Diabetes: The Projection Decades Later
Statistics
Fig 1. Incidence of diabetes in children under age 10 years in Norway, 1925–1995
Almost a hundred years ago, Insulin changed childhood diabetes from a rare fatal disease to a condition in which prolonged survival was possible. The projection of diabetes has increased to 30.3 million in 2017 from 1.58 million in 1958, an exponential rate of 30.8% each year averaged out. We now know of more than 1 person in our lives that suffers from diabetes. Decades of study have well established the knowledge and treatment modalities for successfully managing diabetes however success requires a collaborative team working diligently with the patient and family to achieve optimal health.
Awareness
In America alone, 90.6 million (2015) have prediabetes and only 10% of adults are aware that they have it. This number is expected to increase to 107.7 million by 2030.
Prevention
The goals of diabetes prevention are:
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Preventing or delaying the onset of diabetes
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Preserving beta cell (pancreas) function
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Preventing or delaying microvascular and cardiovascular complications
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Reducing costs of diabetes care
Identifying high risk individuals is the first step towards taking action
Individuals whose BMI > 25kg/m2 (BMI > 23kg/m2 in Asian Americans), > 45 years old, women with a history of gestational diabetes with the following risk factors should be screened:
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Family history of diabetes mellitus in a first-degree relative
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High-risk race/ethnicity (eg, African, Latino, Asian, or Native American descent)
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Sedentary lifestyle
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Hypertension
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Dyslipidemia
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History of cardiovascular disease
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Polycystic ovary syndrome (women)
Diet and lifestyle
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DIET - As the saying goes, you are what you eat. Diet is an unavoidable part of one’s lifestyle. Dietary Approaches to Stop Hypertension (DASH) diet or a Mediterannean Diet are recommended and both are still flexible to alter accordingly to an individual’s preference.
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Exercise - 30 to 60 minutes of moderate-intensity aerobic activity on most days of the week (at least 150 minutes of moderate-intensity aerobic exercise per week) can help with weight loss and reduce the risk of diabetes.
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Smoking cessation
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