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What Segments Of The U.s. Population Are At Increased Risk Of Type 2 Diabetes

Take Steps To Prevent Type 2 Diabetes

Take Steps To Prevent Type 2 Diabetes

Diabetes (“dy-ah-BEE-teez”) is a leading cause of disability and death in the United States. Diabetes increases the risk of serious health problems like: Blindness Nerve damage Kidney disease Heart disease Stroke The good news is that you can do a lot to prevent or delay getting type 2 diabetes, including: Watching your weight Eating healthy Staying active Continue reading >>

Understanding The Social Factors That Contribute To Diabetes: A Means To Informing Health Care And Social Policies For The Chronically Ill

Understanding The Social Factors That Contribute To Diabetes: A Means To Informing Health Care And Social Policies For The Chronically Ill

Go to: Recent health reform efforts offer many segments of the US population at highest risk for developing chronic conditions opportunities for improved and coordinated medical care through new insurance coverage and innovative care arrangements. Yet, with some notable exceptions, health reform measures did not go far enough to systematically identify metrics to support the development of policies and the allocation of resources for populations at risk for chronic conditions. Research has demonstrated that social determinants are associated with the disproportionate development of chronic conditions and challenges encountered when managing them; this is particularly true of Type 2 diabetes, which will be used to illustrate concepts throughout this article.1–12 Clinical interventions have consistently evolved to improve disease management, particularly as a growing number of clinicians recognize the importance of social determinants of health (eg, income, education, housing, and access to nutritious food) and their contribution to health disparities.12–16 However, to further challenge the underlying nonmedical social and environmental contributors to chronic conditions, a focus on the individual within a systems perspective is necessary. On a systems level, this requires two vital building blocks: 1) data that accurately capture social determinants of health, and 2) policies that both intersect public health principles and practice and promote linkage of social determinants to health care delivery. Although part of the structure to fulfill these requirements already exists, the multifactorial complexity of chronic conditions, such as Type 2 diabetes, requires additional targeted activities to further advance efforts to prevent and to manage them. Continue reading >>

Diabetes Risk Assessment In Mexicans And Mexican Americans

Diabetes Risk Assessment In Mexicans And Mexican Americans

Abstract OBJECTIVE Parental diabetes history is a well-known risk factor for type 2 diabetes and considered strong evidence for a genetic basis of type 2 diabetes. Whether this relationship is affected by other known risk factors, specifically obesity, remains unclear, possibly due to a relative paucity of lean diabetic patients. RESEARCH DESIGN AND METHODS This issue was investigated using data from a high-risk population from Mexico (National Health Survey 2000, n = 27,349), with observations replicated using U.S. citizens of Mexican descent from the National Health and Nutrition Examination Survey 2001–2002 and 2003–2004 (n = 1,568). RESULTS As expected, positive parental diabetes was a significant risk factor for type 2 diabetes, regardless of age, sex, or adiposity level. However, positive parental diabetes conferred greater risk in leaner individuals than in their overweight peers (P = 0.001). In other words, the effect of BMI on type 2 diabetes risk was smaller in the presence of parental diabetes history. CONCLUSIONS These findings suggest that parental diabetes is a stronger risk factor for type 2 diabetes in the absence of obesity. Thus, studies in lean diabetic patients could help identify type 2 diabetes susceptibility genes. This study reinforces the concept that parental diabetes and BMI are independent type 2 diabetes risk factors and suggests that glycemic screening may be helpful in assessing type 2 diabetes risk in individuals with parental diabetes history, regardless of their overweight status. RESEARCH DESIGN AND METHODS To address these objectives, a large dataset from the national health survey in Mexico (Encuesta Nacional de Salud 2000 [ENSA 2000]) was used. Degree of genetic load was assessed by self-reported parental diabetes history, and t Continue reading >>

