Diabetes

• What is Diabetes?
• The Impact of Diabetes
• Direct and Indirect Costs of Diabetes
• What is Type 1 Diabetes?
• What is Type 2 Diabetes?
• What Are the Other Types of Diabetes?
• Who is at Greater Risk for Type 1 Diabetes?
• Who is at Greater Risk for Type 2 Diabetes?
• Warning Signs of Diabetes
• Symptoms

What is Diabetes? [Index]

Diabetes is a disease in which the body does not produce or properly use insulin.  Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.  The cause of diabetes is a mystery, although both genetics and environmental factors such as obesity and lack of proper exercise appear to play roles.  There are two major types of diabetes, type 1 and type 2.

The Impact of Diabetes [Index]

There are 15.7 million people or 5.9% of the population in the United States who have diabetes.  While an estimated 10.3 million have been diagnosed, unfortunately, 5.4 million people are not aware that they have the disease.  Each day approximately 2,200 people are diagnosed with diabetes.   About 798,000 people will be diagnosed this year.

Diabetes is the seventh leading cause of death (sixth-leading cause of death by disease) in the United States.  Based on death certificate data, diabetes contributed to 198,140 deaths in 1996.  Diabetes is a chronic disease that has no cure.

Diabetes is a Silent Killer

Many people first become aware that they have diabetes when they develop one of its life-threatening complications.

• Blindness.  Diabetes is the leading cause of new cases of blindness in people ages 20-74.  Each year, from 12,000 to 24,000 people lose their sight because of diabetes.

• Kidney Disease.  Diabetes is the leading cause of end-stage renal disease, accounting for about 40% of new cases.  In 1995, approximately 27,900 people initiated treatment for end stage renal disease (kidney failure) because of diabetes.

• Nerve Disease and Amputations.  About 60-70 percent of people with diabetes have mild to severe forms of diabetic nerve damage, which, in severe forms, can lead to lower limb amputations.  In fact, diabetes is the most frequent cause of non-traumatic lower limb amputations.  The risk of a leg amputation is 15-40 times greater for a person with diabetes.  Each year, more than 56,000 amputations are performed among people with diabetes.

• Heart Disease and Stroke.  People with diabetes are 2 to 4 times more likely to have heart disease which is present in 75 percent of diabetes-related deaths (more than 77,000 deaths due to heart disease annually).  And, they are 2 to 4 times more likely to suffer a stroke.

Direct and Indirect Costs of Diabetes [Index]

Diabetes is one of the most costly health problems in America.  Health care and other costs directly related to diabetes treatment, as well as the costs of lost productivity, run $98 billion annually.

What is Type 1 Diabetes? [Index]

Type 1 Diabetes is a disease that results from the body's failure to produce insulin -- the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them.  There are two forms of Type 1.  Immune-mediated diabetes mellitus results from an autoimmune process in which the body's immune system attacks and destroys the insulin producing cells of the pancreas.  Since glucose cannot enter the cells, it builds up in the blood and the body's cells literally starve to death.  The second, Idiopathic Type 1, refers to rare forms of the disease that have no known cause.   People with Type 1 diabetes must take daily insulin injections to stay alive.

• There are an estimated 500,000 to 1 million people with Type 1 diabetes in the United States today.

• The risk of developing Type 1 diabetes is higher than virtually all other severe chronic diseases of childhood.

• Peak incidence occurs during puberty, around 10 to 12 years of age in girls and 12 to 14 years of age in boys.

• The symptoms for Type 1 diabetes can mimic the flu in children.

• Type 1 diabetes tends to run in families.  Brothers and sisters of children with Type 1 diabetes have about a 10 percent chance of developing the disease by age 50.

• The identical twin of a person with Type 1 diabetes has a 25 to 50 percent chance of developing Type 1 diabetes.

• There is a higher incidence of Type 1 diabetes in whites than in other racial groups.

What is Type 2 Diabetes? [Index]

Type 2 diabetes results from insulin resistance (a condition in which the body fails to make enough or to properly use insulin), combined with relative insulin deficiency.  Often Type 2 diabetes can be controlled through losing weight, improved nutrition and exercise alone, but many people need oral medications and/or insulin to control their diabetes.

• Of the nearly 16 million Americans with diabetes, 90-95 percent (14.9 million) have Type 2 diabetes.  Of these, roughly a third are unaware they have the disease.

• People with Type 2 diabetes usually develop the disease after age 45, but often are not aware they have diabetes until severe symptoms occur or they are treated for one of its serious complications.

• The risk for Type 2 diabetes increases with age.  Nearly 18.4 percent of the United States population aged 65 and older has diabetes.

• Studies indicate that diabetes is generally under-reported on death certificates, particularly in the cases of older persons with multiple chronic conditions such as heart disease and hypertension.  Because of this, the toll of diabetes is believed to be much higher than officially reported.

What Are the Other Types of Diabetes? [Index]

Gestational diabetes is a temporary form of insulin resistance that usually occurs halfway through a pregnancy as a result of excessive hormone production in the body, or the pancreas' inability to make the additional insulin that is needed during some pregnancies in women with no previous history of Type 1 or Type 2 diabetes.  Gestational diabetes usually goes away after pregnancy, but women who have had gestational diabetes are at an increased risk for later developing Type 2 diabetes.

Researchers have identified a small percentage of diabetes cases that result from specific genetic syndromes, surgery, chemicals, drugs, malnutrition, infections, viruses and other illnesses.

Who is at Greater Risk for Type 1 Diabetes? [Index]

• Siblings of people with Type 1 diabetes

• Children of parents with Type 1 diabetes

• People over age 65

• People with a family history of diabetes

• People who are overweight

• People who do not exercise regularly

• People with low HDL cholesterol or high triglycerides

• Certain racial and ethnic groups (e.g., African Americans, Latinos, Asian & Pacific Islanders, and Native Americans)

• Women who had gestational diabetes, a form of diabetes occurring in 2-5 percent of all pregnancies, or who have had a baby weighing 9 pounds or more at birth.

• African Americans.  African Americans are 1.7 times as likely to have Type 2 diabetes as the general population.   An estimated 2.3 million African Americans, or 10.8%, have diabetes.

• Latinos.  Latinos are almost twice as likely to have Type 2 diabetes.  For example, diabetes affects 1.2 million or 10.6% of the Mexican American population.

• Native Americans.  Overall prevalence of Type 2 diabetes in Native Americans is 12.2% vs. 5.2% of the general population.  In some tribes, 50% of the population has diabetes.