Tag Archives: diabetes rate

Type 2 Diabetes: Scope of the Problem

97 mg/dl. Yippee!

Type 2 diabetes is the most important public health problem in the U.S. and most of the developed world. The U.S. Centers for Disease Control and Prevention predicts that one of every three Americans born in the year 2000 will develop diabetes.

The most common form of diabetes by far is type 2, which describes at least 85% of cases. It’s less serious than type 1 diabetes. Type 1 diabetics have an immune system abnormality that destroys the pancreas’s ability to make insulin. Type 1’s will not last long without insulin injections. On the other hand, many type 2 diabetics live well without insulin shots.

The epidemic of diabetes in the U.S. and the developed world overwhelmingly involves type 2, not type 1.

“Prediabetes” is what you’d expect: a precursor that may become full-blown type 2 diabetes over time. Blood sugar levels are above average, but not yet into the diabetic range. One in four people with prediabetes develops type 2 diabetes over the course of three to five years. Researchers estimate that 35% of the adult U.S. population had prediabetes in 2008. That’s one out of every three adults, or 79 million. Only 7% of them (less than one in 10) were aware they had it.

In the U.S. as of 2010, 26 million folks have diabetes. That includes 11% of all adults.

The rise of diabetes parallels the increase in overweight and obesity, which in turn mirrors the prominence of refined sugars and starches throughout our food supply. These trends are intimately related. Public health authorities 40 years ago convinced us to cut down our fat consumption in a mistaken effort to help our hearts. We replaced fats with body-fattening carbohydrates that test the limits of our pancreas to handle them. Diabetics and prediabetics fail that test.

Dr. Richard K. Bernstein, notable diabetologist, wrote that, “Americans are fat largely because of sugar, starches, and other high-carbohydrate foods.”

We’re even starting to see type 2 diabetes in children, which was quite rare just thirty years ago. It’s undoubtedly related to overweight and obesity. Childhood obesity in the U.S. tripled from the early 1980s to 2000, ending with a 17% obesity rate.  Overweight and obesity together describe 32% of U.S. children.

Diabetes is important because it has the potential to damage many different organ systems, deteriorating quality of life. It can damage nerves (neuropathy), eyes (retinopathy), kidneys (nephropathy),  and stomach function (gastroparesis), just to name a few.

Just as important, diabetes can cut life short. Compared to those who are free of diabetes, having diabetes at age 50 more than doubles the risk of developing cardiovascular disease—heart attacks, strokes, and high blood pressure. Compared to those without diabetes, having both cardiovascular disease and diabetes approximately doubles the risk of dying. Compared to those without diabetes, women and men with diabetes at age 50 die seven or eight years earlier, on average.

Diabetic complications and survival rates will improve over the coming decades as we learn how to better treat this ancient disease.

Steve Parker, M.D.

Prediabetes and Diabetes on the March in U.S. Adolescents

The June, 2012, issue of Pediatrics has an article stating that the incidence of diabetes and prediabetes in U.S. adolescents increased from 9% in 1999 to 23% in 2008.  The finding is based on the NHANES survey of 12 to 19-year-olds, which included a single fasting blood sugar determination.

The investigators offered no solution to the problem.  I’m no pediatrician, but my educated guess is that the following measures would help prevent adolescent type 2 diabetes and prediabetes:

  • more exercise
  • eat less refined starches and sugar
  • maintain body weight in the healthy range
I’m sure many of the adolescent type 2 diabetics and prediabetics are overweight or obese.  A 2010 study out of Colorado found a low-carbohydrate, high-protein diet safe and effective for adolescents.  Fortunately, the decades-long ascent of the adolescent obesity rate in the U.S. seems to have peaked for now.
The paleo diet would restrict consumption of concentrated sugars and refined starches, but it’s hard to get adolescents to skip those items.

Steve Parker, M.D.

PS: I scanned the article quickly and don’t remember if the researchers broke down the diabetes cases by type 1 and type 2.  I’d be shocked if type 1 diabetes rose this much over the last decade.