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It's time to sound the alarm for diabetes

November 17, 2014

It’s time to sound the alarm for diabetes, at least, for some. November is American Diabetes Month.

Dr. Chelsea Gordner, an adult and pediatric endocrinologist at Baystate Medical Center/Baystate Children’s Hospital, said there is both good and bad news concerning the nearly 30 million children and adults in the United States with diabetes.

Number of New Cases Falling

First, the good news. Researchers at the Centers for Disease Control and Prevention (CDC) report that adult diabetes rates have begun to level off. While the number of people living with the disease increased an average of 0.6 percent annually between 2008 and 2012, the number of new cases fell an average of 5.4 percent.

People get diabetes when their bodies do not produce or properly use insulin. Insulin is a hormone that aids in the conversion of sugar, starches and other foods into energy that is needed for daily life.

People with type 1 diabetes, previously called juvenile-onset diabetes, have a total lack of insulin which requires insulin injections or a pump. Those with type 2 diabetes, previously called adult-onset diabetes, have insulin, but cannot use it effectively. They are in a state of "insulin resistance," requiring medications and/or insulin injections.

Millions have prediabetes

"While the CDC is reporting a slowdown in numbers diagnosed, there are still many people living with diabetes who are undiagnosed, and many others who are at high risk for developing type 2 diabetes," Dr. Gordner said.

The bad news is that the American Diabetes Association says another 86 million Americans have prediabetes – a condition marked by higher than normal blood sugars – and 30% of them will go on to develop type 2 diabetes within five years unless they address their risk factors.

Risk factors for developing diabetes include:

  • being overweight or obese
  • leading a sedentary lifestyle
  • high blood pressure
  • high cholesterol
  • over 45 years old
  • a family history of diabetes

Also, African Americans and Hispanics are more at risk for the disease.

"Prediabetes puts you at high risk of developing type 2 diabetes and also increases your risk of developing cardiovascular disease. By modifying your risk factors and adopting a healthy lifestyle – from eating more nutritious foods and limiting your portions to exercising to maintain an appropriate weight – you can help delay or prevent some of the serious complications of diabetes such as heart disease, stroke, blindness, kidney damage and limb amputations," Dr. Gordner said.

She said many people with prediabetes may not even know it, because they won’t have any symptoms. The only way you can tell for sure if you have prediabetes is for your doctor to order a simple blood test.

Symptoms and getting tested

Primary care physicians may order a blood glucose screening for patients over 45 years of age, particularly if they are overweight with a number of other factors such as high blood pressure, high blood cholesterol, family history of diabetes, or vascular disease.

Symptoms of diabetes include:

  • frequent urination
  • unusual thirst
  • extreme hunger
  • unusual weight loss
  • and extreme fatigue and irritability

Also, those with type 2 diabetes may have:

  • frequent infections
  • blurred vision
  • cuts and bruises that are slow to heal
  • tingling/numbness in the hands or feet
  • recurring skin, gum or bladder infections

Risk to children and teens

Diabetes, however, isn’t just a disease for adults. According to a study published in the Journal of the American Medical Association in May, nearly 167,000 children and teens younger than 20 have type 1 diabetes. However, more children today are being increasingly diagnosed with type 2 diabetes.

"The increased prevalence of type 2 diabetes in youth is clearly linked to their being overweight or obese. The same risk factors for type 2 diabetes that exist for adults, also exist for kids. What makes matters worse is that treatment options for children are fewer than what is available for adults (metformin and insulin only), and that they are more likely to not respond as well to oral medication alone," said pediatric endocrinologist Dr. Rushika Conroy of Baystate Children’s Hospital.

"The other diseases that an adult can develop from years of poorly controlled type 2 diabetes can also develop in children and adolescents in the same amount of time, suggesting that this may be the first generation of children who do not outlive their parents," she added.

Prevention of type 2 diabetes in youth is no different than it is for adults. It could involve lifestyle modifications like increasing daily activity, eating less calorically-dense, nutrient-poor foods, and eating more nutrient-rich foods.