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Diabetes Has Become An Epidemic

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 >>

Canada Still Has A Chance To Reverse Its Diabetes Epidemic

Canada Still Has A Chance To Reverse Its Diabetes Epidemic

Earlier this year I retired after a dozen years as president of Innovative Medicines Canada. Shortly after I took an assignment with the Canadian Diabetes Association and the opportunity to work on what is one of Canada's largest and most perplexing challenges: our diabetes epidemic. For years public health authorities have been sounding the alarm. But the tone has become more urgent in recent years -- with terms like "burning platform" and "crisis" increasingly used. Since 2000, the prevalence of diabetes has more than doubled. In the next 10 years, both prevalence and direct health-care costs for diabetes are projected to grow by more than 40 per cent. In 2016, an estimated 29 per cent of Canada's population have either diabetes or prediabetes. The prevalence of diabetes in Canada is now slightly higher than in the United States. In fact, Canada has the second highest prevalence rates in recent study of 34 Organization for Economic Cooperation and Development (OECD) countries. This is having a profound impact on the health of millions of Canadians, and costs our health-care system billions of dollars per year. In medical and human terms, the numbers are staggering: Diabetes reduces the average lifespan by five to 15 years. It is estimated that one of 10 deaths in Canadian adults was attributable to diabetes in 2008-2009. People with diabetes are over three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with end-stage renal disease and over 20 times more likely to be hospitalized for a non-traumatic lower limb amputation compared to the general population. Diabetes contributes to 30 per cent of strokes, 40 per cent of heart attacks, 50 per cent of kidney failure requiring dialysis and 70 per cent of non-traumat 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 >>

Global Diabetes Epidemic Must Not Become Epidemic Of Blindness

Global Diabetes Epidemic Must Not Become Epidemic Of Blindness

Systematic eye screening, preventive treatment can have far-reaching impact The global epidemic in type 2 diabetes mellitus is of unprecedented proportions. In absolute numbers, it probably exceeds any previous epidemic in the history of mankind. There are now more than 400 million people with diabetes in the world, and the number is projected to exceed 600 million by 2030. In 2000, there were “only” 150 million people in the world with diabetes. In China alone, there are now more diabetic patients than were in the world when diabetic eye screening and preventive care for diabetic eye disease started in the 1980s. During 20 years with type 2 diabetes, roughly 66% of patients develop retinopathy and about 33% develop sight-threatening retinopathy, where treatment is needed to prevent vision loss. Thus, we may expect that one-third of the more than 400 million people currently with diabetes will develop diabetic macular oedema or proliferative diabetic retinopathy within the next 20 years. Taking action Systematic screening for eye disease in diabetic patients started in northern Europe in the 1980s, with dramatic lowering of diabetic blindness, for example, in Iceland. In the UK, systematic screening over the past 2 decades has demoted diabetes from being the most frequent cause of blindness in the working-age population. A global effort to prevent an epidemic of diabetic blindness must be based on the proven success of systematic eye screening and preventive treatment. This is a huge task. Presently, systematic screening for diabetic eye disease is regularly undertaken in a few northern European countries and sporadically by some eye clinics and regions elsewhere. Most diabetic patients around the world do not have access to diabetic eye screening. The cost is consi Continue reading >>

Cities Are The Front Line In The Global Diabetes Epidemic

Cities Are The Front Line In The Global Diabetes Epidemic

Today, 437 million people worldwide have type 1 or type 2 diabetes. New estimates published this month show that three-quarters of a billion people could have the disease by 2045 — and cities are the front line of this challenge. As the growth fast becomes unmanageable for health systems, shortening the lives of millions of urban citizens and constraining economic growth, Novo Nordisk is working with a coalition of major cities to bend the curve on type 2 diabetes. We’re calling for local political and health leaders of all cities to ask what it will take to change the trajectory of the disease in their area and to put into practice the new models that we are forging. A rapidly urbanizing world is changing not just where we live but also how we live. As my predecessor at Novo Nordisk wrote, the way cities are designed, built, and run creates health benefits for citizens — but critically it also creates risks. Towns and cities, where half of the world’s population now lives, are home to two-thirds of people with diabetes. That’s why when we initiated the Cities Changing Diabetes program in 2014, we set out to put a spotlight on urban diabetes. This effort has grown into a global partnership of nine major cities, home to over 75 million people, and over 100 expert partners united in the fight against urban diabetes. Without concerted action, health systems around the world will reach a point in coming decades when they won’t be able to effectively treat patients sustainably. We conservatively estimate that the related costs of diabetes — including medication, supplies, hospital care, and the treatment of complications — will exceed $1 trillion a year by 2045. The catastrophic rise in diabetes won’t be stemmed by medicine alone. That’s why cities need t Continue reading >>

What Is The Mechanism Of Action In The Treatment Of Diabetes?

