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Diabetes: A Growing Epidemic and Health Care Concern
Recent population studies throughout the country have shown that diabetes is increasing rapidly in the United States (US). In the past 15 years the number of people with diagnosed diabetes has more than doubled. An estimated 23.6 million Americans now have diabetes, and almost 6 million of them do not know they have it. This alarming growth in the number of individuals with diabetes has been closely associated with a similar rate of increased obesity both nationally and in our state of Virginia. Recent evidence shows that in addition, 57 million people in the US have pre-diabetes. Those with pre-diabetes have blood glucose levels that are higher than normal and they are at high risk for developing type 2 diabetes. The pre-diabetes population coupled with the 24 million people with already diagnosed diabetes means we are talking about 25% of the US population.
The Cost of Diabetes
According to the American Diabetes Association the amount of money spent for diabetes last year was $116 billion in direct medical costs and $58 billion in lost productivity, disability and premature death from complications. With the projected increase in the number of people developing diabetes each year, these costs can have a devastating effect on the US economy healthcare budget. One in five healthcare dollars is spent caring for someone with diabetes. If you or someone you love has diabetes, you know how much this disease costs your own family. One bit of good news from the Center for Disease Control is "outpatient training to help people with diabetes learn to self-manage their disease prevents hospitalizations. Each dollar invested in diabetes training can cut health care costs by $8.76." Learning to control diabetes can help people live healthier lives and prevent the costly complications of this disease.
People with diabetes have a shortage of insulin or a decreased ability to use insulin adequately resulting in higher than normal blood glucose levels. When blood glucose is not well controlled, over time, it can damage vital organs in the body, such as the eyes, the kidneys, the nerves, the heart and blood vessels. There are two main types of diabetes. Type 1 most often appears in children or young adults when the body stops producing insulin. Type 2, most often associated with obesity and physical inactivity, accounts for 90 to 95% of diabetes cases and is most common in people over 40 years of age, although there has been a recent increase in type 2 diabetes among children and teens.
How do you know whether you are at risk for diabetes?
The American Diabetes Association (ADA) recommends that all adults have a blood test to screen for diabetes starting at age 45, and if results are normal, this test should then be repeated every three years. If you have one or more risk factors mentioned in this article, testing should be considered at a younger age and at more frequent intervals. You can also take the risk test on the ADA website www.diabetes.org for an evaluation of your risk level.
Risk factors are those aspects of a person's lifestyle, genetic traits or environment that are associated with the development of a disease. For example: smoking is a risk factor for the development of lung cancer and heart disease. Risk factors for developing diabetes are: high blood pressure, abnormal cholesterol levels, being 25% over your ideal body weight, lack of exercise, having had a baby weighing over 9 pounds or previous gestational diabetes during pregnancy, and having a family history of diabetes. Additionally, the risk of developing type 2 diabetes increases with age and obesity. It's more common in people with a family history of diabetes and in people who are African Americans, Hispanic Americans, Native and Asian Americans.
Know Your Risk Factors
It's important to work hard to eliminate or decrease the risks that you may have for developing diabetes. For example, if you don't have an exercise program, keep in mind that not being physically active is a risk factor for developing diabetes. Studies show that 30 minutes of exercise on most days, as recommended by the Surgeon General, can reduce your risks. Talk with your doctor about getting started on an exercise program. It's also a good idea to learn the normal values for the tests that are used to evaluate your risk level, such as your fasting blood glucose and cholesterol levels. Ask your healthcare provider to help you learn about ways to decrease your risks for diabetes. Lastly, if you are over your ideal body weight, lowering your weight with a nutrition plan that is low in saturated fat, rich in fiber, fruits and vegetables, can improve your health, lower your risk for diabetes, and help you manage diabetes if you have already been diagnosed. For people who already have diabetes good blood glucose management is essential in order to prevent complications or slow down the progression of the disease.
Of course everyone is different, and what risk factor needs attention for one person may be different for another. The important thing is to get an early start on finding out what your risk factors are, and then begin addressing them right away, rather than waiting until more significant health problems set in. Learning to live with and thrive with diabetes will usually require some lifestyle change, but by making some simple risk factor adjustments today, the progression of this disease can be slowed or prevented all together.
Rosemary Ferguson, RN, MSN, CDE
Diabetes Nurse Specialist