Diabetes: The Fastest Growing Epidemic in America

Are You At Risk?

According to the Centers for Disease Control, the prevalence of diabetes has become epidemic in this country. Today, nearly 24 million children and adults have the disease and nearly 6 million people are unaware that they may have it. Another 57 million people have elevated blood glucose levels and are considered to have pre-diabetes. In just the past decade alone, the number of new cases of diabetes has increased by 90% and it is now estimated that one in three Americans born in the year 2000 or after will develop the disease in their lifetime.

What exactly is diabetes? Diabetes can be defined as a condition in which the body does not produce enough insulin, as seen in type 1 diabetes, or does not properly utilize insulin, resulting in insulin resistance, and eventual insulin deficiency as seen in type 2 diabetes. Insulin, a hormone secreted by the pancreatic beta-cells, acts like a key to allow glucose to enter the cells where it is then used as fuel. When our body fails to properly use insulin, we end up with high levels of glucose in our blood. The problem with having too much glucose in the blood is that it makes the blood “sticky” and therefore, blood is unable to flow into the capillaries, which are the body’s smallest blood vessels. As a consequence, people with diabetes are at particular risk for cardiovascular disease, renal disease, vascular disease, and eye disorders.

Diabetes often goes undiagnosed because often times its symptoms go unnoticed. However, early detection and treatment is extremely important in order to decrease the chances of developing the complications associated with diabetes. Some symptoms of diabetes include: excessive thirst, excessive hunger, excessive urination, unusual weight loss, increased fatigue, blurry vision, and irritability. The criteria for establishing the diagnosis of diabetes includes symptoms along with a random blood glucose level equal to or greater than 200 mg/dl; a fasting (at least 8 hours) blood glucose equal or greater than 126 mg/dl; or a 2-hour post-load glucose equal or greater than 200 mg/dl. Each of these criteria must be confirmed at least twice, unless overt symptoms of hyperglycemia are present. In addition, a fasting blood glucose between 100 mg/dl and 125 mg/dl signals pre-diabetes.

The American Diabetes Association has established risk factors for diabetes. These are:

• Family history of diabetes
• Age ≥ 45
• BMI ≥ 25 kg/m²
• Physical inactivity
• Ethnicity (African American, Latino, Native American, Asian American)   
• Previously identified pre-diabetes
• History of gestational diabetes or delivery of a baby weighing >9 pounds
• High blood pressure (≥ 140/90 mm/Hg)
• HDL-C ≤ 35 mg/dl and/or triglycerides ≥ 250 mg/dl
• Clinical condition associated with insulin resistance (PCOS, acanthosis nigricans)
• History of vascular disease

Fortunately, there is good news amidst this growing epidemic. Type 2 diabetes is both treatable and preventable. Conventional treatment such as oral medications and insulin is typically how diabetes is managed; however, lifestyle changes may allow many people to put diabetes in remission or even avoid it altogether. Clinical trials such as the Diabetes Prevention Program study conclusively show that making dietary changes and increasing physical activity can make a huge difference in warding off diabetes. There are many dietary modifications that can be made, but simply by incorporating plenty of fresh fruits and vegetables into your diet and limiting intake of processed foods and sugar sweetened beverages/soft drinks, the risk for diabetes can be decreased by more than 60%! Additionally, physical activity has been shown to be particularly effective in reducing the risk of diabetes. Regular exercise not only improves your body’s ability to use insulin and lower blood glucose levels, but it also helps to manage weight and reduce stress, both of which can actually raise blood glucose levels. Last, but certainly not least, studies have shown that a modest weight loss of even 5-10% of your overall body weight can enhance insulin sensitivity and lower blood glucose levels, as well as improve blood lipids and blood pressure.

When considering making lifestyle changes, it is important to understand that it is a process that takes place over time. There simply is no such thing as a quick fix when it comes to treating diabetes. While medications are useful for controlling symptoms, unfortunately, they do not treat the underlying cause of the disease. Small changes really do add up, and making just a few small changes in your lifestyle can have a big impact on your health.