New study may signal a ‘slowing of the diabetes epidemic,’but minorities and the young still at higher risk.

Diabetes is a serious health problem in the United States, as more Americans are diagnosed every day. Yet the incidence and prevalence of diabetes may have leveled off in the last few years, according to the results of a new study.

The study found that rates of diabetes started to reach a plateau around the end of the last decade. Looking at 32 years of data, the researchers discovered that diabetes incidence, which is the annual rate of new diagnoses, actually decreased by an average 5.4% every year from 2008-2012.1

While diabetes rates doubled through the 1990's and most of the 2000's, there may now be a "slowing of the diabetes epidemic," wrote the researchers in a recent article in JAMA.

"The last two decades have brought about universal recognition of the dual epidemics of obesity and diabetes in the United States and around the world," J. Michael Gonzalez-Compoy, MD, PhD, DiabeticLifestyle editorial board member.  Although slow to come, "consensus has finally been achieved that overweight and obesity represent a spectrum of a chronic, preventable and treatable disease. Science now also supports the concept that adiposopathy (“sick fat”) is a cause of metabolic diseases that include pre-diabetes and diabetes."

Collaborative implementation of interventions arching across communities, the work place, government, public health agencies, and medical practice, has now started to bear fruit. "The last two years have seen three new medications approved for the long-term treatment of obesity (Qsymia, Belviq, and Contrave), and another medication has received a favorable review by the FDA’s advisory committee last month (high dose liraglutide, Victoza)," noted Dr. Gonzalez-Campoy, Medical Director and Chief Executive Officer, Minnesota Center for Obesity, Metabolism and Endocrinology in Eagan, Minnesota.

At the same time, the fruitful collaboration of physicians and industry has brought better treatments for prediabetes and diabetes. "The progress afforded by such collaboration now allows physicians to treat overweight, obesity, and adiposopathy, which are directly the cause of most cases of type 2 diabetes in all age groups. In addition to public health interventions and the advent of electronic media, which have created awareness in the general population, physicians are now able to implement therapies that lower the blood glucose without causing weight gain," said Dr. Gonzalez-Campoy.

The article below discusses the welcome observation that all of this has finally slowed the dual epidemics of obesity and diabetes.

Study Findings

The study examined more than 660,000 adults who filled out responses to the National Health Interview Survey (NHIS), a questionnaire designed to assess estimates of common health problems in the US. Researchers found noticeable trends when they measured for diabetes' prevalence and incidence in the general population from 1980 to 2012.

Like the incidence of diabetes, its prevalence also slowed. From 1990 to 2008, diabetes increased every year by an average 4.5%, but from 2008 to 2012, it only increased by an average 0.6% every year. Despite the decreasing rates of incidence and prevalence in the general population, the study documented steady increases of diabetes in minorities and young adults, as well as the lower-educated populations.

In particular, non-Hispanic black and Hispanic adults had a much more noticeable increase in the incidence of diabetes, compared to non-Hispanic white adults. There was also a higher rate of increase in the incidence of diabetes in adults that had a high school level of education or less, compared to adults who had further education after high school.

Surprisingly, the prevalence of diabetes also increased at a higher rate for young adults, aged 20 to 44 years, compared to older adults. Another recent JAMA study found increases over the last decade in the incidences of Type 1 and Type 2 diabetes in adolescents (21% and 30%, respectively).2

"Continued increases in this age group among these young adults is concerning," said Dr. Linda S. Geiss, from the Centers for Disease Control and Prevention in Atlanta, Georgia.

Dr. Geiss, who led the recent research into diabetes' long-term trends, said that while further data must be compiled to see how prevalently young people are being diagnosed with diabetes, this chronic condition can be a challenge for those afflicted at a younger age.

"Having developed diabetes early in life," Dr. Geiss said, "these young adults will spend a lifetime controlling their disease and have long exposures to a disease that may put them at risk of developing diabetes complications and comorbidities such as kidney disease, neuropathy, and cardiovascular disease."

Shift Linked to Obesity Rates

While the increasing prevalence of diabetes in young people is a serious problem, the national estimates suggest the diabetes epidemic at large may be slowing. However, the reason behind  this observation is not known.

According to Dr. Geiss and other experts, the answer could lie in diabetes's close connection to obesity, which is the leading cause of the disease, accounting for around 90% to 95% of diabetes cases. Studies have shown, therefore, that weight reduction decreases the risk of developing obesity and diabetes.3-8

Even for those that do have diabetes, though, healthy caloric consumption is important for controlling blood glucose and preventing diabetic complications, said Dr. Ralph Audehm, a general practitioner and clinical director based in Victoria, Australia.

"Very low calorie diets have an initial phenomenal impact," Dr. Audehm said, where patients not only see a great reduction in their weight, but also a decrease in their need for medications and insulin. Dr Audehm added that “the challenge is sustaining a healthy diet over the long term, so diabetics can enjoy better health for years to come.”

The authors reported no conflicts of interest. The Centers for Disease Control and Prevention supported the research, with all data collected by the National Center for Health Statistics.

Courtesy: OntrackDiabetes

Comments

comments