Type 2 Diabetes Statistics And Facts

Type 2 Diabetes Statistics And Facts

Type 2 diabetes is the most common form of diabetes. Read on to learn some of the key facts and statistics about the people who have it and how to manage it. Risk factors Many risk factors for type 2 diabetes include lifestyle decisions that can be reduced or even cut out entirely with time and effort. Men are also at slightly higher risk of developing diabetes than women. This may be more associated with lifestyle factors, body weight, and where the weight is located (abdominally versus in the hip area) than with innate gender differences. Significant risk factors include: older age excess weight, particularly around the waist family history certain ethnicities physical inactivity poor diet Prevalence Type 2 diabetes is increasingly prevalent but also largely preventable. According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. The CDC also gives us the following information: In general Research suggests that 1 out of 3 adults has prediabetes. Of this group, 9 out of 10 don't know they have it. 29.1 million people in the United States have diabetes, but 8.1 million may be undiagnosed and unaware of their condition. About 1.4 million new cases of diabetes are diagnosed in United States every year. More than one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four. Cases of diagnosed diabetes cost the United States an estimated $245 billion in 2012. This cost is expected to rise with the increasing diagnoses. In pregnancy and parentingAccording to the CDC, 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed w Continue reading >>

Lifestyle Risk Factors And New-onset Diabetes Mellitus In Older Adults

Lifestyle Risk Factors And New-onset Diabetes Mellitus In Older Adults

Go to: Abstract The combined impact of lifestyle factors on incidence of diabetes mellitus later in life is not well established. The objective of this study was to determine how lifestyle factors, assessed in combination, relate to new-onset diabetes in a broad and relatively unselected population of older adults. Methods We prospectively examined associations of lifestyle factors, measured using repeated assessments later in life, with incident diabetes mellitus during a 10-year period (1989–1998) among 4883 men and women 65 years or older (mean [SD] age at baseline, 73[6] years) enrolled in the Cardiovascular Health Study. Low-risk lifestyle groups were defined by physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men. The main outcome measure was incident diabetes defined annually by new use of insulin or oral hypoglycemic medications. We also evaluated fasting and 2-hour postchallenge glucose levels. Results During 34 539 person-years, 337 new cases of drug-treated diabetes mellitus occurred (9.8 per 1000 person-years). After adjustment for age, sex, race, educational level, and annual income, each lifestyle factor was independently associated with incident diabetes. Overall, the rate of incident diabetes was 35% lower (relative risk, 0.65; 95% confidence interval, 0.59–0.71) for each 1 addi Continue reading >>

Workplace Bullying And Violence 'risk Factors' For Type 2 Diabetes

Workplace Bullying And Violence 'risk Factors' For Type 2 Diabetes

"Workplace bullying increases risk of type 2 diabetes by 46%, study finds," reports the Mail Online. A new study looked at data from 4 different Nordic research projects to investigate whether employees exposed to workplace bullying and violence at work are at increased risk of developing type 2 diabetes. A distinction was made between workplace bullying and violence (or threats of violence) at work because bullying can take many forms. Also, some professionals, such as police or prison officers, usually have training designed to help them cope better with violence at work. The study found that people who said they'd experienced workplace bullying or violence had an increased risk of developing type 2 diabetes compared with those who didn't report any bullying or violence. These are interesting findings with a number of potential explanations. Stress, caused by bullying or violence, can have a wide range of potential effects. For example, it can lead to comfort eating and spending longer sitting still at your desk, which can cause weight gain. Being overweight is a risk factor for type 2 diabetes. Of course, regardless of the potential link to an increased risk of diabetes, workplace bullying and violence shouldn't be ignored. The GOV.UK website provides more advice about what to do if you feel you're being bullied or harassed at work. Where did the story come from? The study was carried out by a team of researchers from Denmark, Sweden, Finland, the UK and China. It was funded by a number of Nordic research institutions, including NordForsk, the Nordic Programme on Health and Welfare, the Project on Psychosocial Work Environment and Healthy Ageing , and the Danish Working Environment Foundation. The study was published in the peer-reviewed medical journal Diabetologia Continue reading >>

