Disproportionate Impact On Some Americans

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 >>

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 >>

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 Adults In The U.s. Have Diabetes Or Pre-diabetes, Study Finds

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 >>

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 >>

Rise Of Diabetes Epidemic Leads To Innovations In Diabetic Patient Care Nationwide

Rise Of Diabetes Epidemic Leads To Innovations In Diabetic Patient Care Nationwide

Kingwood, Texas, Nov. 06, 2017 (GLOBE NEWSWIRE) -- The 2017 National Diabetes Statistics Report, published by the Centers for Disease Control and Prevention, found that 30.3 million people are living with diabetes in the United States. Within the U.S. there are 7.2 million people living with undiagnosed diabetes. The rate of diabetes in the U.S. has reached epidemic proportions and is ranked as the seventh leading cause of death. Vision Source, North America’s largest independent optometric alliance, has created specialized training to support the rising need for wholistic diabetic patient care. The BrainStream Diabetes Practice Protocol is a continuing education course offered exclusively to Vision Source member optometrists and serves as a guide for detecting and monitoring diabetes. This training program personalizes the patient experience by melding state-of-the-art equipment with leading optometric clinical skills. Through the application of BrainStream Diabetes Practice Protocol training techniques, Vision Source optometrists use comprehensive medical eye exams to assess the overall health of the internal ocular structures including the retina and optic nerve. For patients living with diabetes, Vision Source clinicians assess ocular findings to detect diabetes, review the advancement of the disease, determine if the disease is being controlled, and how prescribed medications are affecting ocular health. “Vision Source is proud to partner with a host of managed care organizations nationwide to ensure that patients have access to an enhanced healthcare experience,” stated Vision Source Vice President and Chief Medical Officer Dr. Paul Williams, OD. “Through our partnerships, Vision Source furthers our commitment to fighting the diabetes epidemic by building Continue reading >>

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