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

Family History Of Type 2 Diabetes: A Population-based Screening Tool For Prevention?

Family History Of Type 2 Diabetes: A Population-based Screening Tool For Prevention?

Purpose: To evaluate the use of self-reported family medical history as a potential screening tool to identify people at-risk for diabetes. Methods: The HealthStyles 2004 mail survey comprises 4345 US adults who completed a questionnaire to ascertain personal and family history of diabetes, perceived risk of diabetes, and practice of risk-reducing behaviors. Using number and type of affected relatives, respondents were ranked into three familial risk levels. Adjusted odds ratios (AORs) were obtained to evaluate associations between familial risk and prevalent diabetes, perceived risk of disease, and risk-reducing behaviors. Validity of family history as a screening tool was examined by calculating sensitivity, specificity, and positive and negative predictive values. Results: Compared to those of average risk, people with moderate and high familial risk of diabetes were more likely to report a diagnosis of diabetes (AOR: 3.6, 95% CI: 2.8, 4.7; OR: 7.6, 95% CI: 5.9, 9.8, respectively), a higher perceived risk of diabetes (AOR: 4.6, 95% CI: 3.7, 5.7; OR: 8.5, 95% CI: 6.6, 17.7, respectively), and making lifestyle changes to prevent diabetes (AOR: 2.2, 95% CI: 1.8, 2.7; OR: 4.5, 95% CI: 3.6, 5.6, respectively). A positive familial risk of diabetes identified 73% of all respondents with diabetes and correctly predicted prevalent diabetes in 21.5% of respondents. Conclusion: Family history of diabetes is not only a risk factor for the disease but is also positively associated with risk awareness and risk-reducing behaviors. It may provide a useful screening tool for detection and prevention of diabetes. Type 2 diabetes accounts for 90%–95% of all cases of diabetes1 and is a classic example of a multifactorial disease involving the complex interplay of modifiable and nonmod Continue reading >>

Diabetes In Older Adults

Diabetes In Older Adults

What is the epidemiology and pathogenesis of diabetes in older adults? According to the most recent surveillance data, the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, Continue reading >>

Diabetes Statistics

Diabetes Statistics

SHARE RATE★★★★★ Diabetes: a serious global health problem on the rise If you have diabetes or are at risk for developing the disease, you’re certainly not alone. It is estimated that almost 400 million people worldwide are affected by diabetes. Unfortunately, the numbers of people with diabetes are increasing in every country.1 One large study conducted in China in 2010, which included 100,000 people, found that 11.6% of participants had type 2 diabetes and about half had pre diabetes (defined as impaired glucose tolerance, impaired fasting glucose, or A1C between 5.7% and 6.4%).1 In the US alone, the Centers for Disease Control and Prevention (CDC) estimated that in 2010 diabetes affected 25.8 million people (that’s 8.3% of the population). Among these, 18.8 million were diagnosed and 7 million were undiagnosed. Diabetes was most common in people 65 years of age or older, occurring in approximately 27% of this age group.2 The statistics are even more sobering if you consider the percentages of adults in the US with prediabetes. Based on statistics from 2005 to 2008, the CDC found that 35% of US adults (age 20 years and older) had prediabetes, with the highest rate among adults 65 years of age and older. Prediabetes affects 1 in 2 adults (50%) in this age range. When these percentages are applied to the entire population of the US (2010 census data), this translates to 79 million adults 20 years of age or older with prediabetes.2 Dramatic increase in numbers for type 2 diabetes in US Results from two major studies conducted in the US have shown a dramatic increase in the prevalence of type 2 diabetes over the past four decades. The Framingham Heart Study (a very important long-term health study conducted in a group of people from Framingham, Massachusetts) 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 >>

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 >>

Study Links A Lack Of Sleep In Children With Increased Risk Of Developing Type 2 Diabetes

Study Links A Lack Of Sleep In Children With Increased Risk Of Developing Type 2 Diabetes

