The Prevention of Type 2 Diabetes: Are We Ready for the Challenge?

Abstract

The increase in the prevalence of diabetes during the past 20 years is alarming. Recent data presented by the American Diabetes Association (ADA) reported that 17 million Americans, or 6.2% of the population, now have diabetes. Of these 17 million, 5.9 million, or close to 35%, have undiagnosed diabetes. In the approximately 30 minutes that it would take the average reader to read this entire issue of Clinical Diabetes , about 46 patients will be newly diagnosed with diabetes. Recent research efforts, especially for type 1 diabetes, have been to find a “cure.” Although that would be a wonderful discovery, much of our research to date has focused on the treatment of hyperglycemia and the management of diabetes-related complications. From a public health standpoint, it is clear that prevention of diabetes, both type 1 and type 2, would have even more far-reaching implications than either of these other goals. Diabetes is the leading cause of adult blindness (12,000–24,000 new cases each year), end-stage renal disease (more than 114,000 cases of diabetes-related dialysis or transplantation in 1999), and non-traumatic lower extremity amputation (82,000 diabetes-related amputations between 1997 and 1999). Heart disease is the leading cause of death in people with diabetes, who have a two- to fourfold higher risk for developing it than that of the general population. The costs of care for diabetes and its complications are staggering and difficult to quantify. Conservatively, total costs for diabetes exceed $98 billion per …