Diabetes Still All-Too-Common
New research published in the highly respected Journal of the American Medical Association (JAMA) indicates that in 2011-2012, the prevalence of diabetes was about 13% among American adults. At the same time, up to 38% of adults qualified for a diagnosis of prediabetes. That means that about half of all U.S. adults were diabetic or prediabetic.
Prediabetes is a condition that often precedes a diagnosis of full-blown type 2 diabetes. It’s characterized by rising insulin insensitivity, and a dwindling ability to remove excess blood sugar (glucose) from the circulation. More recent data suggests that this rising trend appears to be leveling off. That’s welcome news, but the fact that up to half of adults are at risk for—or are already suffering from—type 2 diabetes is nothing to crow about.
Diabetes is a serious illness that involves a growing inability for the body to handle oscillations in blood sugar (after eating) and an eventual inability to produce adequate insulin. Insulin is a hormone released in response to high blood sugar levels. Under normal circumstances, it acts to shepherd glucose molecules into the body’s cells, removing it from the circulation, and allowing the cells to burn the glucose for energy.
When glucose levels are routinely too high (from overeating, or eating too many simple carbohydrates too quickly), insulin begins to lose its effectiveness. Eventually the pancreas, where insulin is produced, “burns out” and stops producing the hormone altogether. At this point, diabetes patients become dependent on daily insulin injections for survival.
The cost in terms of lost productivity and additional healthcare resources was estimated to be $245 billion in 2012. That’s billion, with a “B”. While it would be all-too-easy to become discouraged by these statistics, experts remain guardedly optimistic. "Although obesity and type 2 diabetes remain major clinical and public health problems in the United States, the current data provide a glimmer of hope," write William H. Herman, M.D., M.P.H., and Amy E. Rothberg, M.D., Ph.D., of the University of Michigan Health System, Ann Arbor, in an accompanying editorial.
"The shift in cultural attitudes toward obesity, the American Medical Association's (AMA's) recognition of obesity as a disease, and the increasing focus on societal interventions to address food policy and the built environment are beginning to address some of the broad environmental forces that have contributed to the epidemic of obesity. The effort of the AMA to promote screening, testing, and referral of high-risk patients for diabetes prevention through its Prevent Diabetes STAT program and the CDC's efforts to increase the availability of diabetes prevention programs, ensure their quality, and promote their use appear to be helping to identify at-risk individuals and provide the infrastructure to support individual behavioral change.”
Andy Menke, Sarah Casagrande, Linda Geiss, Catherine C. Cowie. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA, 2015; 314 (10): 1021 DOI: 10.1001/jama.2015.10029
William H. Herman, Amy E. Rothberg. Prevalence of Diabetes in the United States. JAMA, 2015; 314 (10): 1005 DOI: 10.1001/jama.2015.10030