Researchers weigh in on soaring diabetes rates

More than 19 million Americans have diabetes, and if rates continue to soar, there could be 30 million suffering from the chronic, sometimes fatal, disease by 2050.

Diabetes is “a side effect of prosperity” that is growing alarmingly around the world, says Christopher Saudek, director of the diabetes center at Johns Hopkins University. “Any nation that increases its body weight is going to increase its diabetes.” In the USA, he says, diabetes rates have risen 6% a year for the past decade.

Saudek, president of the American Diabetes Association, spoke Tuesday at a briefing by the Journal of the American Medical Association on its theme issue on diabetes, published today.

Among reports:

  • Differences in the long-term diabetes complications among ethnic groups may have more to do with genetic susceptibility than access to good medical care, say researchers at Kaiser Permanente in Oakland.

An analysis of data on 62,432 diabetic patients enrolled in the Kaiser Permanente HMO in Northern California found that whites have higher rates of heart attack than blacks, Asians, and Latinos, while minorities experience more kidney failure than whites. Rates of congestive heart failure and stroke were similar for blacks and whites but were lower for Asians and Latinos.

The incidence of limb amputations was similar among blacks, whites, and Latinos, but in Asians, the rate was a startling 60% lower than that of whites.

The disparities suggest the complications have “genetic underpinnings,” Kaiser researcher Joe Selby says.

  • Children with diabetes are more likely to suffer dangerous highs and lows in blood sugar levels if they are underinsured, have had erratic blood sugar level swings in the past three months or have psychiatric problems that could cause them to skip insulin injections.

A study by researchers at the University of Colorado-Denver looked at 1,243 diabetics under age 20 and their incidence of severe high blood sugar, called ketoacidosis, and very low blood sugar levels, or hypoglycemia. Either condition can cause coma and death.

The researchers found that 80% of the episodes occurred in 20% of the children, suggesting that children at greatest risk can be identified and targeted for extra help. Researchers estimate the cost of treating ketoacidosis and hypoglycemia in diabetic children in the USA at more than $100 million per year during the late 1990s.

  • One or two drinks of alcohol a day improve insulin sensitivity in older women, who are at increased risk of diabetes after menopause. In a study of 63 postmenopausal, non-diabetic women, researchers at the Human Nutrition Research Center, part of the U.S. Department of Agriculture in Beltsville, Md., found that those who had one or two drinks before bed — they were given grain alcohol mixed with orange juice — each night for eight weeks had better insulin sensitivity and lower levels of triglycerides, a type of fat, than non-drinkers. Earlier studies have found that moderate drinking reduces heart disease risk, researchers say. The new data show a similar effect on diabetes risk.
  • Women who are born small may be at higher risk of developing gestational diabetes, a transient form of the disease, during their first pregnancy, says a report from the University of Colorado and the University of Virginia. Gestational diabetes often disappears after pregnancy, but it is a risk factor for later development of diabetes in the mother. The finding suggests that susceptibility to diabetes may be “preprogrammed in uteruo,” researchers say.

 

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