1 in 3 Americans at Risk for Diabetes

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1 in 3 Americans at Risk for Diabetes

Many Have the Disease and Don't Know It

By

Salynn Boyles

WebMD Medical News

Reviewed By

Louise Chang, MD

on Friday, May 26, 2006

May 26, 2006 – As many as a third of American adults with type 2 diabetes

don’t even know they have the disease, according to alarming new findings

from

the National Institutes of Health and the CDC.

Even more disheartening, one in three adults in the U.S. either has

diabetes

or a prediabetes condition known as impaired

glucose

tolerance.

That means that 73 million American have the disease or are on their way to

getting it, says Cowie, PhD, of the National Institute of Diabetes

and Digestive and Kidney Diseases (NIDDK).

" We knew that there had been an increase in diagnosed cases [of type 2

diabetes], " Cowie tells WebMD. " The hope was that this rise would be

counterbalanced

by a decline in undiagnosed cases. But that is not what we are seeing. "

Blacks, Hispanics Most at Risk

Cowie and colleagues analyzed data from a national survey collected between

1999 and 2002, and compared them to data collected between 1988 and 1994.

Participants

were asked if they had diabetes, and they were given fasting blood tests to

confirm the diagnosis, identify new cases, and identify people with the

prediabetes

condition.

Among the survey’s main findings:

List of 4 items

• The prevalence of diagnosed diabetes among adults in the U.S. rose from

5.1% in the early survey to 6.5% in the most recent one.

• The percentage of adults with undiagnosed diabetes remained fairly steady.

A total of 2.7% of adults in the U.S. have the disease without knowing it.

• Almost 1 in 4 U.S. adults aged 65 or over -- 22% of elderly Americans --

have diabetes.

• Diabetes was twice as common in blacks and Mexican-Americans as it was in

whites.

list end

Type 2 diabetes accounts for about 95% of all diabetes cases, and virtually

all undiagnosed cases of the disease.

Obesity

is a major risk factor for type 2 diabetes; age, family history, and

sedentary lifestyle also contribute to risk.

Diabetes is the most common cause of blindness,

kidney failure,

and amputations among adults in the U.S. It is also a major risk factor for

heart disease and

stroke.

Prediabetes Not Benign

The analyzed data were taken from the National Health and

Nutrition

Examination Survey (NHANES), conducted by the CDC’s National Center for

Health Statistics. NHANES is the only national health survey to examine both

diagnosed

diabetes and undiagnosed disease, confirmed by physical exams that include

blood glucose testing.

Over the years studied, roughly 26% of adults in the U.S. had impaired

fasting glucose, meaning that blood sugar levels were higher than normal

after an

overnight fast, but not high enough to be considered diabetes. This

condition is also known as impaired glucose tolerance and prediabetes.

The prediabetes condition has no symptoms, but Cowie points out that it is

far from benign.

" These people have a very high risk of developing diabetes within a decade,

and even if they don’t they are still at high risk for having a

heart attack

or stroke, " she says.

Positive lifestyle changes can often prevent or delay the onset of diabetes

in people with prediabetes. Study after study has shown that losing modest

amounts

of weight and getting even a moderate amount of exercise on a daily basis

can make a big difference.

" Even doing something simple like walking 30 minutes a day, five days a week

can lower risk, " she says.

Know Your Risk Factors for Type 2 Diabetes

But people who don’t know they are at risk may be less inclined to make

diabetes-preventing lifestyle changes.

The list of potential risk factors is long, and people with any of the risks

should discuss diabetes testing with their health care provider, the report

concludes. The risk factors include:

List of 10 items

• Having a family history of diabetes.

• Being overweight.

• Having an inactive lifestyle, meaning that they exercise less than 3 times

a week.

• Being a member of a high-risk ethnic population (African-American,

Hispanic/Latino American, American Indian, Alaska Native or Pacific

Islander, and some

Asian- Americans).

• Having

high blood pressure.

• Having low HDL (good) cholesterol or high triglyceride level.

• Having a history of diseases of the blood vessels to the heart, brain, or

legs.

• Having had pregnancy-related diabetes.

• Having polycystic ovary syndrome.

• Being age 45 and older.

list end

" The important message to get out to the community is that these are the

people who are at risk for developing type 2 diabetes, " says M.

Jr.,

MD.

is a professor of medicine at Indiana University School of Medicine

and is chairman emeritus of the NIDDK’s National Diabetes Education Program.

He tells WebMD limited public health funds make both finding undiagnosed

diabetes cases and taking care of people who know they have the disease a

challenge.

" We only have so much to invest, " he says. " We may want to spend more on

screening efforts, but the reality is that we may need to spend more taking

care

of the people we already know about. "

SOURCES: Cowie, C.C. Diabetes Care, June 2006; vol 29: pp 1263-1268.

C. Cowie, PhD, director, Diabetes Epidemiology Program, NIDDK.

M.

, MD, professor of medicine, Indiana University School of Medicine;

chairman emeritus, NIDDK National Diabetes Education Program.