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Yahoo! Health are reporting: One-Third of U.S. Adults Diabetic or Pre-Diabetic
May 26, 2006 02:02:22 PM PST
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FRIDAY, May 26 (HealthDay News) -- The number of Americans diagnosed with type 2 diabetes has now topped 19 million, and a new study says a third of adults with the disease don't even know they have it.
The researchers found that another 26 percent of adults had "impaired fasting glucose," a precursor to diabetes.
"So, if you add that together with the 9.3 percent of people with diabetes, that means that fully one-third of the adult population -- 73 million Americans -- have diabetes or they may be on their way to getting it," said lead researcher Catherine Cowie, director of the diabetes epidemiology program at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
Her team's report appears in the June issue of Diabetes Care.
The researchers note that about 95 percent of all cases of diabetes in the United States fall under the category of type 2 disease -- a gradual loss of insulin production and sensitivity that's usually linked to overweight and obesity.
According to the U.S. National Institutes of Health and the U.S. Centers for Disease Control and Prevention, survey data from the National Health and Nutrition Examination Survey of 1988 to 1994 and 1999 to 2002 indicate the incidence of diabetes among people aged 20 and older has gone from about 5.1 percent of the population in the older survey to 6.5 percent by 2002.
"In the 1999 to 2002 survey, participants were interviewed to find out whether they had ever been told that they had diabetes," said Cowie. "In addition, the people had a blood test after they fasted overnight."
Among the 4,761 adults in surveyed, 9.3 percent had type 2 diabetes -- that translated to about 19.3 million people in the entire U.S. population, Cowie said. "In addition, we found that about one-third of the 9.3 percent don't know they have it," she noted.
Diabetes continues to affect blacks and Mexican-Americans about as much as whites, Cowie noted. "In fact, in blacks, diagnosed diabetes rose more significantly between the two surveys than it did for other groups," she said.
"In addition, it rose more significantly in men than in women," Cowie added.
It's even worse among older Americans. About 22 percent of those over 65 have diabetes, Cowie said. "Combine that with 40 percent of those with impaired fasting glucose, [and] it's affecting 62 percent of the adult population in that age group," she said.
There is a huge portion of the population who don't know they have diabetes or who are at risk for diabetes, Cowie said.
"We aren't doing a good enough job of diagnosing these one-in-three people who don't know they have diabetes as well as people who have pre-diabetes," Cowie said. "We really need to be a better job of convincing people that should be adopting healthy behaviors that will prevent these conditions."
One expert thinks that the number of undiagnosed diabetics and pre-diabetics may be underestimated.
"The findings suggest that the prevalence of undiagnosed diabetes is stable," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "This might be true, and due to the fact that as diabetes rates are rising, we're at least attentive to it, and usually finding it when it's there. But this finding might also be misleading."
Undiagnosed diabetes may be less likely in people who participate in health surveys than those who do not, Katz said. "I am suspicious that there is more undiagnosed diabetes than these findings suggest," he noted.
"Since type 2 diabetes is often preventable, almost any is too much," Katz said. "Seeing a steady rise in the rates of this serious and potentially debilitating disease we have the wherewithal to prevent is compelling testimony of past failings and future needs," he said.
This is neither the first, nor the last time this message will be delivered in a scientific paper, Katz said.
"My hope is that we will do what needs to be done to make healthful diets and activity patterns more accessible to all, and diabetes a bit less so," he said.
One-third Of Adults With Diabetes Still Don't Know They Have It
This is a "busy" news day. Here is ScienceDaily's take on the study: One-third Of Adults With Diabetes Still Don't Know They Have It
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One-third Of Adults With Diabetes Still Don't Know They Have It
The prevalence of diagnosed diabetes in U.S. adults age 20 and older has risen from about 5.1 percent to 6.5 percent, according to researchers at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), who analyzed national survey data from two periods--1988 to 1994 and 1999 to 2002. However, the percentage of adults with undiagnosed diabetes did not change significantly over the years studied.
About 2.8 percent of U.S. adult--one-third of those with diabete--still don't know they have it. The study, published in the June 2006 issue of Diabetes Care, notes that type 2 diabetes accounts for up to 95 percent of all diabetes cases and virtually all undiagnosed diabetes cases. Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. It is the most common cause of blindness, kidney failure, and amputations in adults and a major cause of heart disease and stroke.
