The Silent Epidemic The Basics of Diabetes

By: Molly Boll

Are you aware of an often-undiagnosed disease that is currently growing at an alarming rate? It is a disease that is making headlines around the world for the devastating health complications that it inflicts on our bodies. It is a disease of the young, the elderly, the rich, and the poor. It does not discriminate. It causes serious health complications, such as heart disease and stroke, blindness, kidney disease, and amputations, to name a few.

Diabetes is the silent epidemic hitting our worldwide population today. It is a disease that currently has no cure. In the United States, there are over 20.8 million children and adults – some 7% of the total population – living with diabetes. Only 14.6 million have been diagnosed, leaving over 6.2 million people undiagnosed and untreated. Per the American Diabetes Association (ADA), if present trends continue, one in three Americans, and one in two minorities, born in 2000 will develop diabetes at some point in their lifetime. Can you imagine the implications this will have on our medical systems? Our hospitals and clinics are already overflowing with people needing chronic and acute healthcare.

This will be the first in a series of articles on diabetes. Some of the topics that will be covered in this series include: what diabetes entails; its symptoms and complications; the myths surrounding diabetes; proper nutrition for those with diabetes; what to do during sick days; and monitoring your blood glucose levels. All of these articles are geared toward helping you to prevent diabetes, or to better live with the disease if you have already been diagnosed.

The ADA regularly reports statistics that paint a vivid picture of the prevalence of diabetes in the United States population.

Two million children between the ages of 12 and 19, or 1 in 6 overweight adolescents in this age group, have pre-diabetes. 20.6 million, or 9.6% of all people over the age of 20 have some form of diabetes. For those older than 60, there are 10.3 million, or 20.9% who have diabetes – typically Type II Diabetes. Men with diabetes account for approximately 10.9 million, or 10.5% of the male population over 20 years old. Women with diabetes account for approximately 9.7 million, or 8.8% of the female population over 20 years old.

This disease is more prevalent in Mexican Americans, American Indians and Alaska Natives; 12.8% of American Indians and Alaska Natives age 20 years or older who received medical care in 2003 had diabetes. More and more countries around the world are seeing increasing numbers of their populations having diabetes, diagnosed or undiagnosed. There is an alarming spike in the diagnosis of diabetes in China, Japan, and other Asian countries where fast foods, unhealthy food choices, and increased sedentary lifestyles are becoming more and more popular. These are the main reasons for an increase in diabetes worldwide today.

Another statistic from the American Diabetes Association reads:

“Diabetes is the fifth-deadliest disease in the United States. Since l987, the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined. Some 224,092 deaths were attributed to Diabetes. Diabetes as a cause of death is under reported.”

What is Diabetes? 

Simply put, diabetes is a disease in which the body does not properly control the amount of sugar in the blood. Diabetes can be categorized into four different types.

Type I was previously called insulin-dependent diabetes mellitus (DDM) or juvenile-onset diabetes. It occurs when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make the hormone “insulin” that regulates blood glucose. People with Type I Diabetes must inject insulin. Type I diabetes is usually found in children and young adults, although it can occur at any age. Some 5% – 10% of all people with diabetes have Type I. To date, there is no known way to prevent Type I diabetes.

Type II has been called adult-onset diabetes and accounts for about 90% – 95% of those diagnosed with diabetes. This type usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. The pancreas gradually loses its ability to produce insulin. Type II diabetes is usually associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, or race/ethnicity. Current clinical reports reflect that Type II diabetes is being increasingly diagnosed in children, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Gestational Diabetes is a form of glucose intolerance found in some women during pregnancy. Though it can affect any pregnant women, it occurs more often in those who are obese and have a family history of diabetes, and those having babies over 9 pounds. Women who have had gestational diabetes have a 20-50% chance of developing diabetes in the 5-10 years following their pregnancy.

Pre-Diabetes is a condition that raises the risk of developing Type II diabetes, heart disease, and stroke. Glucose levels in those with pre-diabetes are higher than normal, but not high enough to be classified as diabetes. If one’s fasting glucose levels are 100 – 125 after an overnight fast, one is said to be “pre-diabetic” and has a condition that is called Impaired Fasting Glucose (IFG). Another way of looking at pre-diabetes is a measure of Impaired Glucose Tolerance (IGT), where two hours after an oral glucose tolerance test, the blood levels measure 140 – 199.

The ADA reports that 54 million American adults had IFG or Pre-Diabetes in 2002. Can you imagine 54 million people on the verge of getting diabetes? Read on, as there is HOPE!

Progression to full diabetes in people with the “pre-diabetes” condition is not inevitable. There are many studies that have shown that people with pre-diabetes who lose weight and increase their physical activity can delay and even prevent diabetes, as they return their blood glucose levels to normal. Our series of articles will give you tools on how to prevent diabetes.

Since the majority of the people who will be reading these articles are over the age of 55, we will concentrate on Type II diabetes, which is the type of diabetes usually found in people of this age group.

Who is at risk for Type II diabetes?

The following people are at the greatest risk for Type II diabetes: those with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG); those over the age of 45; those with a family history of diabetes; those who are overweight; those who do not exercise regularly; those with low HDL cholesterol or high triglycerides, and high blood pressure; certain racial/ethnic groups; and women who had gestational diabetes or those who had a baby over 9 pounds at birth.

The warning signs of Type II diabetes can include:

Frequent urination
Unusual thirst
Extreme hunger
Extreme fatigue
Frequent infections
Recurring skin/bladder infections
Tingling/numbness in hands/feet

Often, however, people with Type II diabetes have no symptoms.

Though not currently curable, Type II Diabetes is treatable. People can manage their blood glucose by following a healthy meal plan, implementing an exercise program into their daily lives, losing excess weight, and taking medications (oral and insulin). Self-management and diabetes education are imperative in achieving good control of diabetes. It is interesting to note, per the ADA, “that among adults with diagnosed diabetes, 16% take insulin only, 12% take both insulin and oral medications, 57% take oral medications only, and 15% do not take either insulin or oral medications,” as they are able to control their diabetes through nutrition and exercise.

Our next article will discuss how to prevent diabetes; what to do when you are recently diagnosed with diabetes; and how to thrive with this disease. We will also be discussing some myths about diabetes.