Minorities face even greater risk, new study finds
Author: Anita Manning, USA TODAY
Reprinted from USA Today, June 16, 2003
NEW ORLEANS – A third of the people born in the USA in 2000, and more than half of Hispanic women, will develop diabetes, says the first study to estimate lifetime risk of the disease.
The chances are highest among women and minorities, said Venkat Narayan, chief of the diabetes epidemiology section at the Centers for Disease Control and Prevention, who presented the study here Saturday at a meeting of the American Diabetes Association. Women live longer than men, he said, so they have more time to develop illness. Minorities have a combination of genetic predisposition and higher obesity rates that puts them at risk.
The estimates show that Americans are at least as likely to get diabetes as they are to develop breast cancer, for which women have a one-in-eight lifetime risk, or heart disease; for which people at age 40 have a 30% risk, Narayan said.
An estimated 17 million Americans have diabetes. It is a leading cause of heart and kidney diseases, limb amputation and blindness.
The report, based on U.S. health data, highlights the “urgent need” to make diabetes prevention a priority, said Judith Fradkin of the National Institute of Diabetes and Digestive and Kidney Diseases.
“We know we can prevent it,” she said, citing studies that show modest weight loss and exercise can ward off the disease. “But it’s a tough prescription for physicians to write.”
Narayan’s study did not differentiate between type 2 diabetes, which accounts for more than 90% of cases, and the rarer type 1, an autoimmune disease that affects about 1 million Americans. In type 1, the body destroys insulin-producing cells in the pancreas. Type 2 results from the body’s inability to use insulin efficiently. All diabetics have a higher-than-normal amount of sugar, or glucose, in their blood and may take insulin or other medications to reduce it.
But studies presented Sunday suggest that although a prevention for type 1 diabetes remains elusive, a strategy for holding off dangerous complications is emerging:
- Announcing the “disappointing” results of a Diabetes Prevention Trial, Jay Skyler of the University of Miami reported that insulin capsules given to people at moderate risk of type 1 diabetes don’t prevent or postpone the disease. The oral insulin trial, which ended last month, is the second part of a larger study designed to test a theory that insulin could prime the immune system and prevent destruction of insulin-producing cells. The first part of the study, which ended two years ago, found no protective effect from insulin injections given to people at high risk of type 1. Skyler said more studies are planned this fall to try to save insulin-producing cells in newly-diagnosed patients.
- More hopeful results from a second study show that type 1 diabetics who intensively control their blood sugar levels for the first few years of their illness reap benefits that carry over the long term. Researchers following participants in the Diabetes Control and Complications Trials, which ended in 1993, found those who had kept their blood sugar levels close to normal for an average of 6.5 years are less likely to have clogging of arteries or other complications of diabetes, even after eight years of higher blood sugar.
The reasons are not clear, but the lesson, said researcher John Lachin of George Washington University, is that intensive management of diabetes early on can bring positive changes that “actually increase over time.”