Diabetes is becoming a more common disease in the U.S. but one that remains little understood by those most at risk.
An estimated 26 million U.S. children and adults have either diabetes 1 or 2 and another 79 million have what is known as “prediabetes,” meaning they are at risk of developing type 2 diabetes.
Type 1 diabetes is a condition in which the body does not produce insulin. It usually develops in children or young adults and is nowhere near as common as type 2, comprising only 10% of all U.S. diabetes cases. Type 1 is primarily genetic, meaning it's not related to lifestyle.
Type 2 diabetes usually develops from lifestyle factors, such as poor diet and excessive weight. It's similar to type 1 in that insulin levels are out of control. The result is excessive levels of blood sugar.
Managing type 2 diabetes
Some people may be able to control type 2 diabetes symptoms by losing weight, eating a healthy diet, exercising, and monitoring their blood glucose levels. But it's usually a progressive disease and the patient will probably have to take insulin to treat it.
Because of America's obesity epidemic, type 2 diabetes is growing at an alarming rate. A late 2012 study by the U.S. Centers for Disease Control and Prevention found 18 U.S. states saw diabetes cases increase more than 100% from 1995 to 2010.
The report, appearing in CDC's Morbidity and Mortality Weekly Report, found that states with the largest increases are Oklahoma (226 percent), Kentucky (158 percent), Georgia (145 percent), Alabama (140 percent), and Washington (135 percent).
"Regionally, we saw the largest increase in diagnosed diabetes prevalence in the South, followed by the West, Midwest, and Northeast," said Linda Geiss, a statistician with CDC's Division of Diabetes Translation and lead author of the report. "These data also reinforce findings from previous studies, which indicate that the prevalence of diagnosed diabetes is highest in the southern and Appalachian states."
Extremely serious
Undiagnosed, diabetes is extremely serious. Those with the disease can lose limbs and their eyesight and they can die from its complications.
How do you know if you have it? Being obese or overweight is a major risk factor. Having a lot of visceral fat, also known as central obesity or belly fat, is a risk multiplier, causing the body to release chemicals that can play havoc with the body's cardiovascular and metabolic systems.
The risk also increases as a person ages, though experts aren't sure why.
According to the National Institutes of Health (NIH), symptoms of diabetes include blurry vision, excessive thirst, fatigue, hunger, frequent urination and unexplained weight loss.
Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms.
Symptoms of type 1 diabetes develop over a shorter period of time. People may be very sick by the time they are diagnosed.
Diagnostic tests
A urine test may reveal elevated blood sugar levels but by itself does not diagnose diabetes. Measuring blood sugar levels after fasting is a much more reliable method.
According to NIH, diabetes is diagnosed if the fasting blood glucose level is higher than 126 mg/dL twice. Levels between 100 and 126 mg/dL are called impaired fasting glucose or pre-diabetes. These levels are risk factors for type 2 diabetes.
Once diagnosed, a patient will need to measure their blood sugar daily using a glucose meter.
“Many patients will need to test 6-8 times per day, but some will need to test more, depending upon their activity level, how often they eat and what other types of activities their day may include,” said Carol Wysham, MD, section head for the Rockwood Center for Diabetes and Endocrinology. “It is not reasonable or practical to set a specific number for all people with diabetes who are on intensive insulin regimens, as no two people’s lives are the same. Even for the same individual, no two days are exactly alike. A person may need to test six times one day and 10 the next.”
Possible new treatment
While diabetes is normally treated with insulin, University of Michigan (U-M) researchers have found that amlexanox, an off-patent drug currently prescribed for the treatment of asthma and other uses, also reverses obesity, diabetes and fatty liver in mice.
“One of the reasons that diets are so ineffective in producing weight loss for some people is that their bodies adjust to the reduced calories by also reducing their metabolism, so that they are ‘defending’ their body weight,” said researcher Alan Saltiel. “Amlexanox seems to tweak the metabolic response to excessive calorie storage in mice.”
Saltiel is teaming up with clinical-trial specialists at U-M to test whether amlexanox will be useful for treating obesity and diabetes in humans.
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