Children who don't get enough sleep at night are at higher risk for developing Type 2 diabetes, according to a new study published Tuesday by the American Academy of Pediatrics. Researchers observed self-reported sleep times, then took body measurements and blood samples in over 4,500 children aged 9 and 10 in Britain. Children who slept on average one hour longer per night than others in the study had a lower body mass index, lower insulin resistance, and lower fasting glucose than those who who slept an hour less. While the study did not follow the participants long enough to see if they actually developed diabetes, the markers that are considered type 2 diabetes risk factors in adults were there. The researchers suggest that increasing sleep duration by even half an hour could be associated with a lower body mass index and a reduction in insulin resistance. The American Academy of Pediatrics and the American Academy of Sleep Medicine recommend 11 to 14 hours of sleep a night for children ages one to two and 10 to 13 hours of sleep for ages three through five. In school-aged children, the groups recommend nine to 12 hours of sleep a night for children up to 12 and eight to ten hours of sleep for teenagers. Dr. Edith Bracho-Sanchez, a pediatric specialist, told ABC News that she often tells her patients that sleep is just as important for health as eating healthy or getting enough exercise. Inadequate sleep for children is linked to lower academic performance, irritability and behavior problems, difficulty concentrating, and now even an increased risk of type 2 diabetes, according to Bracho-Sanchez. Bracho-Sanchez adds that her number one tip for parents looking to increase the amount of sleep their child gets each night is to remove all electronics from the child's be Continue reading >>

Forecasting The Burden Of Type 2 Diabetes In Singapore Using A Demographic Epidemiological Model Of Singapore

Forecasting The Burden Of Type 2 Diabetes In Singapore Using A Demographic Epidemiological Model Of Singapore

Objective Singapore is a microcosm of Asia as a whole, and its rapidly ageing, increasingly sedentary population heralds the chronic health problems other Asian countries are starting to face and will likely face in the decades ahead. Forecasting the changing burden of chronic diseases such as type 2 diabetes in Singapore is vital to plan the resources needed and motivate preventive efforts. Methods This paper describes an individual-level simulation model that uses evidence synthesis from multiple data streams—national statistics, national health surveys, and four cohort studies, and known risk factors—aging, obesity, ethnicity, and genetics—to forecast the prevalence of type 2 diabetes in Singapore. This comprises submodels for mortality, fertility, migration, body mass index trajectories, genetics, and workforce participation, parameterized using Markov chain Monte Carlo methods, and permits forecasts by ethnicity and employment status. Results We forecast that the obesity prevalence will quadruple from 4.3% in 1990 to 15.9% in 2050, while the prevalence of type 2 diabetes (diagnosed and undiagnosed) among Singapore adults aged 18–69 will double from 7.3% in 1990 to 15% in 2050, that ethnic Indians and Malays will bear a disproportionate burden compared with the Chinese majority, and that the number of patients with diabetes in the workforce will grow markedly. Conclusions If the recent rise in obesity prevalence continues, the lifetime risk of type 2 diabetes in Singapore will be one in two by 2050 with concomitant implications for greater healthcare expenditure, productivity losses, and the targeting of health promotion programmes. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) li 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 >>

Are Spouses Of Patients With Type 2 Diabetes At Increased Risk Of Developing Diabetes?

Are Spouses Of Patients With Type 2 Diabetes At Increased Risk Of Developing Diabetes?

OBJECTIVE—To determine whether spouses of patients with type 2 diabetes have an increased risk of diabetes compared with spouses of subjects with normal glucose tolerance. RESEARCH DESIGN AND METHODS—A random sample of spouses of patients with type 2 diabetes (group 1S) attending a general practice diabetes clinic was compared with spouses of nondiabetic subjects (as determined by oral glucose tolerance test [OGTT]) (group 2S). Spouses in both groups underwent OGTT, fasting lipid profile, and blood pressure (BP) measurements. RESULTS—A total of 245 subjects in group 1S and 234 subjects in group 2S underwent OGTT. Group 1S had a significantly higher incidence of fasting glucose, impaired glucose tolerance, or type 2 diabetes (19.1 vs. 9.4%). Group 1S also had higher fasting glucose and triglyceride levels, higher BMI, and a trend toward higher BP. Multivariate logistic regression analysis, adjusted for BMI and age, showed the risk of diabetes in the spouse of a patient with diabetes was 2.11 (95% CI 1.74–5.1), as compared with the spouse of a subject with normal glucose tolerance. Similarly, the risk of any degree of glucose intolerance in a spouse of a patient with type 2 diabetes was 2.32 (1.87–3.98), as compared with a spouse of a subject with normal glucose tolerance. CONCLUSIONS—Spouses of patients with type 2 diabetes have a significantly increased risk of glucose intolerance and type 2 diabetes, and they should be classified as high risk for diabetes. This finding has implications for screening programs, which should include spouses of subjects with diabetes. In many parts of the world, type 2 diabetes is increasing in prevalence, particularly among high-risk ethnic populations (1). While genetic influences on the risk of type 2 diabetes are likely to 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 >>

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 >>

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 >>

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 >>

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