Diabetes Facts

What is diabetes?

Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.

Diabetes is a chronic disease that has no cure. There are an estimated 20.8 million children and adults in the United States, or 7.0% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed, unfortunately, 6.2 million people are not aware that they have the disease. At least 54 million people have pre-diabetes.

If present trends continue, one in three Americans, and 1 in 2 minorities, born in 2000 will develop diabetes in their lifetime. Each day, approximately 4,110 people are diagnosed with diabetes. In 2005 1.5 million new cases of diabetes were diagnosed in people age 20 years or older.

The Dangerous Toll of Diabetes

Diabetes is the fifth-deadliest disease in the United States. Since 1987 the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined.

Based on death certificate data, diabetes contributed to 224,092 deaths in 2002. Studies indicate that diabetes is generally under-reported on death certificates, particularly in the cases of older persons with multiples chronic conditions such as heart disease and hypertension. Because of this, the toll of diabetes is believed to be much higher than officially reported.

Many people first become aware that they have diabetes when they develop one of its serious and life-threatening complications such as:

• Heart Disease and Stroke
•  High Blood Pressure
• Blindness
• Kidney Disease
• Nervous System Damage
• Amputations
• Dental Disease
• Pregnancy Complications
• Sexual Dysfunction
• Others
  

Types of Diabetes

Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes. Several clinical trials of methods of the prevention of type 1 diabetes are currently in progress or are being planned.

Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Clinically-based reports and regional studies suggest that type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Gestational diabetes is a form of glucose intolerance diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years. 70% of women who have had gestational diabetes will develop type 2 diabetes at some point during their lifetime.

Other types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases. Pre-diabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke. People with pre-diabetes have blood glucose levels higher than normal but not high enough to be classified as diabetes.

  People with pre-diabetes have impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Some people have both IFG and IGT.

IFG is a condition in which the fasting blood sugar level is 100 to 125 milligrams per deciliter (mg/dL) after an overnight fast. The level is higher than normal but not high enough to be classified as diabetes.

IGT is a condition in which the blood sugar level is 140 to 199 mg/dL after a 2-hour oral glucose tolerance test. The level is higher than normal but not high enough to be classified as diabetes.

In a cross-section sample of U.S. adults aged 40-74 years tested from 1988 to 1994, 33.8% had IFG, 15.4% had IGT, and 40.1% had prediabetes (IGT or IFG or both). Applying these percentages to the entire U.S. population in 2000, an estimated 35 million adults aged 40-74 had IFG, 16 million had IGT, and 41 million had prediabetes (there is overlap between the IFG and IGT groups).

Progression to diabetes among those with prediabetes is not inevitable. Studies have shown that people with prediabetes who lose weight and increase their physical activity can prevent or delay diabetes and even return their blood glucose levels to normal.

More recent estimates from 1999-2002 indicate that, among US adults age 20 years and older, 26% had IFG, which was similar to the prevalence in 1988-1994 (25%). Applying this percentage to the entire U.S. population, 54 million American adults had IFG in 2002. Because IGT was not measured in 1999-2002, these data suggest that at least 54 million American adults had prediabetes in 2002.

2 million adolescents aged 12-19 (1 in 6 overweight adolescents aged 12-19) have prediabetes.

The Risk of Diabetes

Who is at Greater Risk for Type 1 Diabetes?

Siblings of people with type 1 diabetes

Children of parents with type 1 diabetes

Who is at Greater Risk for Type 2 Diabetes?

People with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)

People over age 45

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, high blood pressure

Certain racial and ethnic groups (e.g., Non-Hispanic African Americans, Hispanic/Latino Americans, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives)

Women who had gestational diabetes, or who have had a baby weighing 9 pounds or more at birth

Warning Signs of Diabetes

Type 1 Diabetes

Frequent urination

/Unusual thirst

Extreme hunger

Unusual weight loss

Extreme fatigue

Irritability

Type 2 Diabetes

Any of the type 1 symptoms

Frequent infections

Blurred vision

Cuts/bruises that are slow to heal

Tingling/numbness in the hands/feet

Recurring skin, gum, or bladder infections

Often people with type 2 diabetes have no symptoms

Treating diabetes

To survive, people with type 1 diabetes must have insulin delivered by injection or a pump.

Many people with type 2 diabetes can control their blood glucose by following a healthy meal plan and exercise program, losing excess weight, and taking oral medication.

Many people with diabetes also need to take medications to control their cholesterol and blood pressure.

Diabetes self-management education (DMSE) is an integral component of medical care.

Among adults with diagnosed diabetes, 16% take insulin only, 12% take both insulin and oral medication, 57% take oral medication only, and 15% do not take either insulin or oral medications.