What Is The Mechanism Of Action In The Treatment Of Diabetes?

Insulin therapy is necessary for type 1 diabetics because they have an absolute insulin deficiency due to the autoimmune destruction of the pancreatic beta cells. Insulin therapy is also used in treating type 2 diabetes. As the disease advances, many type 2 diabetics will require insulin therapy, because the beta cells are damaged by hyperglycemia, and patients develop significant defects in insulin secretion. These drugs bind to and block the ATP-sensitive K+ channel on pancreatic beta cells, causing depolarization and increased insulin secretion (review Humoral Regulation). These drugs improve glycemic control, but patients taking them tend to gain weight. Sulfonylureas (glyburide, glimepiride) are older drugs and less expensive. A potential problem is that they can induce too much insulin secretion and hypoglycemia can result. The meglitinides (repaglinide, nateglinide) are newer drugs that are designed to avoid this problem. They have a shorter half-life, and are taken at mealtimes to enhance insulin secretion and prevent postprandial hyperglycemia. Incretins are gastrointestinal hormones that increase insulin secretion (review Incretins). GLP-1 agonists are peptide drugs with a longer half-life than the native hormone because they are resistant to digestion by the protease DPP-4. DPP-4 inhibitors (“gliptins”) prolong the action of native incretins. DPP-4 inhibitors are less effective at lowering HbA1c than GLP-1 agonists, but an advantage is that they are oral drugs. GLP-1 agonists have the added benefit of inducing weight loss (several kilograms, depending upon the length of treatment). The mechanism is thought to be that GLP-1 delays stomach emptying into the small intestine, causing patients to eat less because they feel full sooner. These drugs improve insu Continue reading >>

What Are The Side Effects Of Eating Junk Food (like Lays, Kurkure, Etc.) Regularly?

What Are The Side Effects Of Eating Junk Food (like Lays, Kurkure, Etc.) Regularly?

Usually junk food is eaten by children's. These are some side effects of eating junk food On children's According to the Women’s and Children’s Health Network, diet has a significant effect on children’s study habits. Junk food and foods with high sugar content deplete energy levels and the ability to concentrate for extended periods of time. Energy and focus are especially crucial for school-age children. Children set the foundation for lifelong habits in their youth, making junk food particularly hazardous to their well-rounded development. Physical activity is also essential for children of all ages, and regularly eating junk food does not provide the necessary nutrients children need for sufficient energy to engage in physical activity. A lack of physical activity is harmful to physical and mental well being and may also exclude a child from critical social development. A study published in “Pediatrics” in 2004 found fast-food consumption in children was linked with many dangerous precursors for obesity. According to this study, kids who ate fast food were more likely to consume a higher amount of calories, fat, carbohydrates and added sugars in one fast food meal. They were also less likely to consume as much fiber, milk and fruits and vegetables as children who did not eat fast food. Children who consumed more fattening foods while eating fast food were also likely, in general, to eat more unhealthy foods at other meals. According to a statement released by the journal “Nature Neuroscience” in 2010, high-calorie food can be addictive, causing children who occasionally eat fast food to learn problematic patterns of eating. These factors were found to place children who regularly ate fast food at increased risk for obesity. According to the Prevention Continue reading >>

The Diabetes Epidemic

The Diabetes Epidemic

In the 1990s, the prevalence of diabetes took a sharp and unexpected upward turn, according to annual surveys of more than 100,000 participants conducted by scientists at the U.S. Centers for Disease Control and Prevention in Atlanta. Their study, "Diabetes Trends in the U.S.: 1990-1998," appeared in the September 2000 issue of Diabetes Care . Related Articles 'Poisoning by sugar' and the 'safe for diabetics' foods myth Do 'heart healthy' diets cause diabetes? What is diabetes? The glycemic index: why everyone's talking about it Diabetes is a potentially devastating disease that tends to be taken less seriously than it should because its beginning symptoms may not be alarming. However, its slow progression can lead to recurrent infections and ulcerations, nerve damage, gangrene (which often results in amputations), blindness, kidney failure, heart disease and stroke. Individuals with diabetes have a reduced life expectancy. About 16 million Americans have diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases' latest estimates. As a result of the new research, that figure could increase by several million. Frightening statistics he study found that in eight years, the prevalence of diabetes among adults in the United States rose by 33 percent, from 4.9 percent in 1990 to 6.5 percent in 1998. Among Hispanics, it increased by 38 percent, going from 5.6 percent to 7.7 percent. Among African-Americans, it increased by 26 percent, going from 7.0 percent to 8.9 percent. These numbers are cause for concern. But by far the most worrying are those in the 30 to 39 age group. There, the prevalence increased by 70 percent, from 2.1 percent in 1990 to 3.7 percent in 1998. The youngest age group that the study considered, those 18 to 29, showed on Continue reading >>

