Diabetes, February 2007

Diabetes a Growing Health Problem, Report Shows

Persons with diabetes are three times more likely than others to say their health is flagging, according to a report from the Centers for Disease Control and Prevention (CDC).

Half of the estimated 21 million adult Americans with diabetes now rate themselves as having only fair or poor health.

The news is troubling because fair or poor health among persons with diabetes is also associated with the presence of diabetes-related complications.

Complications may include lower extremity amputation, blindness, kidney failure, and cardiovascular disease," say editors of the CDC journal Morbidity and Mortality Weekly Report (MMWR).

In the study, CDC researchers looked over 2005 data from the federal Behavioral Risk Factor Surveillance System, an ongoing survey of adult Americans' health and health risk factors.

Reports Show Worsening Health

Among the poll's questions: "Would you say that, in general, your health is excellent, very good, good, fair, or poor?"

According to the survey, nearly 50 percent of those with diabetes said they were only in fair or poor health - a number three times higher than that of people without diabetes.

The rate of fair/poor health among people ages 45 and older with diabetes has remained stable over the past 10 years, hovering around 50 percent. But the CDC notes that health complaints are rising among younger Americans.

Among people with diabetes ages 18 to 44, reports of fair/poor health rose from about 36 percent in 1996 to 43 percent by 2005, the researchers found.

Race and availability of insurance were also key to health. Hispanic Americans, especially, are 60 percent more likely than Caucasians to note poor health linked to diabetes.

A lack of health insurance boosted the likelihood of poorer health by 70 percent, the study found.

Diabetes care is becoming an increasing burden on the US health care system, according to two other government reports.

Between 1996 and 2003, the number of adult diabetes patients soared from 9.9 million to 13.7 million, and their individual annual spending on prescription medications jumped almost 86 percent, from $476 to $883.

According to the reports from the Agency for Healthcare Research and Quality, overall care for patients with diabetes - including treatment in and out of hospital and for other illnesses such as congestive heart failure - averaged more than $10,000 annually.

The new diabetes statistics come on the heels of good and bad news from the federal government's annual report, Health, United States for 2006.

That report found that diabetes continues to be a growing threat, especially among older adults. Eleven percent of adults ages 40 to 59, and 23 percent of those 60 and older, have diabetes.

The report also focuses on the problem of chronic pain.

According to the report, 25 percent of adults say they have experienced pain that lasts at least one day, and 10 percent say they have lived with pain that persists a year or more.

"We are living longer, and we have more chronic conditions," says lead author Amy Bernstein, Sc.D., chief of the analytic studies branch at the CDC’s National Center for Health Statistics.

"Diabetes rates are increasing, obesity rates are increasing. And, as people live longer, they get more chronic conditions, including pain," says Dr. Bernstein.

According to the report, 21 percent of adults aged 65 and older said they had experienced pain in the past month that lasted for more than 24 hours. And almost three-fifths of adults 65 and older said their pain had lasted a year or more.

Between the periods 1988-1994 and 1999-2002, the percentage of adults who took a narcotic medication to alleviate pain in the past month rose from more than 3 percent to more than 4 percent.

Good News Reported for Other Diseases

The news from the report was not all bad, however.

Despite the rise in obesity and diabetes, life expectancy for Americans reached nearly 78 years in 2004, which is a record high.

In addition, since 1990, the gap in life expectancy between men and women has narrowed from seven to just over five years.

Among women, life expectancy is just over 80 years, and it is almost 75 for men.

Also, the gap in life expectancy between Caucasians and African Americans has narrowed from seven years in 1990 to five years in 2004.

Heart disease remains the nation's leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, according to the report.

And deaths from cancer - the number two killer - fell 8 percent.

Always consult your physician for more information.

Online Resources

(These links are provided for the education and convenience of our Neighbors. AAMC is not responsible for the content of Internet sites.)

American Association of Clinical Endocrinologists

American Diabetes Association

American Dietetic Association

Centers for Disease Control and Prevention (CDC)

Everyday Choices, ADA, AHA, and ACS

National Diabetes Education Program

National Diabetes Information Clearinghouse

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

National Institutes of Health (NIH)

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Feel Good - Aim for a Healthy Weight

Many of the strategies that produce successful weight loss and maintenance help prevent obesity and help you feel better.

Improving eating habits and increasing physical activity play a vital role in preventing obesity.

Recommendations for adults include many ways to start feeling better.

Eat five to nine servings of fruits and vegetables daily.

A vegetable serving is one cup of raw vegetables or one-half cup of cooked vegetables or vegetable juice.

A fruit serving is one piece of small to medium fresh fruit, one-half cup of canned or fresh fruit or fruit juice, or one-fourth cup of dried fruit.

Choose whole grain foods such as brown rice and whole wheat bread.

Avoid highly processed foods made with refined white sugar, flour, and saturated fat.

Weigh and measure food in order to be able to gain an understanding of portion sizes. For example, a 3-ounce serving of meat is the size of a deck of cards. Avoid supersized menu items.

Balance the food “checkbook.” Taking in more calories than are expended for energy will result in weight gain. Regularly monitor weight.

Avoid foods that are high in “energy density,” or that have a lot of calories in a small amount of food.

For example, a large cheeseburger with a large order of fries may have almost 1,000 calories and 30 or more grams of fat.

By ordering a grilled chicken sandwich or a plain hamburger and a small salad with low-fat dressing, you can avoid hundreds of calories and eliminate much of the fat intake.

For dessert, have fruit or a piece of angel food cake rather than the “death by chocolate” special or three pieces of home-made pie.

Remember that much may be achieved with proper choices in serving sizes.

Accumulate at least 30 minutes or more of moderate-intensity activity on most, or preferably all, days of the week.

Examples of moderate intensity exercise are walking a 15-minute mile, or weeding and hoeing a garden.

Look for opportunities during the day to perform even ten or 15 minutes of some type of activity, such as walking around the block or up and down a few flights of stairs.

Always consult your physician for more information.