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Diabetes' Toll Continues to Grow
Date:3/21/2008

But it's not too late to protect yourself and your family, experts say

FRIDAY, March 21 (HealthDay News) -- News from the diabetes front seems to grow more discouraging by the day.

Rates of the disease, fueled by obesity and sedentary lifestyles, have risen unchecked in the United States, with diabetes now affecting about 7 percent of the population. That's an estimated 20.8 million adults and children, according to the American Diabetes Association.

Federal projections estimate that by 2050, some 48 million Americans will have type 2 diabetes. And the disease will bring with it complications such as blindness, hearing loss, kidney disease, nervous system disorders and amputations of extremities.

"Studies have suggested that for the first time in history, the generation of people born in 2000 is probably going to have shorter life expectancy than their parents," said Dr. Sue Kirkman, vice president of clinical affairs for the American Diabetes Association. "That's attributable to obesity, diabetes and heart disease. Is that what we want for our children?"

What's worse, one of the most promising medicines for treating type 2 diabetes -- Avandia -- now appears to increase a person's risk of heart attack and heart failure, according to recent studies.

Still, medical experts say the fight against diabetes can be won -- if everyone decides to do what's best for themselves and their families.

That fight will get its yearly boost on Tuesday when the American Diabetes Association will "sound the alert" about diabetes on the 20th annual American Diabetes Alert Day. It's a one-day "call to action" to encourage those at risk for developing type 2 diabetes or those with loved ones at risk to take the Diabetes Risk Test and, if they score high, to schedule an appointment to see their health-care provider. The Diabetes Risk Test is available in English and Spanish by calling the association at 1-800-DIABETES (1-800-342-2383) or online at www.diabetes.org/alert.

But the finding on Avandia calls into question the safety of the entire class of drugs known as thiazolidinediones. For now, Avandia -- and other thiazolidinediones such as Actos -- remains on the market. But last year, the U.S. Food and Drug Administration mandated stricter labeling, including "black box" warnings, for the medications.

Medical experts recommend that each person discuss with their physician the risks and rewards of using Avandia.

"Every patient is different," said Kirkman. "Every patient has different risk factors. Every patient has reasons why one medicine might be better for them than another."

But medicines are only part of the solution. A better response would be drastic changes to American lifestyles, starting with improved diets and more exercise, to avoid type 2 diabetes in the first place.

"The statistics are pretty gloomy, but we also know people who are at risk for diabetes can do a lot to prevent it from coming on," Kirkman said. "There's a lot people can do to try and control their fate."

Diabetes comes in two types.

The most common form, type 2, or what used to be called adult-onset diabetes, occurs when either the body does not produce enough of the hormone insulin or the cells ignore the insulin. The body needs insulin to transport sugar in the blood to cells for energy. Being overweight, an unhealthy diet, and lack of exercise are common contributors to this form of the disease.

Type 1 diabetes, usually diagnosed in children and young adults, occurs when the body isn't capable of producing insulin.

Researchers reviewing data from the National Health Interview Survey found that from 1990 to 2005, cases of diabetes increased 4.6 percent each year. They rose from 26.4 cases per 1,000 people to 54.5 per 1,000 people in the most recent year available.

The diabetes epidemic has grave implications for America, said Martha Funnell, a clinical nurse specialist for the University of Michigan and a past president of the American Diabetes Association. Health care costs are expected to soar as more people with diabetes complications fill doctors' offices and emergency rooms.

Even the U.S. economy will be affected as potentially healthy people find themselves unable to work. "You're losing folks in the prime of their years, and that has an impact on society and our economy," Funnell said.

Fortunately, there are steps that can be taken, both large and small, to help fight diabetes.

On the large-scale side, Kirkman said, governments should spend more money on physical education in schools and on public transportation, instead of new road construction.

"We know people who take public transportation are more physically active," she said. "Do we choose to encourage that?"

On a more personal level, people can make healthy lifestyle choices and help pass those choices along to their children, Funnell said.

But is anyone listening and willing to try?

"The messages are those same old 'eat healthy and exercise,' and we hear those to the point where we think, 'Yeah, yeah, yeah, everybody knows we need to do these things,' " Funnell said.

However, even small measures -- standing more often during the day or walking during a lunch break or eating an apple instead of ice cream -- can help make a difference.

"Maybe it would seem to outsiders as a small step, but it's just taking that one step and the next step and the next," Funnell said. "Like global warming, it's saying, 'What can I do for myself and my family this week, this month, this year, that will make a difference?' "

More information

To learn more, visit the American Diabetes Association.



SOURCES: Sue Kirkman, M.D., vice president of clinical affairs, American Diabetes Association, New York City; Martha Funnell, M.S., R.N., C.D.E., clinical nurse specialist, University of Michigan, Ann Arbor, and a past president of the American Diabetes Association; American Diabetes Association, prepared statement, March 17, 2008


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