The Basics of Diabetes
Diabetes is a disease in which the blood sugar levels are above normal. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ which lies near the stomach, makes a hormone called Insulin to help glucose get into the cells of our body. When you have Diabetes, your body either does not make enough or adequate Insulin or it cannot used it's own Insulin correctly. This causes sugar to build up in your blood.
High Blood sugars can damage body organs and cause tissue damage. High blood sugars pass through the kidneys and causes a larger than normal volume of urine, which can lead to an increase in thirst. Although the sugar in the blood is high, it cannot be used for energy by the body. This is one of the reasons why people with poorly controlled blood sugars may loose weight.
Diabetes is a disorder of metabolism, the way the body uses digested food for energy. The digestive tract breaks down carbohydrates, sugars and starches, found in many foods, into glucose, a form of sugar that enters the blood stream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Diabetes develops when the body doesn’t make enough insulin or is not able to use insulin effectively, or both.
Insulin is made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.
If beta cells don’t produce enough insulin, or the body doesn’t respond to the insulin that is present, glucose builds up in the blood instead of being absorbed by cells in the body, leading to prediabetes or diabetes. Prediabetes is a condition in which blood glucose levels or A1C levels, which reflect average blood glucose levels — are higher than normal but not high enough to be diagnosed as Diabetes. In Diabetes, the body’s cells are starved of energy despite high blood glucose levels.
The Complications of Diabetes
Diabetes increases your risk for many serious health problems. If you choose to follow the advice of your Health Care team, all of these can be prevented, or delayed.
Long-term complications of Diabetes develop gradually. The longer you have Diabetes, and the less controlled your Blood Sugar is, the higher the risk of developing complications becomes. Eventually, the complications of Diabetes can become disabling or even life-threatening.
- Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you are more likely to have heart disease or stroke.
- Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.
- Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
- Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
- Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.
- Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
- Hearing impairment. Hearing problems are more common in people with diabetes.
- Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:
The key to delaying or avoiding complication is learning how to control your bllod sugar. All of these complications can be avoided, or their onset greatly delayed, by learning how to keep your blood sugars in a safe range and you will learn how to do this as you progress.
The Economic and Statistics Impact of Diabetes in the United States: 2013-2013.
Statistics About Diabetes
Overall Numbers, Diabetes and Prediabetes
- Prevalence: In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.
- Diabetes does not discriminate. It impacts all social, economical, and ethnic background .
- Approximately 1.25 million American children and adults have type 1 diabetes.
- Among individuals age 20 or older, 1.7 million new cases of Diabetes were newly-diagnosed in 2012, and approximately 4,657 new cases of diabetes are diagnosed each year.
- Undiagnosed: Of the 29.1 million, 21.0 million were diagnosed, and 8.1 million were undiagnosed.
- Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors (diagnosed and undiagnosed).
- New Cases: 1.4 million Americans are diagnosed with diabetes every year.
- Prediabetes: In 2012, 86 million Americans age 20 and older had prediabetes; this is up from 79 million in 2010.
- Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death.
Diabetes in Youth
- About 208,000 Americans under age 20 are estimated to have diagnosed diabetes, approximately 0.25% of that population.
- In 2008—2009, the annual incidence of diagnosed diabetes in youth was estimated at 18,436 with type 1 diabetes, 5,089 with type 2 diabetes.
Diabetes by Race/Ethnicity
The rates of diagnosed diabetes by race/ethnic background are:
- 7.6% of non-Hispanic whites
- 9.0% of Asian Americans
- 12.8% of Hispanics
- 13.2% ofnon-Hispanic Blacks
- 15.9% of American Indians/Alaskan Natives
The breakdown among Asian Americans:
- 4.4% for Chinese
- 11.3% for Filipinos
- 13.0 for Asian Indians
- 8.8% for other Asian Americans.
The breakdown among Hispanic adults:
- 8.5% for Central and South Americans
- 9.3% for Cubans
- 13.9% for Mexican Americans
- 14.8% for Puerto Ricans.
Deaths
Diabetes was the seventh leading cause of death in the United States in 2010 based on the 69,071 death certificates in which diabetes was listed as the underlying cause of death. In 2010, diabetes was mentioned as a cause of death in a total of 234,051 certificates.
Diabetes may be underreported as a cause of death. Studies have found that only about 35% to 40% of people with diabetes who died had diabetes listed anywhere on the death certificate and about 10% to 15% had it listed as the underlying cause of death.
Complications/Co-Morbid Conditions
- Hypoglycemia: In 2011, about 282,000 emergency room visits for adults aged 18 years or older had hypoglycemia as the first-listed diagnosis and diabetes as another diagnosis.
- Hypertension: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 71% had blood pressure greater than or equal to 140/90 millimeters of mercury or used prescription medications to lower high blood pressure.
- Dyslipidemia: In 2009–2012, of adults aged 18 years or older with diagnosed diabetes, 65% had blood LDL cholesterol greater than or equal to 100 mg/dl or used cholesterol-lowering medications.
- CVD Death Rates: In 2003–2006, after adjusting for population age differences, cardiovascular disease death rates were about 1.7 times higher among adults aged 18 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
- Heart Attack Rates: In 2010, after adjusting for population age differences, hospitalization rates for heart attack were 1.8 times higher among adults aged 20 years or older with diagnosed diabetes than among adults without diagnosed diabetes.
- Stroke: In 2010, after adjusting for population age differences, hospitalization rates for stroke were 1.5 times higher among adults with diagnosed diabetes aged 20 years or older compared to those without diagnosed diabetes.
- Blindness and Eye Problems: In 2005–2008, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) people had diabetic retinopathy, damage to the small blood vessels in the retina that may result in loss of vision.
- Kidney Disease: Diabetes was listed as the primary cause of kidney failure in 44% of all new cases in 2011.
- In 2011, 49,677 people of all ages began treatment for kidney failure due to diabetes.
- In 2011, a total of 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant.
- Amputations: In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes.
- About 60% of non-traumatic lower-limb amputations among people aged 20 years or older occur in people with diagnosed diabetes.
Cost of Diabetes
- $245 billion: Total costs of diagnosed diabetes in the United States in 2012
- $176 billion for direct medical costs
- $69 billion in reduced productivity
After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.
