Diabetes Epidemic in the United States diabetes and increases the risk of heart disease by nearly 50 percent. cases of diabetes among children who are …
AACE Key Goals and Recommendations for Diabetes Prevention and s Management Diabetes Epidemic in the United States
? Diabetes is the sixth leading cause of death in the US, contributing to over 200,000 deaths every year Approximately 18 million individuals in the US have diabetes, almost a third of whom are unaware they have the disease Another 16 million individuals in the US have a condition known as pre-diabetes, or impaired glucose tolerance Unless treated, pre-diabetes dramatically increases the risk for developing type 2 diabetes and increases the risk of heart disease by nearly 50 percent There is a growing epidemic of type 2 diabetes in children and adolescents that may be linked to obesity and physical inactivity Type 2 diabetes now accounts for between 8 and 46 percent of all new cases of diabetes among children who are referred to pediatric centers for care Diabetes is also a major contributor to heart disease, stroke, and high blood pressure In adults, diabetes is the leading cause of new blindness, end-stage renal failure, and nontraumatic lower limb amputations People with diabetes are 2 to 4 times more likely than the general population to have heart disease or to
suffer a stroke It disproportionately affects people of color African Americans and Latinos die twice as often from the disease as whites, and American Indians and Alaskan Natives die three to four times as often In the American Indian and Alaskan Native communities, type 2 diabetes has rates 8 to 10 times higher than among whites African American adults have a 60 percent higher rate, and Latinos have a 90 percent higher rate of type 2 diabetes than whites Simple preventive and treatment measures available today can dramatically improve the likelihood that people will never develop type 2 diabetes and can give good care to those who have type 1 diabetes With only 30 minutes of walking a day and a healthy diet, people with impaired glucose tolerance can reduce their chance of developing type 2 diabetes by 58 percent The economic cost of diabetes is conservatively estimated at 132 billion annually This includes 92 billion in direct medical expenditures and 40 billion attributable to disability and premature mortality US spends 1 out of every 4 Medicare dollars on diabetes
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AACE Recommendations s Preventative
? ? Reducing the progression of diabetes, through the
Power of Prevention, would save the United States 4,290,000,000 annually Screen for diabetes in populations at high risk at age 30 Risk factors include the following: Family history of diabetes Cardiovascular disease Overweight Sedentary lifestyle Latino/Hispanic, African American, Asian American, Native American, or Pacific Islander ethnicity Previously identified impaired glucose tolerance or impaired fasting glucose Hypertension
American Association of Clinical Endocrinologists 1000 Riverside Avenue ?Suite 205 ?Jacksonville, FL 32204 ?904-353-7878 wwwaacecom or wwwpowerofpreventioncom
Increased levels of triglycerides, low concentrations of high-density lipoprotein cholesterol, or both History of gestational diabetes Delivery of a baby weighing more than 9 pounds 4 kg Polycystic ovary syndrome
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With obesity as a prime modulator of insulin resistance, a key reason for the epidemic of Insulin Resistance Syndrome, obesity prevention is essential in curtailing this epidemic
Management
? ? A1C Blood Sugar Test 65 Pre and Post-Prandial Blood Sugar Levels ? Before eating pre-prandial 110 mg/dL ? Two hours after eating post-prandial 140 mg/dL Addressing the underlying
pathophysiology of insulin resistance, which leads not only to CVD but also to diabetes and other disorders
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? Recognizing additional associated disorders to insulin resistance such as polycystic ovary syndrome PCOS, which affects one in ten US women of child-bearing age; and non-alcoholic fatty liver disease ? Improving the detection of the Insulin Resistance Syndrome by emphasizing the use of the 2-hour post glucose challenge as the most sensitive clinically available test for insulin resistance ? Achieving normal glucose levels improves in-patient outcomes ? Blood sugar should be controlled below 110 mg/dL in ICU patients, and to a similar level before meals outside the ICU ? Maximum glucose levels should not exceed 180 mg/dL in non-critical-care units ? During prelabor, blood sugar should be 100 mg/dL prepranidal and 120 mg/dL 1-hour postprandial During labor and delivery, levels should be 100 mg/dL
American Association of Clinical Endocrinologists 1000 Riverside Avenue ?Suite 205 ?Jacksonville, FL 32204 ?904-353-7878 wwwaacecom or wwwpowerofpreventioncom
Source:diabetes.ucsf.edu
