Happy holidays! As the year 2011 yields to 2012, here’s hoping that certain issues in our lives diminish. One of them is the scourge we’ve lived with for a long time: type 2 diabetes. There is so much we can do to prevent and manage this illness, and today I begin a multi-part article on the subject with this introduction.
In 2011, the Institute of Diabetes and Digestive and Kidney Diseases published statistics on diabetes in the U.S. The statistics show the impact of this disease on the general population:
— Diabetes affects 25.8 million people (8.3% of the U.S. population)
— The prevalence of diabetes for the younger age group (20-64 years) is two million and for those over 65 years it is 11 million
— Diabetes is the seventh leading cause of death in the U.S.
— Diabetes is a major cause of heart disease and stroke in this country
— Diabetes in the leading cause of blindness, nontraumatic lower-limb amputations, and kidney failure in the U.S.
— Based on fasting blood glucose (FBG) or hemoglobin A1C (HbA1C), the prevalence of prediabetes in the younger and older age groups is 35% and 50%, respectively
— 79 million American adults over 20 years old have “prediabetes”
— There are racial and ethnic differences in people affected by diabetes: 7.1% of non-Hispanic whites; 8.4% of Asian American; 11.8% of Hispanics/Latinos;, and 12.6% of non-Hispanic blacks
Now, hemoglobin A1C (HbA1C) is a blood test commonly used to help with the diagnosis of diabetes as well as to monitor the effectiveness of diet, exercise, weight reduction, and drug treatments. It is a form of hemoglobin that reflects the average blood glucose concentration in the last 90 days.
The treatment goal is to lower the HbA1C to below seven percent, according to the American Diabetes Association. (But the cutoff point for the diagnosis of diabetes in Asians is lower than non-Asians at 6.3%.) Still, recent large trials show that a target level of seven percent may be too aggressive and would increase the rate of dangerous episodes of high blood sugar. Nonetheless, it is agreed by all diabetes experts that persistently high HbA1C levels definitely increase the risk of diabetic complications: neuropathy; stroke; heart attack; kidney failure; and blindness.
In a UK study, a one-percent decrease in HbA1C over a 10-year period resulted in a risk reduction of 21% for diabetes-related mortality, 14% for heart attack, 19% for cataract extraction, 43% for peripheral vascular disease, and 12% for stroke.
In part two, I’ll look at the drugs used to control type 2 diabetes.
Until then, read the article How to Cut Your Diabetes Risk by 80%.