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Issue 105 Item 2 Diabetes To Overpower Health Care System

Apr 22, 2002

That according to the director of the diabetes division of the CDC Diabetes has reached epidemic levels in the United States and threatens to

overpower the nation’s health care system, a key federal health official told a conference of diabetes experts last Tuesday in St. Louis.

"I predict the quality of care will soon start to decline because there will be too many people with diabetes and too few health professionals to care for them," said Dr. Frank Vinicor, director of the diabetes division of the Centers for Disease Control and Prevention. "There won’t be enough time or money to provide for them."

Vinicor said the increase comes at a time when researchers and clinicians are increasing efforts to learn more about its causes, prevention and treatment. But they face an onslaught.

Type 2 diabetes, which accounts for 90 percent to 95 percent of all diabetes cases, climbed 33 percent nationally in the past decade. Seventeen million Americans are estimated to have it, according to new figures from the Centers for Disease Control and Prevention.

The disease is the nation’s sixth leading cause of death.

Researchers are alarmed by rising incidences among others long considered at low risk, such as children, Caucasians, people in their 30s and those of normal weight.

More people also are being put at risk of developing complications of diabetes such as blindness, heart disease, amputation of limbs and kidney failure.

Missouri and Illinois are among states with the highest rates of obesity, a leading cause of diabetes. Rates of diabetes in the two states are higher than the national average – 7 percent versus 5 percent nationally. That’s about 884,000 people in Illinois and more than 270,000 people in Missouri.

Two million Missourians – about 51 percent of the population – are estimated as being at increased risk because of age, obesity and lack of physical activity. In Illinois, 3 million people are at increased risk.

At least a half-dozen medical studies have found that the smaller a baby is at birth and the poorer its nutrition during fetal development, the greater the likelihood of its developing a chronic disease, such as diabetes, three and four decades later.

Diabetes could be triggered by such a condition if the person gains weight or develops other risk factors, researchers speculate.

But other factors can be controlled.

Health professionals were buoyed by the findings of the Diabetes Prevention Program released this year. It provided the first scientific evidence that type 2 diabetes can be prevented.

Most people with pre-diabetic conditions develop the disease within 10 years and increase their risk of heart attack or stroke by 50 percent.

The trial found that modest weight loss – 5 percent to 7 percent of body weight – and increased physical activity, such as brisk walking for 30 minutes per day, can cut a person’s risk of developing diabetes by more than half.

"To get this science into practice, it’s going to require more than just walking into the doctor’s office for a pill," Vinicor said, referring to the Diabetes Prevention Program. "The effort is going to have to be in the community – at the work site and in the neighborhoods. It’s significant that lifestyle was twice as effective as metformin in treating the disease – and that those findings held true for everyone, regardless of weight, age or ethnicity."

As recently as a decade ago, diabetes in children and teens was assumed to be the result of genetics. Only 1 percent to 2 percent had type 2 diabetes.

Today, up to half of all new cases are caused by eating or other lifestyle factors.

"That’s an alarming figure," Vincor said. "As the people who get diagnosed get younger and younger, it means that they will have 40 years or more to live with the disease. That’s a lot to ask of a lot of people to deal with diabetes all those years