Physician Focus: Diabetes -- Persistent Epidemic


Program Highlights: 

  • The incidence of diabetes has tripled in the U.S. since 1980 and now affects nearly 20 million adults 18 and older.
  • The disease is the 7th leading cause of death in the U.S. and contributes to other serious conditions such as heart disease, blindness, kidney disease, and amputations.
  • Another 86 million Americans are living with pre-diabetes, and 90 percent of those are unaware of their condition.
  • The incidence of diabetes is directly and proportionately linked to the increase in the rates of obesity.

Most dictionaries define ‘epidemic’ as a large number of cases of a specific disease occurring at the same time. Diabetes certainly fits the definition. It has for decades, and it appears it will continue to do so for years to come.

According to the Centers for Disease Control, the number of Americans with diagnosed diabetes has more than tripled from 1980 through 2011, soaring from 5.6 million to 20.9 million. Nearly 10 percent of Americans now have this chronic condition, and for seniors, the figure is much higher: 25 percent of those 65 and older are afflicted. And the condition is not confined to the U.S. The World Health Organization cites similar statistics for the global population.

Given those numbers, “It is clear diabetes can’t be considered anything other than an epidemic,” says Michael Thompson, M.D. of UMass Memorial Health Care.

Dr. Thompson, Ambulatory Physician Leader for the Diabetes Center of Excellence at UMass Memorial Health Care and Chief of Adult Diabetes Clinical Research at UMass Memorial Medical Center, appears on the May edition of Physician Focus with the Massachusetts Medical Society to discuss the current state of diabetes, how and why it’s become so prevalent, available treatments, and what can be done to reduce its incidence. Hosting this edition is primary care physician Bruce Karlin, M.D.

Diabetes is a condition in which the levels of glucose (the sugar formed from the food we eat) in the blood are above normal. Insulin, a hormone produced by the pancreas, helps to move glucose into cells in the body, but with diabetes, the body doesn’t make enough insulin or can’t use its own well enough, causing sugar to build up in the blood.

If not managed properly, the complications of diabetes can be severe: damage to the blood vessels and nerves, blindness, kidney damage, amputations, and cardiovascular disease – the last being the biggest co-related condition of the disease.

So how did diabetes become so widespread? “It’s directly and proportionately linked to the increase in obesity,” says Dr. Thompson, and that, he says, is related to the kinds of foods we eat and the density of calories in our food.

Eating high-calorie foods, being overweight, and a leading a sedentary lifestyle are all risk factors for diabetes. Having an immediate family member - parent or sibling - with diabetes also raises the risk.
Dr. Thompson also sounds an alarm about pre-diabetes. This condition – a level of blood sugar higher than normal but below the level for a diagnosis of diabetes – affects 86 million more Americans, and 90 percent of those patients aren’t aware they have this condition. Without lifestyle changes, many of these patients will develop Type 2 diabetes within five years.

“Everyone should look at their risk factors,” says Dr. Thompson. “There’s a tremendous need for education, and it’s clearly worth the effort to have people thinking about pre-diabetes and stopping it there.”
For those diagnosed with diabetes, Dr. Thompson says, “It’s important to be positive, to have a good outlook toward taking care of yourself. The key elements are to take action, to be objective about your situation, and to accept if you need therapy. We’re really asking people to eat right and to live a healthy life."

Watch the above video for additional discussion, including conversation about the differences between Type 1 and Type 2 diabetes; the symptoms of the disease, how it is diagnosed, the importance of the hemoglobin A1C test, weight-loss surgery as a cure for diabetes, and specific treatments for the condition.

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