Over time, diabetes can lead to blindness, kidney failure, and nerve damage. These types of damage are the result of damage to small vessels, referred to as microvascular disease.
Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. This is referred to as macrovascular disease.
Diabetes affects approximately 17 million people (about 8% of the population) in the United States. In addition, an estimated additional 12 million people in the United States have diabetes and don't even know it.
From an economic perspective, the total annual cost of diabetes in 1997 was estimated to be 98 billion dollars in the United States. The per capita cost resulting from diabetes in 1997 amounted to $10,071.00; while healthcare costs for people without diabetes incurred a per capita cost of $2,699.00.
During this same year, 13.9 million days of hospital stay were attributed to diabetes, while 30.3 million physician office visits were diabetes related. Remember, these numbers reflect only the population in the United States. Globally, the statistics are staggering.
The risk actually varies depending on where you live. This is in part due to the environment you live in, and in part due to the genetic makeup of your family. In the United States, the lifetime risk of developing diabetes is estimated at 33% for males and 39% for females for people born in the year 2000.
It has also been calculated that for those diagnosed before the age of 40, the average life expectancy is reduced by 12 years for men, and 19 years for women.
The risk for developing diabetes increases in certain cases such as the following.
* Genetics - People with a close relative with type 2 diabetes are at higher risk.
* Ethnic background - For example, the actual prevalence of diabetes in the Caucasian population of the US is about 7.2% while in the African American population, it increases to about 11%. In a well known group of Native Americans, the Pima Indians, the prevalence increases to almost 35%.
* Birth weight - There is a relationship between birth weight and developing diabetes, and it's the opposite of what you'd intuitively think. The lower the birth weight the higher the risk of type 2 diabetes.
* Metabolic syndrome - People who have the metabolic syndrome are at especially high risk for developing diabetes.
* Obesity - Obesity is probably the most impressive risk factor. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shape person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shape person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.
While diabetes is characterized by high blood sugar values, type 2 diabetes is also associated with a condition known as insulin resistance. While there is an element of impaired insulin secretion from the beta cells of the pancreas especially when toxic levels of glucose occur (when blood sugars are constantly very high), the major defect is the body's inability to respond properly to insulin.
Eventually, the pancreas is working it's best to produce more and more insulin, but the body tissues (for example, muscle and fat cells) do not respond and become insensitive to the insulin.
At this point, overt diabetes occurs as the body is no longer able to effectively use its insulin to maintain normal blood sugar levels. Over time, these high levels of sugar result in the complications we see all too often in patients with diabetes.