What is diabetes?
Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.
Diabetes is a chronic disease that has no cure. There are an estimated 20.8 million children and adults in the United States, or 7.0% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed, unfortunately, 6.2 million people are not aware that they have the disease. At least 54 million people have pre-diabetes.
If present trends continue, one in three Americans, and 1 in 2 minorities, born in 2000 will develop diabetes in their lifetime. Each day, approximately 4,110 people are diagnosed with diabetes. In 2005 1.5 million new cases of diabetes were diagnosed in people age 20 years or older.
The Dangerous Toll of Diabetes
Diabetes is the fifth-deadliest disease in the United States. Since 1987 the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke, and cancer have declined.
Based on death certificate data, diabetes contributed to 224,092 deaths in 2002. Studies indicate that diabetes is generally under-reported on death certificates, particularly in the cases of older persons with multiples chronic conditions such as heart disease and hypertension. Because of this, the toll of diabetes is believed to be much higher than officially reported.
Many people first become aware that they have diabetes when they develop one of its serious and life-threatening complications such as:
- Heart Disease and Stroke
- High Blood Pressure
- Kidney Disease
- Nervous System Damage
- Dental Disease
- Pregnancy Complications
- Sexual Dysfunction
Types of Diabetes
Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. This form of diabetes usually strikes children and young adults, although disease onset can occur at any age. Type 1 diabetes accounts for 5% to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes. Several clinical trials of methods of the prevention of type 1 diabetes are currently in progress or are being planned.
Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or Other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Clinically-based reports and regional studies suggest that type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently, particularly in American Indians, African Americans, and Hispanic/Latino Americans.
Gestational diabetes is a form of glucose intolerance diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common among obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5% to 10% of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5-10 years. 70% of women who have had gestational diabetes will develop type 2 diabetes at some point during their lifetime.
Other types of diabetes result from specific genetic conditions (such as maturity-onset diabetes of youth), surgery, drugs, malnutrition, infections, and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases. Pre-diabetes is a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke. People with pre-diabetes have blood glucose levels higher than normal but not high enough to be classified as diabetes.
The Risk of Diabetes
Who is at Greater Risk for Type 1 Diabetes?
Who is at Greater Risk for Type 2 Diabetes?
Warning Signs of Diabetes
Type 1 Diabetes
Type 2 Diabetes
Among adults with diagnosed diabetes, 16% take insulin only, 12% take both insulin and oral medication, 57% take oral medication only, and 15% do not take either insulin or oral medications.