Diabetes: A 21st Century Scourge - The Facts and Figures

The causes of diabetes and how it ravages the body is sobering. The shocking reality of diabetes is that despite all of the medical advances and its worldwide prevalence it continues on a skyward rise into the stratosphere. As if that is not sobering enough the facts listed below will help bring the point home.

• Nearly 26 million children and adults in the United States (nearly 8.5 % of the population) have diabetes
• 79 million Americans are thought to be prediabetic
• 1.9 million Americans are diagnosed with diabetes every year
• Nearly 10% of the entire U.S. population has diabetes, including over 25% of seniors
• As many as 1 in 3 American adults will have diabetes in 2050 if present trends continue
• The economic cost of diagnosed diabetes in the U.S. is $245 billion per year
• 1.9 million Americans aged 20 years or older are newly diagnosed with diabetes                each year (5,205/day)
• Compared to non-Hispanic whites the risk of diagnosed is 1.2 times higher among Asian Americans, 1.7 times higher among Hispanic Americans, and 1.8 times higher among African Americans
• Diabetes is the primary cause of death  for 71,382 Americans each year
• Diabetes contributes to the death of 231,404 Americans annually (combining death certificates that list diabetes as the primary and a contributing cause of death)
• $245 billion annually attributable to diagnosed diabetes, including $176  billion in direct costs and $69 billion in indirect costs (disability, work loss, premature mortality)
• People with diagnosed diabetes have health care costs 2.3 times higher than what expenditures would be in the absence of diabetes
• About 60% to 70% of people with diabetes have mild to severe forms of neuropathy
• More than 60% of nontraumatic lower-limb amputations occur in people with diabetes
• About 65,700 nontraumatic lower-limb  amputations are performed in people with diabetes annually (180/day)
• Diabetes is the leading cause of kidney failure, accounting for 44% of all new cases of kidney failure
• Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes, and the risk for stroke is 2 to 4 times higher among people with diabetes
• Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years
• The prevalence of diagnosed diabetes in the U.S. increased by 128% from 1988 to 2008
• Diabetes kills more Americans every year than AIDS and breast cancer combined

 In the next few articles in this series we will strike a happier tone by covering some of the ways diabetes can be mitigated or reversed. There is plenty of hope and good news so there is no need to despair despite the statistics. We will also discuss the psychology of diabetes and its effect on the lives of those that have it and the people who help care for them.

Diabetes: A 21st Century Scourge - The Ravages of Diabetes Continued

Uncontrolled blood sugar levels is the calling card of Type II diabetes that eventually leads to circulatory issues that are life changing. Foot ulcers, peripheral nerve damage and the accompanying pain, and blindness can result when blood vessels are weakened by the inflammatory action of unregulated blood sugar. Nightmarish as those conditions may be the complications of diabetes can worsen overtime leading to renal failure, heart attacks and stroke.

Diabetic Nephropathy

Silently and slowly high blood glucose levels damages the kidneys of diabetics and pre-diabetics which takes its toll. The kidneys help filter the blood and flush the body of unwanted toxins. Overtime high sugar levels cause the thickening and scarring of nephrons. The process eventually leads to renal (kidney) failure. To make matters worse it can take anywhere from 5 – 10 years before the symptoms of acute kidney damage are experienced. Some of the symptoms include nausea with vomiting, swelling of the legs, headaches, chronic fatigue, and poor appetite. Kidney damage is a leading cause of death in diabetics. As it is kidney function can be a direct correlation to the quality of a person’s life.

Strokes

High blood glucose levels create all sorts of negative domino effects in the body. One part of the domino effect is the scarring and deterioration of blood vessels that occur. The body attempts to repair these blood vessels that are constantly under attack. In doing so the material used to make the repairs “builds up” in the blood vessels creating blockages. Sometimes these blockages occur in arteries and blood vessels that supply blood to brain. When the blockages are severe enough a stroke soon follows. The result of the stroke could lead to paralysis, speech loss, inability to coordinate movement or even death. Smaller strokes could lead to dementia or senility.

Heart Attacks

Diabetes and cardiovascular diseases seem to go hand in hand. Primarily because of the circulatory issues created by having diabetes in the first place. From there it becomes much easier for cardiovascular disease to gain a foothold especially if poor lifestyle habits and predisposition to these diseases exist. Diabetics experience heart attacks more frequently than non-diabetics. Diabetics are also twice as likely to die following a heart attack as non-diabetics.