Over the years studied, about 26 percent of adults age 20 and older continued to have impaired fasting glucose (IFG), a form of pre-diabetes. IFG, in which blood glucose measured after an overnight fast is high but not yet diagnostic of diabetes, increases the risk of heart disease as well as the risk of developing type 2 diabetes.
"It's important to know if you have pre-diabetes or undiagnosed type 2 diabetes," said Dr. Larry Blonde, chair of the National Diabetes Education Program (NDEP), jointly sponsored by the NIH, CDC, and 200 partner organizations. "You should talk to your health care professional about your risk. If your blood glucose is high but not high enough to be diagnosed as diabetes, losing weight and increasing physical activity will greatly lower your risk of getting type 2 diabetes. If you have diabetes, controlling your blood glucose, blood pressure, and cholesterol will prevent or delay the complications of diabetes."
The researchers also found that:
*nearly 22 percent of people age 65 and older had diabetes.
*about 13 percent of non-Hispanic blacks age 20 and older had diabetes. Diabetes was twice as common in non-Hispanic blacks compared to non-Hispanic whites.
*about 8 percent of Mexican Americans age 20 and older had diabetes. Because the average age of Mexican Americans is younger than for other groups, the age-and sex-adjusted prevalence of diabetes in Mexican Americans is twice that of non-Hispanic whites and about equal to that of non-Hispanic blacks.
*IFG and undiagnosed diabetes were about 70 percent more common in men than in women, especially in non-Hispanic white men.
*nearly 40 percent of people age 65 and older had IFG, which becomes more common with age.
In the study, the researchers compared two slices of data, one from 1988 to 1994 and the other from 1999 to 2002. The data were derived from a national sample of U.S. adults age 20 years and older who took part in the National Health and Nutrition Examination Survey (NHANES) conducted by the CDC's National Center for Health Statistics. Survey participants were interviewed in their homes and received a physical exam with a blood test, which included a glucose reading taken after an overnight fast. The NHANES is unique because it includes a blood test that detects undiagnosed diabetes and IFG.
"This study updates and generally corroborates earlier analyses that were based on 2 years of NHANES data," said lead author Catherine Cowie, Ph.D., of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "We're seeing a rising prevalence of diagnosed diabetes that is not substantially offset by a drop in the rate of undiagnosed--about one-third of adults with diabetes still don't know they have it. Another 26 percent of adults have a form of pre-diabetes."
Pre-diabetes, which usually causes no symptoms, is serious because many people with the condition develop type 2 diabetes in the next 10 years. Also, pre-diabetes substantially raises the risk of a heart attack or stroke even if type 2 diabetes does not develop.
People with pre-diabetes may have IFG or impaired glucose tolerance (IGT) or both.
*In IFG, blood glucose is high (100 to 125 milligrams per deciliter or mg/dL) after an overnight fast but not high enough to be diagnostic of diabetes.
*In IGT, blood glucose is high (140 to 199 mg/dL) 2 hours after drinking a sugary drink in an oral glucose tolerance test but not high enough to be diagnostic of diabetes.
In the current study, researchers did not assess the prevalence of IGT because an oral glucose tolerance test was not a part of the survey.
People with pre-diabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting calories in their diet and increasing physical activity (for example, walking 30 minutes a day 5 days a week). A major study of people with IGT has shown that lifestyle changes leading to a 5 to 7 percent weight loss lowered diabetes onset by 58 percent.
If you are over age 45, you should consult your health care provider about testing for pre-diabetes or diabetes. If you are younger than 45, overweight, and have another risk factor, you should ask about testing. You are at greater risk of developing pre-diabetes and type 2 diabetes if you:
*are age 45 or older
*have a family history of diabetes
*are overweight
*have an inactive lifestyle (exercise less than three times a week)
*are members of a high-risk ethnic population (e.g., African American, Hispanic/Latino American, American Indian and Alaska Native, Asian American, Pacific Islander)
*have high blood pressure: 140/90 mm/Hg or higher
*have an HDL cholesterol less than 35 mg/dL or a triglyceride level 250 mg/dL or higher
*have had diabetes that developed during pregnancy (gestational diabetes) or have given birth to a baby weighing more than 9 pounds
*have polycystic ovary syndrome, a metabolic disorder that affects the female reproductive system
*have acanthosis nigricans (dark, thickened skin around neck or armpits)
*have a history of disease of the blood vessels to the heart, brain, or legs
*have had IFG or IGT on previous testing.
