Rise in Diabetes is Alarming: Cause, Complications and Control

Despite advances in medicine and preventative measures, the outlook for the rise of diabetes is not optimistic.  The most recent figures from the Centers for Disease Control gathered in 2021 indicate: [1]

• 4 million people of all ages—or 11.6% of the U.S. population—have diabetes
• 6 million people aged 18 years or older have prediabetes (38.0% of the U.S. population)
• The percentage of adults with diabetes increased with age, reaching 29.2% among those aged 65 years or older

While the figures for the U.S. are alarming, the estimates for the worldwide population are even more concerning. In a 2021 study[2] published in The Lancet, a weekly peer-reviewed general medical journal, researchers estimated the number of people with diabetes, both Type 1 and Type 2 (the most common), at 529 million or 6% of the world’s population. They project by 2050 that 1.3 billion people worldwide will be living with the disease.

According to the researchers, total diabetes prevalence, especially among older adults, primarily reflects Type 2 diabetes, which is largely preventable and, in some cases, potentially reversible if identified and managed early.

Factors contributing to diabetes

Just looking at the U.S., there are several factors attributed to the increase in diabetes: awareness and testing, aging, and obesity: [3]

Awareness and testing:  As more people become aware of the effects of diabetes, the level of testing for the disease has increased. Also, doctors have started screening patients for diabetes, giving rise to a new term “prediabetes.”

Aging population: The risk of diabetes increases with aging. People are living long due to advances in healthcare. A significant percentage of the aging population is being diagnosed with diabetes.

Obesity: Diabetes has increased with an increase in obesity. Obesity can be traced to lack of physical exercise and increased use of both carbonated drinks and foods high in sugar, which can induce chronic inflammation, a factor that can lead to diabetes.  (In 2022, the U.S. and territories had an obesity prevalence higher than 20%, which equates to more than 1 in 5 adults.)[4] 

Diabetes can lead to serious complications

High blood sugar can lead to prediabetes and Type 2 diabetes and set the stage for other serious conditions, including:

• Heart disease: People with Type 2 diabetes are two times more likely to develop and die from cardiovascular disease, including heart attacks, strokes, and heart failure, says the American Heart Association.[5] This is because high blood sugar damages heart blood vessels and nerves. The potential for heart-related complications increases when along with nerve damage, someone has high blood pressure, abnormal cholesterol, and high triglycerides.

• Chronic kidney disease: In the United States about 1 in 3 people with diabetes have diabetic nephropathy, which is chronic kidney disease (CKD). It occurs because diabetes damages blood vessels and other cells in the kidneys that filter waste from blood. This can lead to kidney damage and high blood pressure. The latter can cause further kidney damage because it increases pressure in the kidneys’ delicate filtering system.[6]

• Diabetic retinopathy (vision loss): The condition occurs when high blood sugar damages small blood vessels at the back of the eyes, leading to vision loss.[7]

• Peripheral neuropathy: Diabetic neuropathy or nerve damage is a very common complication that may affect as many as half the people with diabetes.[8] Over time, high blood glucose levels or blood sugar, and high levels of fats in the blood from diabetes can damage nerves. When this happens, the nervous system’s signaling can no longer function correctly.

Neuropathy caused by diabetes cannot be reversed, since the body cannot naturally repair damaged nerve tissues. [9] Keeping blood sugars within the target range is critical. In addition to eating healthy to keep blood sugars in the target range, diabetics should check their feet daily for:

• Dry and cracked skin
• Blisters or sores
• Bruises or cuts
• Redness, warmth, or tenderness (often absent because of nerve damage)
• Firm or hard spots

Avoid dry feet (if you want to add this part)

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Prevent Type 2 Diabetes

The World Health Organization (WHO) recommends that lifestyle changes are the best way to delay the onset of Type 2 diabetes and its complications. Changes include:[10]

• Reach and keep a health body weight
• Stay physically active with at least 30 minutes of moderate exercise each day
• Eat a healthy diet and avoid sugar and saturated fat
• Do not smoke tobacco.

If you have been diagnosed with prediabetes, start making the changes that will help you delay or prevent it.

[1] “National Diabetes Statistics Report, CDC, Accessed June 22, 2024. https://www.cdc.gov/diabetes/php/data-research/index.html

[2] Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021, Ong, Kanyin Liane et al, The Lancet, Volume 402, Issue 10397, 203 – 234. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext

[3] Shaikh, Dr. Jasmine, MD, “Why is Diabetes Increasing in the United States,” Accessed June 22, 2024. https://www.medicinenet.com/why_is_diabetes_increasing_in_the_united_stat/article.htm

[4] “Adult Obesity Prevalence Map,” CDC, Accessed June 22, 2024. https://www.cdc.gov/obesity/php/data-research/adult-obesity-prevalence-maps.html

[5]“Cardiovascular Disease and Diabetes,” American Heart Association, Accessed June 22,2024. https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks/cardiovascular-disease--diabetes

[6] “Diabetic nephropathy (kidney disease),” Mayo Clinic, Accessed June 22, 2024. https://www.mayoclinic.org/diseases-conditions/diabetic-nephropathy/symptoms-causes/syc-20354556

[7] “Vision Loss,” CDC, Accessed June 22, 2024. https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html

[8] “Diabetic Neuropathy,” Mayo Clinic, Accessed June 22, 2024. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580

[9] Neel, Duggal, “Diabetic Neuropathy: Can It Be Reversed,” healthline, February 5, 2020. https://www.healthline.com/health/diabetes/can-diabetic-neuropathy-be-reversed

[10] “Diabetes,” World Health Organization, Factsheet, Accessed June 22, 2024. https://www.who.int/news-room/fact-sheets/detail/diabetes