Type 2 Diabetes Statistics: Facts And Trends

Type 2 Diabetes Statistics: Facts And Trends

Diabetes mellitus, or diabetes, is a disease that causes high blood sugar. It occurs when there is a problem with insulin. Insulin is a hormone that takes sugar from foods and moves it to the body's cells. If the body does not make enough insulin or does not use insulin well, the sugar from food stays in the blood and causes high blood sugar. There are several different types of diabetes, but the most common is type 2. According to the Centers for Disease Control and Prevention's (CDC) National Diabetes Report, 2014, 90 to 95 percent of people with diabetes in the United States have type 2. Just 5 percent of people have type 1. Contents of this article: Key facts about diabetes in the U.S. Diabetes is at an all-time high in the U.S. The CDC's Division of Diabetes Translation states that 1 percent of the population, which is about a half of a million people, had diagnosed diabetes in 1958. Today, nearly 10 percent of the population have diabetes, according to the American Diabetes Association (ADA). That's 29.1 million Americans, and more than a quarter of these people do not know they have it. The ADA report that the number of people who have diabetes increased by 382 percent from 1988 to 2014. The risk of developing diabetes increases with age. The CDC report that 4.1 percent of people age 20-44 have diabetes, but the number jumps to 25.9 percent for people over 65 years old. As obesity has become more prevalent over the past few decades, so too has the rate of type 2 diabetes. An article in the Journal of Diabetes Science and Technology states that 25.6 percent of Americans are obese, much higher than the 15.3 percent of obese people in 1995. In that same period, the incidence of diabetes increased by 90 percent. Although the link between obesity and diabetes is well Continue reading >>

Diabetes

Diabetes

What is diabetes? Diabetes is a disorder of metabolism—the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose. What are the types of diabetes? The three main types of diabetes are type 1 diabetes type 2 diabetes gestational diabetes Type 1 Diabetes Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live. At present, scientists do not know exactly what causes the body’s immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United St Continue reading >>

"at Risk" Populations And Diabetes

Diabetes impacts nearly 24 million children and adults in the United States—though one-third don’t know they have it. Another estimated 57 million Americans have pre-diabetes, which means they are at risk of developing diabetes. Are You at Risk? Type 2 diabetes is found at alarmingly high rates in racial and ethnic minorities in the U.S., according to Enrique Caballero, MD, director of Joslin’s Latino Diabetes Initiative. Diabetes is much more common among African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders than among Caucasians. Risk for type 2 diabetes increases with age, particularly after age 45. Being overweight or obese is another major risk factor—particularly if the extra weight is around the waist. Therefore, people younger than 45 years of age can develop type 2 diabetes if they have a strong genetic predisposition and are overweight. A recent study conducted by Dr. Caballero and his team at the Latino Diabetes Initiative at Joslin identified that overweight Hispanic children also have profound abnormalities in their circulation (endothelial dysfunction), which puts them at risk not only for type 2 diabetes, but also for cardiovascular disease. Other risk factors include: family history of type 2 diabetes, an inactive lifestyle, high levels of fat in the blood, particularly high triglycerides and/or low HDL cholesterol, high blood pressure, or having had gestational diabetes, or having pre-diabetes. Having these risk factors does not mean you’ll get diabetes, but it does mean you should be screened for it regularly. Multicultural Care Joslin has two clinics staffed by bilingual healthcare providers that offer services and resources for prevention and care: the Latino Clinic and the Asian American Clinic. Joslin also of Continue reading >>