Diabetes: The Epidemic

Diabetes: The Epidemic

On Barbara Young's office table is a graph. A bar chart, actually: four columns of green, purple, red and bright blue showing the progression, in England, of rates of coronary heart disease, stroke, cancer and diabetes over the past five years. The first two are flatlining or falling. Cancer, in red, is rising, but slowly. Trace a line between the blue bars from 2005 to 2010, and it soars off the chart. "Diabetes," says Young flatly, "is becoming a crisis. The crisis. It's big, it's scary, it's growing and it's very, very expensive. It's clearly an epidemic, and it could bring the health service to its knees. Something really does need to happen." Baroness Young is, admittedly, the chief executive of Diabetes UK, Britain's main diabetes charity and campaigning group. It's her job to say such things. But the figures are behind her all the way: diabetes is fast becoming the 21st century's major public-health concern. The condition is now nearly four times as common as all forms of cancer combined, and causes more deaths than breast and prostate cancer combined. Some 2.8m people in the UK have been diagnosed with it; an estimated 850,000 more probably have type 2 diabetes but don't yet know. Another 7m are classified as high-risk of developing type 2; between 40% and 50% of them will go on to develop it. By the year 2025, more than 5m people in this country will have diabetes. The implications for the NHS, obviously, don't bear thinking about. Diabetes already costs the service around £1m an hour, roughly 10% of its entire budget. That's not just because the condition generally has to be managed with medication or insulin, but because by the time they are diagnosed, around half the people with type 2 – by far the most common and fastest growing form – have developed a Continue reading >>

Diabetes

Diabetes

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 >>

Diabetes Epidemic

Diabetes Epidemic

Tweet A number of recent diabetes news articles indicate that the diabetes problem is now a truly global epidemic. Understanding where the problem is at its worst, where the greatest concentrations of diabetics are, and raising awareness are the keys to prevention and the aversion of a future healthcare crisis. The diabetes epidemic is largely focused around massively increased rates of obesity. Obesity, when left unchallenged, leads to pre-diabetes or metabolic syndrome. Either of these conditions, if not swiftly acted against, can lead to the development of full-blown type 2 diabetes. The diabetes epidemic occurs at different rates throughout the world, with the condition changing in some countries from a minor to a serious problem in a matter of years. Global diabetes hotspots are at the forefront of the problem, including the USA, China and India, yet diabetes is now truly global. Some ethnic groups are particularly prone to developing type 2 diabetes, yet it has become apparent that diabetes can strike anywhere. The following selection of news articles indicates that diabetes is a truly global phenomenon, with no country seemingly safe: Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are a Continue reading >>

World Diabetes Day 2014: 5 Reasons Diabetes Has Become An Epidemic In India

World Diabetes Day 2014: 5 Reasons Diabetes Has Become An Epidemic In India

Type 2 diabetes or diabetes mellitus shares a significant percentage of the burden of non-communicable diseases prevalent in India, with over 62 million people currently living with the disease. It has been predicted that by the year 2030, India will cross the mark of 87 million to become the country harbouring the world’s largest diabetic population. Diabetes has been affecting people since 1500 BC, the time when it was first reported. But it wasn’t so rampant back then as it has become now. The drastic increase over the past few decades in a short span of time highlights that something has definitely triggered this epidemic. Dr Geeti Mahajan, consultant, endocrinology, Fortis Memorial Research Institute highlights a few factors that has led to an increase in diabetes cases in India. (Read: The dramatic change in lifestyle: Diabetes is no doubt a multi-factorial disease but the impact of environmental changes on emergence of the disease has made more number of people susceptible to the disease. The rising standard of living has taken charge of every aspect of human life, right from what we eat and what we think to how we live. This, in turn, has increased the prevalence of other lifestyle disorders like obesity, insomnia, heart disease etc., which directly or indirectly increases the risk of diabetes. (Read: Early-onset diabetes: Diabetes was once believed to be a condition that affects the elderly population. Now, times have changed. Right from childhood, people are exposed to an unhealthy lifestyle. So by the time they turn 30, they are diagnosed with diabetes. Currently, the number of people with pre-diabetes is so high that a sudden upsurge in diabetics is inevitable. An increase in the number of cases of early-onset diabetes also increases the chances of diabe Continue reading >>

