Diabetes Danger Rising for Some

You’ve likely heard that the U.S. is in the midst of an epidemic. The incidence of diabetes doubled between 1990 and 2008, according to a report by the Centers for Disease Control and Prevention published in the Sept. 24, 2014 edition of The Journal of the American Medical Association (JAMA).

But, that same report points to some promising news, too. Researchers have discovered a leveling off of diabetes diagnoses between 2008 and 2012 for the overall U.S. adult population. Unfortunately, though, three subgroups – non-Hispanic blacks, Hispanics and adults with only a high school education or less – showed a significant increase in the number of diagnosed cases of both type 1 and type 2 diabetes.

This disparity has many trying to explain why these groups continue to be at risk.

“We do know that these ethnic groups have a genetic tendency towards type 2 diabetes,” said Tatiana Ivan, M.D., a Board-certified family medicine doctor with Baptist Health Primary Care’s Family Medicine Center at West Kendall Baptist Hospital. “We also know that studies have shown conclusively that socioeconomic factors play a role in getting the disease.”

In fact, a 2009 report published by the National Institutes of Health warned that focusing on a biological or genetic cause and ignoring socioeconomic factors, such as education, income, health insurance and access to medical care, could affect advances in type 2 diabetes prevention.

“It’s important that we recognize and educate these groups that lifestyle changes, including adding exercise and healthy eating to their normal routines, leads to less disease all around, and type 2 diabetes can be prevented with these efforts,” Dr. Ivan said.

Unlike with the type 2 variety of diabetes, type 1, which was included in the latest CDC report, seems to have more genetic origins for which lifestyle changes do not prevent the onset, according to the National Institutes of Health.

So for patients who are at high risk for type 2 diabetes because they are obese or overweight, lack physical activity or follow an unhealthy diet, Dr. Ivan recommends consulting with a primary care doctor about how to lower their risks.

“A healthy lifestyle looks different for everyone,” she said. “Running five miles a day isn’t possible for every person. But, finding a physical activity that can be done regularly and adding nutritious foods to your diet are steps in the right direction.”

If access to a doctor or dietitian is a barrier because of lower income, Dr. Ivan suggests finding free or low-cost programs in the community to help jumpstart these lifestyle changes.

“There are innovative programs and free classes, such as the ones offered through Baptist Health, that can get people on the right track,” she said.

Dr. Ivan hopes that through awareness and education, the upward trend of type 2 diabetes in these ethnic and socioeconomic groups will level off and eventually decrease. But she warns that with diabetes rates skyrocketing internationally, this newly released research may not tell the entire story.

“There’s usually a lag in the data,” she said about the CDC report. “I’m hopeful that the trend of overall cases leveling off will continue, but until we’re sure we’re making headway into type 2 diabetes prevention, we need to focus on changing lifestyles to enhance the chances of staying healthy for all patients, especially those at highest risk.”