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National Diabetes Fact Sheet
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Contents
General Information
What is diabetes?
Diabetes mellitus is a group of diseases characterized by high levels
of blood glucose resulting from defects in insulin production, insulin
action, or both. Diabetes can be associated with serious complications
and premature death, but people with diabetes can take steps to control
the disease and lower the risk of complications.
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.
This form of diabetes usually strikes children and young adults, although
disease onset can occur at any age. Type 1 diabetes may account for 5%
to 10% of all diagnosed cases of diabetes. Risk factors for type 1 diabetes
may include autoimmune, genetic, and environmental factors.
Type 2 diabetes was previously called non-insulin-dependent diabetes
mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account
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 insulin. 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. Type 2 diabetes is increasingly
being diagnosed in children and adolescents.
Gestational diabetes is a form of glucose intolerance that is
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.
Other specific 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
may account for 1% to 5% of all diagnosed cases of diabetes.
Treating diabetes
- To survive, people with type 1 diabetes must have insulin delivered
by injections or a pump.
- Many people with type 2 diabetes can control their blood glucose by
following a careful diet and exercise program, losing excess weight,
and taking oral medication.
- Many people with diabetes also need to take medications to control
their cholesterol and blood pressure.
- Diabetes self-management education is an integral component of medical
care.
- Among adults with diagnosed diabetes, 12% take both insulin and oral
medications, 19% take insulin only, 53% take oral medications only,
and 15% do not take either insulin or oral medications.
Treatment with insulin and oral medications—United States, 1999-2001 ![Image of a pie graph. Detailed information is available by clicking on the image or by following the link below.](images/factfig5.gif)
Source: 1999–2001 National Health Interview Survey
Detailed
information about this graph is available.
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Prediabetes: Impaired glucose tolerance and impaired fasting glucose
- Prediabetes is a term used to distinguish people who are at increased
risk of developing diabetes. People with prediabetes have impaired fasting
glucose (IFG) or impaired glucose tolerance (IGT). Some people may have
both IFG and IGT.
- IFG is a condition in which the fasting blood sugar level is elevated (100 to 125 milligrams per deciliter or mg/dL) after an overnight fast but is not high enough to be classified as diabetes.
- IGT is a condition in which the blood sugar level is elevated (140
to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not
high enough to be classified as diabetes.
- In a cross-section of U.S. adults aged 40-74 years who were tested from 1988 to 1994, 33.8% had IFG, 15.4% had IGT, and 40.1% had prediabetes (IGT or IFG or both). Were these percentages applied to the 2000 U.S. population, about 35 million adults aged 40-74 would have IFG, 16 million would have IGT, and 41 million would have prediabetes.
- Progression to diabetes among those with prediabetes is not inevitable.
Studies suggest that weight loss and increased physical activity among
people with prediabetes prevent or delay diabetes and may return blood
glucose levels to normal.
- People with prediabetes are already at increased risk for other adverse
health outcomes such as heart disease and stroke.
Prevention or delay of diabetes
Research studies have found that lifestyle changes can prevent or delay
the onset of type 2 diabetes among high-risk adults. These studies included
people with IGT and other high-risk characteristics for developing diabetes.
Lifestyle interventions included diet and moderate-intensity physical
activity (such as walking for 2 1/2 hours each week). In the Diabetes
Prevention Program, a large prevention study of people at high risk for
diabetes, the development of diabetes was reduced 58% over 3 years.
Studies have also shown that medications have been successful in preventing
diabetes in some population groups. In the Diabetes Prevention Program,
people treated with the drug metformin reduced their risk of developing
diabetes by 31% over 3 years. Treatment with metformin was most effective
among younger, heavier people (those 25-40 years of age who were 50 to
80 pounds overweight) and less effective among older people and people
who were not as overweight. Similarly, in the STOP-NIDDM Trial, treatment
of people with IGT with the drug acarbose reduced the risk of developing
diabetes by 25% over 3 years. Other medication studies are ongoing. In
addition to preventing progression from IGT to diabetes, both lifestyle
changes and medication have also been shown to increase the probability
of reverting from IGT to normal glucose tolerance
There are no known methods to prevent type 1 diabetes. Several clinical
trials are currently in progress or being planned.
Prevention of diabetes complications
Diabetes can affect many parts of the body and can lead to serious complications
such as blindness, kidney damage, and lower-limb amputations. Working
together, people with diabetes and their health care providers can reduce
the occurrence of these and other diabetes complications by controlling
the levels of blood glucose, blood pressure, and blood lipids and by receiving
other preventive care practices in a timely manner.
Glucose control
-
Research studies in the United States and abroad
have found that improved glycemic control benefits people with either
type 1 or type 2 diabetes. In general, for every 1% reduction in results
of A1C blood tests (e.g., from 8.0% to 7.0%), the risk of developing
microvascular diabetic complications (eye, kidney, and nerve disease)
is reduced by 40%.
Blood pressure control
- Blood pressure control can reduce cardiovascular disease (heart disease
and stroke) by approximately 33% to 50% and can reduce microvascular
disease (eye, kidney, and nerve disease) by approximately 33%.
- In general, for every 10 millimeters of mercury (mm Hg) reduction
in systolic blood pressure, the risk for any complication related to
diabetes is reduced by 12%.
Control of blood lipids
- Improved control of cholesterol or blood lipids (for example, HDL,
LDL, and triglycerides) can reduce cardiovascular complications by 20%
to 50%.
Preventive care practices for eyes, kidneys, and feet
- Detecting and treating diabetic eye disease with laser therapy can
reduce the development of severe vision loss by an estimated 50% to
60%.
- Comprehensive foot care programs can reduce amputation rates by 45%
to 85%.
- Detecting and treating early diabetic kidney disease by lowering blood
pressure can reduce the decline in kidney function by 30% to 70%. Treatment
with ACE inhibitors and angiotensin receptor blockers (ARBs) are more
effective in reducing the decline in kidney function than other blood
pressure lowering drugs.
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Page last modified: December 20, 2005
Content Source: National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation
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