Diabetes: A New Growing Public Health Concern

Diabetes: Either you have or you don't.

That's the message that the American Diabetes Association (ADA) is driving home to millions of people who believe they may be "borderline diabetic," or that their "sugar is just a bit high." 

Convenient phrases and stereotypes such as these don't adequately describe one of the nation's leading causes of death and disability. In fact, they tend to only minimize problems associated with the disease. 

The bottom line? An accurate diagnosis is essential, because while a person can live a long and healthy life with diabetes, ignoring it or not taking it seriously can be deadly. 

"It's crucial to know when you have diabetes, to hear the diagnosis, and to pay attention to it," says ADA president Christopher D. Saudek, M.D. 

Saudek, who also heads up the diabetes center at Johns Hopkins University School of Medicine in Baltimore, says he's seen people deny their diabetes "almost to the point of death."

Diabetes mellitus is a chronic disease in which the pancreas produces too little or no insulin, impairing the body's ability to turn sugar into usable energy. Doctors often use the full name "diabetes mellitus," rather than "diabetes" alone, to distinguish this disorder from diabetes insipidus--a different disease altogether that is characterized by excess urination, but is unrelated to blood sugar.

The number of people diagnosed with diabetes has increased more than sixfold from 1.6 million in 1958 to 10 million in 1997, according to the Centers for Disease Control and Prevention (CDC) in Atlanta. 

Today, some 16 million people have the disease--making it a leading cause of death in the United States--yet 5 million don't know they have it. And nearly 800,000 new cases of diabetes are diagnosed each year.

There is no cure for the disease, and the resulting health complications from poorly controlled diabetes are what make it so frightening. Consistently high blood sugar levels can, over time, lead to blindness, kidney failure, heart disease, limb amputations, and nerve damage. 

In fact, diabetes is the leading cause of new cases of blindness in adults between the ages of 20 and 74, and it accounts for 40 percent of people who have kidney failure. 

Cardiovascular disease is 2 to 4 times more common among people with diabetes, and is the leading cause of diabetes-related deaths. The risk of stroke is also 2 to 4 times higher in people with diabetes, and 60 percent to 65 percent have high blood pressure.

Despite these numbers, Saudek says diabetes can be very well-managed and that people can expect to live full and productive lives. Much of the treatment, however, depends largely on self-care practices. It's important, Saudek says, not only to target good behaviors, but also to consistently follow through with them.

Monitoring blood sugar levels is a key component in treatment and management of the disease. Research has indicated that people who keep their blood sugar levels within individual target ranges set by their doctors stand a good chance of reducing the risk of complications from diabetes. 

Moreover, in many cases intensive lifestyle changes in diet and exercise actually can prevent, reduce or delay the risk of developing one type of the disease.

Understanding Diabetes 

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