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Dean Karan demonstrated the
new glucose biosensors used in the measurement of blood sugar
levels in diabetics. Even though it is a vast improvement
over the older method of drawing blood from the vein, it still
requires frequent pricking of the fingers.
Dean Karan listened intently to questions posed by the audience
pertaining to the differences between Type I and Type II
diabetes. The audience asked if diabetes
developed after forty years of age could be transmitted to
their offspring. Dean Karan answered by stating that it
wouldn’t be considered hereditary if it weren’t genetically
September 15, 1998
Diabetes mellitus is a disease caused by a deficiency of
insulin, which is a hormone secreted by the pancreas.
About 16 million Americans have diabetes, but only about
10 million have been diagnosed. Approximately 798,000 new
cases of diabetes are diagnosed annually in the United
The number of persons diagnosed with diabetes has
increased sixfold, from 1.6 million in 1958 to 10 million
in 1997. Diabetes is the nation's seventh leading killer
and contributed to about 187,800 deaths in 1995.
Diabetes is classified into two main types: type 1 and
type 2 . Type 1 diabetes (insulin-dependent), affects
5%-10% of those with diabetes and most often occurs during
childhood or adolescence. Type 2 diabetes (non-insulin-
dependent) is the more common type, affecting 90%-95% of
those with diabetes. Type 2 diabetes usually occurs after
Diabetes and its complications occur among Americans of
all ages and racial/ethnic groups, but the elderly and
certain racial/ethnic groups are more commonly affected by
the disease. About 18% of Americans 65 years of age and
older have diabetes.
Diabetes patients risk debilitating complications such as
blindness, kidney disease, and lower-extremity
Cardiovascular disease is 2-4 times more common among
persons with diabetes; the risk of stroke is 2-4 times
higher; 60%-65% have high blood pressure; and 60%-70% have
mild to severe diabetic nerve damage.
Diabetes Fact Sheet
Diabetes mellitus is a group
of diseases characterized by high levels of blood glucose
resulting from defects in insulin production, insulin action,
or both. Diabetes can be associated with serious complications
and premature death, but people with diabetes can take steps
to control the disease and lower the risk of complications.
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. This form of diabetes usually strikes children
and young adults, who need several insulin injections a day or
an insulin pump to survive. Type 1 diabetes may account for 5%
to 10% of all diagnosed cases of diabetes. Risk factors for
type 1 diabetes include autoimmune, genetic, and environmental
Type 2 diabetes
was previously called non-insulin-dependent diabetes mellitus
(NIDDM) or adult-onset diabetes. Type 2 diabetes may account
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
insulin. Type 2 diabetes is associated with older age,
obesity, family history of diabetes, prior history of
gestational diabetes, impaired glucose tolerance, physical
inactivity, and race/ethnicity. African Americans,
Hispanic/Latino Americans, American Indians, and some Asian
Americans and Pacific Islanders are at particularly high risk
for type 2 diabetes. Type 2 diabetes is increasingly being
diagnosed in children and adolescents.
is a form of glucose intolerance that is 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.
Other specific 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 may account for 1% to 5% of all diagnosed cases of
glucose tolerance and impaired fasting glucose
Impaired glucose tolerance (IGT)
and impaired fasting glucose (IFG) are considered to be
prediabetic conditions, and studies suggest that they may
IGT is a condition in which
the blood sugar level is elevated (between 140 and 199
milligrams per deciliter or mg/dL after a 2-hour oral
glucose tolerance test), but is not high enough to be
classified as diabetes.
IFG is a condition in which
the fasting blood sugar level is elevated (between 110 and
125 mg/dL after an overnight fast) but is not high enough
to be classified as diabetes.
·Among U.S. adults 40-74 years
of age, 16.0 million (15.6%) have IGT and 10.0 million
(9.7%) have IFG.
Research studies in the
United States and abroad have found that lifestyle changes can
prevent or delay the onset of type 2 diabetes among high-risk
adults. These studies included people with IGT and other
high-risk characteristics for developing diabetes. Lifestyle
interventions included diet and moderate-intensity physical
activity (such as walking for 2 1/2 hours each week). For both
sexes and all age and racial and ethnic groups, the
development of diabetes was reduced 40% to 60% during these
studies that lasted 3 to 6 years.
Studies have also shown that
medications have been successful in preventing diabetes in
some population groups. In the Diabetes Prevention Program, a
large prevention study of people at high risk for diabetes,
people treated with the drug metformin reduced their risk of
developing diabetes by 31%. Treatment with metformin was most
effective among younger, heavier people (those 25-40 years of
age who were 50 to 80 pounds overweight) and less effective
among older people and people who were not as overweight.
There are no known methods
to prevent type 1 diabetes. Several clinical trials are
currently in progress.
Research studies in the United
States and abroad have found that improved glycemic
control benefits people with either type 1 or type 2
diabetes. In general, for every 1% reduction in results of
A1C blood tests, the risk of developing microvascular
diabetic complications (eye, kidney, and nerve disease) is
reduced by 40%.
Blood pressure control can
reduce cardiovascular disease (heart disease and stroke)
by approximately 33% to 50% and can reduce microvascular
disease (eye, kidney, and nerve disease) by approximately
In general, for every 10
millimeters of mercury (mm Hg) reduction in systolic blood
pressure, the risk for any complication related to
diabetes is reduced by 12%.
Improved control of
cholesterol and lipids (for example, HDL, LDL, and
triglycerides) can reduce cardiovascular complications by
20% to 50%.
care practices for eyes, kidneys, and feet