The Diabetes Epidemic

The Diabetes Epidemic

The disease, for which there is currently no cure, exacts a tremendous toll on patients, their families, and society. Diabetes, even when carefully controlled with conventional therapies, negatively impacts both the lifespan and quality of life for millions of people. The International Diabetes Federation, or IDF, estimates that in 2015 approximately 415 million people had diabetes worldwide and that by 2040, this will increase to 642 million people worldwide. In the United States, more than 29 million people, or approximately 9% of the U.S. population, suffer from diabetes, and 86 million are living with prediabetes, a serious health condition that increases a person’s risk of type 2 diabetes and other chronic diseases, according to the Centers for Disease Control and Prevention. According to the American Diabetes Association, the total costs of diagnosed diabetes in the U.S. rose dramatically from $174 billion in 2007 to $245 billion in 2012. This includes $176 billion in direct medical costs and $69 billion in reduced productivity. Of the total population with diabetes, approximately 5%, or almost 1.5 million people in the U.S., have type 1 diabetes (T1D). In 2010, it was estimated that the annual cost of T1D to the U.S. healthcare system was approximately $14.4 billion. What is Diabetes? Diabetes mellitus, or simply diabetes, is a group of diseases characterized by high blood glucose (a.k.a., high blood sugar or hyperglycemia) that results from defects in the body’s ability to produce and/or use the hormone insulin. With the advent of, and improvements in, pharmaceutical insulin over the last century, the issue has become less so chronically high blood sugar, but instead blood sugar that must always be monitored, and for most diabetic patients is extremely diffi Continue reading >>

What Is Worse For Your Health: Overweight Or Underweight?

What Is Worse For Your Health: Overweight Or Underweight?

The BMI to mortality relation up to January 2010 seemed clear cut: for the lowest mortality a BMI between 22.5 - <25 is the optimal BMI we should strive for, but then two papers in the Journal Obese and the JAMA turned everything upside down: Let's look at some recent Body mass index vs. Mortality rate data: December 2nd, 2010: NEJM This paper by Amy Berrington Gonzales et al from The New England Journal of Medicine December 2nd, 2010 shows that having a very high BMI is worst that having a too low BMI, optimal BMI being between 22.5-25. It is a large, pooled analysis of prospective studies with the base year later than 1970 totaling 900,000 non-Hispanic white participants who never smoked and didn't have heart disease or cancer If you click on the link you'll get a better view of the graph. January 2010: Graph taken from: based on Heather Orpana's paper published in the Journal Obese on January 2010 BMI and Mortality: Results From a National Longitudinal Study of Canadian Adults a prospective longitudinal study including 18,834 participants, excluding from the analysis deaths within 4 years after starting the study to rule out reverse causation, that is deaths due to preexisting illnesses: The BMI on the graph is the starting BMI when joining the study. January 2nd, 2013: JAMA Network | JAMA | Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysisAll-Cause Mortality Using BMI Categories a paper by Katherine M. Flegal et al estimating of the relative mortality risks associated with normal weight, overweight, and obesity performing a systematic review of 97 studies including around 2,88 million participants and 270,000 deaths. Results Random-effects summary all-cause mortality HRs for Continue reading >>

Globalization Of Diabetes

Globalization Of Diabetes

Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Fueled by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles, the epidemic has grown in parallel with the worldwide rise in obesity. Asia's large population and rapid economic development have made it an epicenter of the epidemic. Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians. Several factors contribute to accelerated diabetes epidemic in Asians, including the “normal-weight metabolically obese” phenotype; high prevalence of smoking and heavy alcohol use; high intake of refined carbohydrates (e.g., white rice); and dramatically decreased physical activity levels. Poor nutrition in utero and in early life combined with overnutrition in later life may also play a role in Asia's diabetes epidemic. Recent advances in genome-wide association studies have contributed substantially to our understanding of diabetes pathophysiology, but currently identified genetic loci are insufficient to explain ethnic differences in diabetes risk. Nonetheless, interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition. Epidemiologic studies and randomized clinical trials show that type 2 diabetes is largely preventable through diet and lifestyle modifications. Translating these findings into practice, however, requires fundamental changes in public policies, the food and built environments, and health systems. To curb the escalating diabetes epidemic, primary prevention through promotion of a healthy diet and lifestyle should be a global public policy priority. THE GLOBAL BURDEN OF TYPE Continue reading >>

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