From Our 2007 Archives

U.S. Predicts Diabetes Epidemic to Go on Unchecked

By Steven Reinberg
HealthDay Reporter

SATURDAY, June 23 (HealthDay News) -- By 2050, an estimated 48 million Americans will have type 2 diabetes as the epidemic continues unabated, according to new federal projections.

But along with the disease will come increases in accompanying health problems, such as blindness and hearing loss, according to several presentations to be made Saturday at the American Diabetes Association annual meeting, in Chicago.

"From 1963 to 2005, we saw periods of sharp increase in the rate of diabetes cases," said Linda S. Geiss, chief of diabetes surveillance at the U.S. Centers for Disease Control and Prevention, and lead author of the first presentation. "Increases in diabetes cases have been going on for 15 years, and it doesn't look like it's slowing down," she added.

Reviewing data from the National Health Interview Survey, Geiss' team found that from 1990 to 2005, cases of diabetes increased from 26.4 per 1,000 people to 54.5 per 1,000 people, a 4.6 percent increase each year.

Geiss believes the diabetes epidemic is largely being driven by obesity, which is also epidemic in the United States. "It's alarming that diabetes has grown for the last 15 years, and it doesn't show any signs of slowing," she said. "That means, for a long time to come, diabetes is going to be a major public health problem."

In another presentation, Dr. Jinan Saaddine, a medical epidemiologist at the CDC, and colleagues calculated the number of people in the United States who will be suffering from diabetic retinopathy by 2050. Diabetic retinopathy is an eye disease that can cause decreased vision and even blindness.

"Right now, there are 5.5 million people with diabetic retinopathy," Saaddine said. "By 2050, that number will increase to 16 million. For the most severe disease, which is the vision-threatening diabetic retinopathy, the number will be increasing from 1.2 million in 2005 to 3.4 million in 2050."

Saaddine warned that the U.S. health-care system will need to take steps to be prepared for this dramatic increase in cases of diabetic retinopathy. "We need to work on better disease management, because diabetic retinopathy happens due to poor disease management," she said.

In a third presentation, Catherine C. Cowie, an epidemiologist with the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, collected data on 5,140 people who had had their hearing tested during 1999-2004 as part of the National Health and Nutrition Examination Survey.

Cowie's team found that among the 399 people with diabetes, 31.6 percent had low-frequency hearing impairment, compared with 14.5 percent of the 4,741 non-diabetics. For higher frequencies, 56.8 percent of diabetics had impaired hearing, compared with 35.8 percent of non-diabetics.

"The high prevalence of this disability among those with diabetes based on national data indicates that screening diabetic patients for hearing impairment is likely to yield a high number of these diagnoses," the study authors wrote. "The potential mechanisms underlying the association of diabetes and hearing impairment need explanation," they concluded.

Two additional presentations Saturday are to deal with undiagnosed diabetes and the perception of diabetes risk among those without the disease.

In one presentation, Xuanping Zhang, a health scientist with the CDC's Division of Diabetes Translation, and colleagues found that an estimated 2.8 percent of people in the United States have diabetes but don't know it.

"There is a relationship between the detection and access to health care," Zhang said. "Not having insurance makes it more difficult for patients to access preventive care."

Using data from the 1999-2004 National Health and Nutrition Examination Survey, Zhang's group found that lack of access to health care due to lack of health insurance, and not seeking health care, were the primary reasons why these diabetes cases were missed.

"The limitation of access to health care really effects the diagnosis of diabetes," Zhang said.

In the final presentation, Jo Azzarello, an associate professor of nursing at the University of Oklahoma College of Nursing, collected data on the awareness of diabetes risk among 442 people who said they didn't have the disease. But, 55 percent of these people were at risk of developing diabetes, and 52 percent were wrong about their perceived risk, the study found.

"Among those who were inaccurate about their risk, 69 percent thought they were at low risk for developing diabetes, when, in fact, they were at risk," she said. "And 31 percent thought they were at risk."

Azzarello said older people tended to be a bit more optimistic about their odds of avoiding diabetes.

"Young people were a little more pessimistic," Azzarello said. "That was worrying. Not only because of needless worry, but if you think that you are going to get diabetes no matter what you do, then people would maybe not be inclined to live a healthy lifestyle. But if you live a healthy lifestyle, you are probably not going to get diabetes."

SOURCES: Jinan Saaddine, M.D., M.P.H., medical epidemiologist, Division of Diabetes Translation; Xuanping Zhang, Ph.D., health scientist, Division of Diabetes Translation; Linda S. Geiss, M.A., Division of Diabetes Translation; all with the U.S. Centers for Disease Control and Prevention, Atlanta; Jo Azzarello, Ph.D., R.N., associate professor of nursing, University of Oklahoma College of Nursing, Oklahoma City; June 23, 2007, presentations, 67th annual sessions, American Diabetes Association, Chicago

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