Diabetes is the most rapidly growing chronic disease of our time, with the United States experiencing a tripling of its prevalence since 1980. According to the Centers for Disease Control and Prevention, the lifetime risk of developing diabetes is now 1 in 3 for males, and 2 in 5 for females. Coupled with this is the grim prediction that the diabetes epidemic could actually lower the life expectancy of Americans for the first time in more than a century. In New York State alone, over 1 million residents have been diagnosed with diabetes, and it is estimated that another 470,000 have diabetes but are not aware.
Diabetes is a disease in which the body does not make any insulin or can't use the insulin it does make as well as it should. There are different types of diabetes. Type 1 diabetes, previously referred to as "juvenile" or "insulin dependent diabetes," is typically diagnosed in children and young adults, but can occur in adulthood. People with type 1 diabetes need to take insulin to survive - either through injections or through use of an insulin pump.
Type 2 diabetes, previously called "adult-onset" or "non-insulin dependent diabetes," accounts for 90-95% of all diagnosed cases. Risk factors for type 2 diabetes include advancing age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity, with African Americans, Hispanic/Latino Americans and American Indians at higher risk (National Diabetes Clearinghouse). Of particular concern is the fact that type 2 diabetes, once a disease diagnosed exclusively in adults, is being diagnosed in children and adolescents, particularly those from minority populations.
Diabetes is the leading cause of new blindness, kidney disease, and amputation, and it contributes greatly to the state's and nation's number one killer, cardiovascular disease (heart disease and stroke). Additional common complications associated with the diagnosis of diabetes include: kidney disease, eye complications, nerve damage, foot and skin complications, gastroparesis (delayed stomach emptying), gum disease and depression. However, proper management of the disease can prevent such complications. Specific information to aid in prevention is referenced below (American Diabetes Association).
Another condition that is closely tied to diabetes is called pre-diabetes. People with pre-diabetes have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), where blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. Pre-diabetes raises the risk of developing type 2 diabetes, heart disease and stroke. Pre-diabetes is very common- estimates are that more than 5 million New Yorkers have this condition, and are therefore at high risk for developing diabetes in the future.
Individuals who are at high-risk for developing diabetes are eligible for up to 2 free diabetes screenings per year through Medicare. Qualifications for high-risk include: high blood pressure, dyslipidemia (history of abnormal cholesterol and triglyceride levels), obesity, or a history of high blood sugar. For those who are diagnosed with Type 2 diabetes and determined to be at-risk for complications, Medicare advertises a "Diabetes Self- Management Training" that is available at your doctor's request for 20% of the Medicare-approved amount after the yearly Part B deductible (http://www.medicare.gov/Health/Diabetes.asp).
The good news is that for many people, type 2 diabetes can be prevented or delayed through changes in diet and increased physical activity. The National Institutes of Health's Diabetes Prevention Program (DPP) demonstrated that weight loss and increased physical activity among people with pre-diabetes prevents or delays diabetes and may return blood glucose levels to normal. In this study, "just 30 minutes a day of moderate physical activity, coupled with a 5-10% reduction in body weight, produced a 58% reduction in diabetes for those with pre-diabetes.
For more information on diabetes prevention and management, the following websites are available.
Diabetes management information from the National Institutes of Diabetes and Digestive and Kidney Diseases
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Easy to read diabetes publications.
American Diabetes Association - comprehensive information on a variety of diabetes prevention and management topics, advocacy, etc.
National Diabetes Education Program - diabetes management information