Diabetes Disparities Among Racial And Ethnic Minorities

Diabetes Disparities Among Racial And Ethnic Minorities

The burden of diabetes is much higher for racial/ethnic minorities than for whites. Minorities have a higher prevalence of diabetes than whites, and some minorities have higher rates of diabetes-related complications and death. Research results help in understanding these disparities and ways to reduce them. Diabetes, the sixth leading cause of death in the United States, is a chronic disease characterized by persistent hyperglycemia (high blood glucose levels). As of 1999, approximately 16 million Americans—5.9 percent of the total population—had been diagnosed with diabetes, and that number is increasing rapidly. In a healthy person, blood sugar levels, which fluctuate based on food intake, exercise, and other factors, are kept within an acceptable range by insulin. Insulin, a hormone produced by the pancreas, helps the body absorb excess sugar from the bloodstream. In a person with diabetes, blood sugar levels are not adequately controlled by insulin. From 1990 to 1998, the prevalence of type 2 diabetes increased by one-third—from 4.9 percent to 6.5 percent of the adult population. In type 2 diabetes, the pancreas produces some insulin, sometimes even large amounts; however, either the pancreas does not produce enough insulin or the body's cells are resistant to the action of insulin. Almost 800,000 people are expected to be newly diagnosed with the disease in 2001, and close to 200,000 will die from its complications. The burden of diabetes is much greater for minority populations than the white population. For example, 10.8 percent of non-Hispanic blacks, 10.6 percent of Mexican Americans, and 9.0 percent of American Indians have diabetes, compared with 6.2 percent of whites.1 Certain minorities also have much higher rates of diabetes-related complications an Continue reading >>

Increased Risk Of Type 2 Diabetes In Alzheimer Disease

Increased Risk Of Type 2 Diabetes In Alzheimer Disease

Alzheimer disease and type 2 diabetes are characterized by increased prevalence with aging, a genetic predisposition, and comparable pathological features in the islet and brain (amyloid derived from amyloid β protein in the brain in Alzheimer disease and islet amyloid derived from islet amyloid polypeptide in the pancreas in type 2 diabetes). Evidence is growing to link precursors of amyloid deposition in the brain and pancreas with the pathogenesis of Alzheimer disease and type 2 diabetes, respectively. Given these similarities, we questioned whether there may be a common underlying mechanism predisposing to islet and cerebral amyloid. To address this, we first examined the prevalence of type 2 diabetes in a community-based controlled study, the Mayo Clinic Alzheimer Disease Patient Registry (ADPR), which follows patients with Alzheimer disease versus control subjects without Alzheimer disease. In addition to this clinical study, we performed a pathological study of autopsy cases from this same community to determine whether there is an increased prevalence of islet amyloid in patients with Alzheimer disease and increased prevalence of cerebral amyloid in patients with type 2 diabetes. Patients who were enrolled in the ADPR (Alzheimer disease n = 100, non-Alzheimer disease control subjects n = 138) were classified according to fasting glucose concentration (FPG) as nondiabetic (FPG <110 mg/dl), impaired fasting glucose (IFG, FPG 110–125 mg/dl), and type 2 diabetes (FPG >126 mg/dl). The mean slope of FPG over 10 years in each case was also compared between Alzheimer disease and non-Alzheimer disease control subjects. Pancreas and brain were examined from autopsy specimens obtained from 105 humans (first, 28 cases of Alzheimer disease disease vs. 21 non-Alzheimer dis Continue reading >>

African Ancestry And Its Correlation To Type 2 Diabetes In African Americans: A Genetic Admixture Analysis In Three U.s. Population Cohorts

African Ancestry And Its Correlation To Type 2 Diabetes In African Americans: A Genetic Admixture Analysis In Three U.s. Population Cohorts

Abstract The risk of type 2 diabetes is approximately 2-fold higher in African Americans than in European Americans even after adjusting for known environmental risk factors, including socioeconomic status (SES), suggesting that genetic factors may explain some of this population difference in disease risk. However, relatively few genetic studies have examined this hypothesis in a large sample of African Americans with and without diabetes. Therefore, we performed an admixture analysis using 2,189 ancestry-informative markers in 7,021 African Americans (2,373 with type 2 diabetes and 4,648 without) from the Atherosclerosis Risk in Communities Study, the Jackson Heart Study, and the Multiethnic Cohort to 1) determine the association of type 2 diabetes and its related quantitative traits with African ancestry controlling for measures of SES and 2) identify genetic loci for type 2 diabetes through a genome-wide admixture mapping scan. The median percentage of African ancestry of diabetic participants was slightly greater than that of non-diabetic participants (study-adjusted difference = 1.6%, P<0.001). The odds ratio for diabetes comparing participants in the highest vs. lowest tertile of African ancestry was 1.33 (95% confidence interval 1.13–1.55), after adjustment for age, sex, study, body mass index (BMI), and SES. Admixture scans identified two potential loci for diabetes at 12p13.31 (LOD = 4.0) and 13q14.3 (Z score = 4.5, P = 6.6×10−6). In conclusion, genetic ancestry has a significant association with type 2 diabetes above and beyond its association with non-genetic risk factors for type 2 diabetes in African Americans, but no single gene with a major effect is sufficient to explain a large portion of the observed population difference in risk of diabetes. The Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>

