Date: February 1st, 2007
If you don’t know someone with diabetes, chances are that you will sometime soon. Even as the prevalence of other chronic diseases slows, this serious condition is exploding as the population grows older, heavier and more sedentary.
“This is one of the few chronic diseases that’s growing at an alarming pace,” said Dr. John Anderson at a recent briefing in Washington, D.C. Anderson is assistant clinical professor of medicine at Vanderbilt University and incoming chair of theAmerican Diabetes Association’s (ADA advocacy committee. Diabetes today affects nearly 21 million Americans and is projected to impact 35 million people by 2015 and 47 million people by 2025, according to the federal Centers for Disease Control and Prevention. About half of people with diabetes are 55 or older.
The Alliance for Aging Research, the ADA and the Biotechnology Industry Organization sponsored the briefing in October for Capitol Hill staff and health advocates to highlight the many challenges of diabetes – and to stress the need for life-saving early detection and prevention.
“We can’t afford all the disease we are creating,” said Dr. William Rowley, a former surgeon now with the Institute for Alternative Futures in Alexandria, Va., which analyzes and forecasts health care trends. “We could prevent 50 percent of diabetes…if we intervene effectively and early.” People with diabetes have more than twice the medical costs of those without the disease.
People with diabetes do not produce or properly use insulin, a hormone made in the pancreas that converts sugar, starches and other food into energy. As a result, their blood sugar levels are too high and must be controlled by medications and/or insulin.
Most common is type 2 diabetes, in which the body gradually loses its ability to produce insulin. About 5 percent to 10 percent of diabetes cases occur in children as type 1 diabetes, in which the body makes no insulin at all. Some pregnant women also develop the disease.
Despite advances in treatment – new oral drugs, new types of insulin, insulin pumps and continuous glucose monitoring, for example – the cause of and cure for diabetes have eluded researchers. Anderson and Alliance Executive Director Daniel Perry called for increased federal funding to help researchers better understand diabetes and discover innovative therapies.
Research has led to better diabetes treatment and devices in the past few years:
- Inhaled insulin as an alternative to multiple daily injections
- Mew drugs such as exenatide (trade name Byetta) and sitagliptin (Januvia), with several more in the pipeline
- Continuous glucose monitoring, in which a tiny sensor inserted under the skin records glucose levels every few minutes and sends them to a monitor worn on the patient’s clothing. The system makes it easier for doctors to identify trends in glucose levels and adjust treatment accordingly.
But medical research is only part of the solution, Rowley noted. Society must do more to help people lose weight, eat healthy food and get more exercise. For diabetics, these lifestyle changes can help control their blood sugar levels and prevent complications such as heart disease, blindness and lower-limb amputations. For the 54 million Americans at risk for diabetes, they can help prevent the disease.
At some point, though, it falls to individuals to do the right thing. To properly manage this “work-intensive illness,” as Anderson called it, patients must check their blood sugar level a dozen or more times a day, watch what they eat and when, take their medications and get regular foot and eye exams.
Dana Lewis, 19, knows – and carries — the burden well. Diagnosed with type 1 diabetes five years ago, the University of Alabama sophomore described how she has learned to live with the condition and benefited from medical advances. She now takes insulin with a painless pump rather than the injections she endured in high school. She uses a continuous glucose monitor.
“I’m very fortunate to be able to afford that,” Lewis said of the expensive monitor. “We need the funding, research and tools” to make diabetes care easier for more people, she added.