Diabetes: A 21st Century Scourge - The Ravages of Diabetes

So far we have discussed some of the causes of diabetes mellitus (aka Type II diabetes). Now it is time to look at what diabetes does or can do to the body if reversal or proper mitigation is not undertaken (*Note: I did not use the word “management” purposefully which will be discussed later). Diabetes has a methodical way of slowly shutting down very important body processes. At first it is a silent thief roaming the body undetected causing painless harm. Later the harm becomes great enough to cause discomfort, outright pain or worse. The silent portion of the process can take years and could remain undiscovered for much of that time. The resulting complications are life changing.

Our Poor Eyes

According to the National Institute of Health (NIH) diabetes is one of the leading causes of blindness affecting 4.1 million adults in the U.S. The blindness is caused primarily by a condition called diabetic retinopathy. One of the most devastating aspects of diabetes is how it affects blood flow and circulation. As blood flow to the retinas decrease due to diabetes the body attempts to compensate by creating new blood vessels. Unfortunately these blood vessels tend to be weak and they rupture. Bleeding in the retina obstructs vision and the laser treatments used to stop the bleeding often destroys portions of the retina. Retinal hemorrhaging and treatments for it can separately or in combination cause permanent blindness.  

On Pins and Needles

Circulatory issues figure prominently with Type II diabetes. It can cause blindness and it can also cause another condition called neuropathy. Neuropathy occurs as blood vessels that supply the peripheral nervous system begin to weaken. The peripheral nerves, starved of nourishment, begin to degenerate creating pain. At first it could feel like being pricked by pins and needles as numbness begin to set in. A downward spiral ensues with ever decreasing circulation causing ever increasing pain.

Ulcers and Infections

Foot ulcers, because of poor or insufficient blood supply, can become a common problem. Blood vessels have the tendency to become clogged in diabetics especially in the extremities robbing them of nourishment and proper attention from the immune system. No nourishment causes tissues to degenerate causing ulcers. In addition, simple cuts or bruises can result in life threatening infections. Both conditions can lead to the onset of gangrene and require amputation of the infected limb. There are approximately 185,000 amputations per year in the U.S. with more than half of those (54%) attributed to vascular diseases (either diabetes or peripheral arterial disease). Diabetics are cautioned to take good care of their feet paying close attention to them. Most practitioners would advise diabetics to never go barefoot and to keep their feet warm, dry and clean.

Diabetes: A 21st Century Scourge - Part I

The Introduction

Sadness is staring an avoidable tragedy in the face and blinking. Have you had the chance to ponder the chart above? In each block are a group of numbers representing various regions of the world. The number at the top of the box represents the number of known Type 2 diabetics as of 2003. The number under it is the projected number of diabetes cases in 2025 with the correlating percent increase under each. By 2025 it is projected that there will be a 62% increase in diabetic patients worldwide. The cynic in me says to invest heavily in diabetes medications and paraphernalia. The optimist in me says I should lend a hand. Digressing to my better nature and refusing to enrich myself on the backs of those who suffer by causing suffering I offer the beginning of my multi-pronged diabetes project (more information will be given on the project at a date sometime in the future). 

Sadness is also having to witness triple digit increases projected in parts of the world that are already stressed and void of much hope. It is interesting that shortages of the most basic needs (food, water, medical attention) in these areas abound but a metabolic syndrome often associated with indulgent eating or consuming way more sugar than the body can handle would become a scourge. More on this point and why it is happening in a later article. 

Type 2 diabetes, also known as diabetes mellitus, is a metabolic disorder that occurs when the cells in the body become so resistant to insulin that blood sugar levels can no longer be controlled by the body (this is a simplistic definition and will be expounded upon later). Often medical intervention is undertaken and treatment can include having to take insulin shots, prescription medications and the need to check blood sugar levels often. The American Diabetes Association estimated that diabetes treatment in the U.S. alone cost more than $245 billion in 2012. If price levels remain the same that would mean an increased expenditure of $140 billion bringing the total to $385 billion annually by 2025 just in the U.S.! That would be more than the GDP of the Federated States of Micronesia (in other words a small country).

Sadness surrounds us but it does not have to remain or persist. We have the power to change it and ourselves. There is a growing contingent of well informed and well-meaning people who are helping to either prevent the scourge of diabetes or bring balance to those who have the condition reversing it and freeing would be lifelong diabetics from their conditional prisons. Let the word go out, if it is not already known, that diabetes is a condition not a disease. It is not something you catch but something you develop and what is done can be undone no matter what the cynics and robbers of joy and health say.

This series will focus on some of the causes, health implications, and modalities concerning diabetes mellitus and is designed to offer and inspire hope for what is a seemingly overwhelming epidemic. Have faith, be strong and let us share this ride together!