Original Article A Population-based Cohort Study Suggests An Increased Risk Of Multiple Sclerosis Incidence In Patients With Type 2 Diabetes Mellitus

Original Article A Population-based Cohort Study Suggests An Increased Risk Of Multiple Sclerosis Incidence In Patients With Type 2 Diabetes Mellitus

Abstract To prospectively investigate the incidence and relative risks of multiple sclerosis (MS) in patients with type 2 diabetes (T2DM). Patients with T2DM (n = 614,623) and age- and sex-matched controls (n = 614,021) were followed from 2000 to 2008 to identify cases of newly diagnosed MS (ICD-9-CM: 340). The person-year approach with Poisson assumption was used to evaluate the incidence density. We estimated the covariate-adjusted hazard ratio (HR) of MS incidence in relation to T2DM diabetes using a multiple Cox proportional hazard regression model. Over 9 years of follow-up, 175 T2DM patients were newly diagnosed with MS, and 114 matched controls had the same first-ever diagnosis, representing a covariate-adjusted HR of 1.44 (95% confidence interval [CI], 1.08–1.94). The sex-specific adjusted HR for both men and women with T2DM was also elevated at 1.34 (95% CI, 0.81–2.23) and 1.51 (95% CI, 1.05–2.19), respectively. Women aged ≤50 years had the greatest risk of MS (HR 2.16; 95% CI, 1.02–4.59). This study demonstrated a moderate but significant association of T2DM with MS incidence, and the association was not confounded by socio-demographic characteristics or certain MS-related co-morbidities. Fig. 1. Flowchart for the study cohort enrollment and follow-up. MS, multiple sclerosis; NHI, National Health Insurance. Type 2 diabetes mellitus is the most common form of diabetes and is currently a major worldwide cause of morbidity and mortality. This is likely to worsen, given the rapidly increasing prevalence of this condition; therefore, an understanding of its etiology and pathogenesis is of considerable importance. By definition, patients with type 2 diabetes have neither autoimmune β cell destruction, as is found in type 1 diabetes, nor one of the other s Continue reading >>

Body Mass Index History And Risk Of Type 2 Diabetes: Results From The European Prospective Investigation Into Cancer And Nutrition (epic)–potsdam Study1,2,3

Body Mass Index History And Risk Of Type 2 Diabetes: Results From The European Prospective Investigation Into Cancer And Nutrition (epic)–potsdam Study1,2,3

Abstract Background: Obesity and increases in body weight in adults are considered to be among the most important risk factors for type 2 diabetes. Objective: The objective was to evaluate and compare the associations between weight changes during 2 different periods of adult life and the risk of type 2 diabetes and age at diagnosis. Design: The study included 7720 men and 10 371 women from the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study with information on weight history; 390 men and 303 women of these participants received a clinical diagnosis of type 2 diabetes during 7 y of follow-up. Multivariate Cox regression models were used to estimate the relative risk (RR) of weight changes between ages 25 and 40 y and ages 40 and 55 y. Results: RR estimates in men and women were slightly higher for each unit of BMI gain between ages 25 and 40 y [men: 1.25 (95% CI: 1.21, 1.30); women: 1.24 (1.20, 1.27)] than between ages 40 and 55 y [men: 1.13 (1.10, 1.16); women: 1.11 (1.08, 1.14)]. Severe weight gain between ages 25 and 40 y was associated with a higher diabetes risk in men (1.5 times) and in women (4.3 times) than were stable weight in early adulthood and weight gain in later life, and it resulted in an average lower age at diabetes diagnosis in men (5 y) and in women (3 y). Conclusion: Weight gain in early adulthood is related to a higher risk and earlier onset of type 2 diabetes than is weight gain between 40 and 55 y of age. Continue reading >>

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