OBJECTIVE—The purpose of this study was to examine the prevalences of diagnosed and undiagnosed diabetes, and impaired fasting glucose (IFG) in U.S. adults during 1999–2002, and compare prevalences to those in 1988–1994.
RESEARCH DESIGN AND METHODS—The National Health and Nutrition Examination Survey (NHANES) contains a probability sample of adults aged 20 years. In the NHANES 1999–2002, 4,761 adults were classified on glycemic status using standard criteria, based on an interview for diagnosed diabetes and fasting plasma glucose measured in a subsample.
RESULTS—The crude prevalence of total diabetes in 1999–2002 was 9.3% (19.3 million, 2002 U.S. population), consisting of 6.5% diagnosed and 2.8% undiagnosed. An additional 26.0% had IFG, totaling 35.3% (73.3 million) with either diabetes or IFG. The prevalence of total diabetes rose with age, reaching 21.6% for those aged 65 years. The prevalence of diagnosed diabetes was twice as high in non-Hispanic blacks and Mexican Americans compared with non-Hispanic whites (both P < 0.00001), whereas the prevalence of undiagnosed diabetes was similar by race/ethnicity, adjusted for age and sex. The prevalence of diagnosed diabetes was similar by sex, but prevalences of undiagnosed diabetes and IFG were significantly higher in men. The crude prevalence of diagnosed diabetes rose significantly from 5.1% in 1988–1994 to 6.5% in 1999–2002, but the crude prevalences were stable for undiagnosed diabetes (from 2.7 to 2.8%) and IFG (from 24.7 to 26.0%). Results were similar after adjustment for age and sex.
CONCLUSIONS—Although the prevalence of diagnosed diabetes has increased significantly over the last decade, the prevalences of undiagnosed diabetes and IFG have remained relatively stable. Minority groups remain disproportionately affected.
Big Changes Urged To Stop Diabetes From Overwhelming The Health Care System
Medical News today are reporting: Big Changes Urged To Stop Diabetes From Overwhelming The Health Care System
11 Jun 2006
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Big changes are urgently needed to stem the growth of diabetes and its growing burden on the USA's health care system, says Dr. Robert Rizza, President of Medicine and Science, American Diabetes Association. He warned that unless significant changes take place, the next 30 years could see an explosion of deaths, heart attacks, strokes and other awful illnesses.
Dr. Rizza says the next 30 years could see, as a result of diabetes:
62 million deaths
35 million heart attacks
13 million strokes
6 million cases of renal failure
8 million cases of blindness and/or eye surgery
2 million lower limb amputations
Unless an outright cure for diabetes is found, the USA will most likely be facing a health care bill of $6.6 trillion over the next three decades. Dr. Rizza added that scientists are making tremendous progress towards an eventual cure for diabetes, but it would be foolish to say that one is just around the corner. Until there is a cure it is vital that every patient receives the best care available. In order to receive the best treatment and care, diabetes patients must…
…have a blood sugar level of under 7%
…have their blood pressure below 130/80 mmHg
…have their bad cholesterol (LDL) levels below 100 mg/dl
…have their good cholesterol (HDL) levels of at least 40 mg/dl for men and 50 mg/dl for women
…have their triglycerides levels below 100 mg/dl
…have a BMI below 25
…have one baby aspirin per day
…be non-smokers
Having this type of ‘optimal care' in place would drastically reduce the number of heart attacks, strokes, kidney failures, eye diseases, amputations and early deaths, said Rizza. He said a daily ‘polypill' for diabetes patients, one which could treat all the complications brought on by diabetes, would make for better compliance and a much lower incidence of complications from diabetes. This ‘polypill' needs to be developed, he said.
Dr. Rizza said that if the rate of growth of the diabetes epidemic remains unchecked, the burden will become such that the economy will suffer seriously.
One-Third of U.S. Adults Diabetic or Pre-Diabetic
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