2000 will develop diabetes. The fifth leading cause of death by disease. Source: National Diabetes Fact Sheet, Centers for Disease Control and Prevention, …
The Burden Of Diabetes And The Promise Of Biomedical Research
Presented by
John Anderson, MD Incoming Chair, ADAs National Advocacy Committee; Frist Clinic, Nashville, TN
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Type 1 Diabetes
Usually diagnosed in children and young adults previously known as juvenile diabetes The body does not produce insulin
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Type 2 Diabetes
The most common form of diabetes–affecting 95 of people with diabetes Either the body does not produce enough insulin or the cells fails to recognize insulin
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Diabetes is Serious
It creates an increased risk for many serious complications:
Heart disease and stroke cardiovascular disease Kidney damage nephropathy Blindness retinopathy Nerve damage Peripheral Vascular
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A National Epidemic
Twenty-one million children and adults in the United States Another 54 million have pre-diabetes Growing at a rate of 8 percent per year One of the most prevalent chronic illnesses among children One in three Americans, one in two minorities born since 2000 will develop diabetes The fifth leading cause of death by
disease
Source: National Diabetes Fact Sheet, Centers for Disease Control and Prevention, 2005
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Getting Worse, Not Better
Diabetes Trends Among Adults in the US
Includes Gestational Diabetes
BRFSS, 1990,1995 and 2001
1990
1995
2001
No Data
4
4-6
6-8
8-10
10
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Getting Worse, Not Better
While the death rates due to heart disease and cancer have declined, the death rate due to diabetes continues to increase
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Diabetes is Costly
NOW: at least 132 billion a year TOMORROW:
strained family budgets bankrupt employer health care systems tremendous public health burden on state and local governments
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The Promise of Research
New Medicines
To regulate blood glucose Overcome insulin resistance Stimulate secretion of insulin from the pancreas Regulate appetite, promoting weight loss
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The Promise of Research
New forms of insulin
Longer lasting Rapid acting
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The Promise of Research
New Devices
Sensor device that can be implanted under the skin Records glucose
levels every few minutes The sensor also interacts with the patients glucose meter, providing a real time warning when glucose is low, while also providing trend data The next big step: link a sensor with an insulin loop, an artificial pancreas
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The Promise of Research
New Knowledge
The data we need to develop standards of care We know what we need to do to prevent the serious complications Better insight into obesity risk factors, obesity control
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The Promise of Research
The Cutting Edge
Islet cell transplantation Understanding the metabolic syndrome, prediabetes syndrome
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Diabetes is Controllable
Glucose control Blood pressure control
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Diabetes is Controllable
Preventive care practices for eyes, kidneys, and feet: reduce severe vision loss reduce foot amputation rates reduce the decline in kidney function
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Diabetes is Controllable Preventable
We can do many things to prevent and control diabetes:
Nutrition Exercise Weight loss Medication Diabetes self management training Community
support
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Getting Worse, Not Better
The new technologies focus on treating the symptoms They are not a cure Uniform access to new technology, medications, standards of care and funding are lacking
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Getting Worse, Not Better
For the past three years, no increase in the two main streams of discretionary funding
The Division of Diabetes Translation DDT under the Centers for Disease Control CDC The National Institute of Diabetes and Digestive and Kidney Diseases NIDDK under the National Institutes of Health NIH
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Getting Worse, Not Better
The status quo is not an option
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