Researchers from Imperial College London and the Harvard School of Public Health have reported in the journal The Lancet the results of an epidemiologic analysis (Danaei) of the incidence and prevalence of diabetes in adults worldwide and the news is not good. Between the years 1980 and 2008 there was a 226% increase worldwide in the number of adults with diabetes. In raw numbers this equates with a rise from 153 million adult diabetics in 1980 to 347 million in 2008. And the statistics show that it is not simply a question of aging and population growth but also of increased prevalence.
Types of Diabetes
Diabetes mellitus occurs when the body is no longer capable of controlling sugar levels in the bloodstream. In Type 1 diabetes, it is believed that an autoimmune process leads the body to attack and destroy the insulin producing cells of the pancreas, the beta cells. Also known as insulin-dependent diabetes mellitus (IDDM), this is sometimes referred to as juvenile diabetes since it typically emerges during childhood or adolescence. Type 2 diabetes, on the other hand, can occur for many reasons, many of them directly related to the growing obesity epidemic. And while Type 2 diabetes can occur for several different metabolic reasons, a common scenario arises where the cells of the body no longer respond effectively to the insulin that is being produced by the pancreas.
Glycemic Control and Diabetic Complications
Numerous studies have shown that one of the most important goals for someone living with diabetes is the need to prevent wide swings in blood sugar levels. Perhaps most importantly is the prevention of blood sugar levels from rising too high and staying too high. Diabetic patients know that their hemoglobin A1C levels can give them a three-month snapshot of how well they have controlled their blood sugar. And study after study has shown that the ability to minimize any of the myriad complications of diabetes is associated with diligent control of blood glucose levels (Skyler).
And the complications of uncontrolled diabetes are many. When blood sugar levels remain high, complications develop that impact the function of the blood vessels and nerves. This routinely leads to the development of vision complications, such as cataract or blindness, peripheral neuropathy (nerve disorders) including loss of sensation in hands or feet, a decreased ability to fight infections leading to poor wound healing and increased risk for amputations, an increased risk of stroke and heart attack, erectile dysfunction and also kidney damage or outright kidney failure.
Medical Costs Associated with Diabetes
With a large number of complications associated with poorly controlled blood sugar and diabetes perhaps it would come as no surprise that the healthcare costs associated with diabetes are staggeringly high and will only go higher. The US Centers for Disease Control and Prevention (CDC) has estimated that the medical costs associated with diabetes in the United States has reached nearly $200 billion US. The new study published in The Lancet indicates that nearly 10% of all adults have or will have diabetes. With an aging population in many industrialized nations and an explosion in the numbers of diabetics, healthcare costs are going to skyrocket.
Type 2 Diabetes Prevention and Control
The majority of people with diabetes are suffering from Type 2 diabetes. This used to be known as “adult-onset diabetes”. This is now a serious misnomer. The number of children, both teens and pre-teens, that are displaying signs of “pre-diabetes” or outright Type 2 diabetes continues to grow. It should not be surprising given the significant rise in childhood obesity and, in Western nations, increased sedentary lifestyles for children and poor dietary habits. Weight loss regimens, increased physical activity and better nutrition will go a long way in combating the dramatic rise in cases of Type 2 diabetes.
Surprising Facts About the Rise in Diabetes
The Danaei study found some striking additional facts beyond the sheer number of current diabetic adults worldwide. In some Pacific Island nations nearly a quarter of all adults now have diabetes. Not surprisingly, given their population sizes, nearly 40% of all of the adult diabetics in the world now live in China and India. Clearly this is not strictly a “Western” problem. Without the application of well-known interventions targeting risk factors for the development of diabetes, it may not be long before diabetes and its complications challenges heart disease as one of the top causes of death worldwide.
Sources
- Danaei et al. 'National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants.' The Lancet, published online 25 June 2011. DOI:10.1016/S0140-6736(11)60679-X
- J.S. Skyler; Effects of Glycemic Control on Diabetes Complications and on the Prevention of Diabetes; Clinical Diabetes; October 2004 vol. 22 no. 4, 162-166
Kenneth Rosen - I am a medical research doctor with more than 20 years of experience studying how the nervous system and skeletal muscle develop and ...
Join the Conversation