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Diabetes on the Rise, Especially Among Minorities

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CHICAGO - The average American born today has a 1 in 3 chance of developing diabetes, but for Hispanics and African-Americans the risk is a staggering 1 in 2, according to the first study assessing the lifetime risk for the increasingly common disease.

The study, reported by the Centers for Disease Control and Prevention in the current issue of the Journal of the American Medical Association, also found that diabetics face a life marked by crippling disease and early death.

The statistics indicate the nation is experiencing a deterioration of healthy lifestyles of unprecedented proportions that will make future generations sicker, according to the American Diabetes Association. Medical costs of the diabetes epidemic will be huge, the association says.

Especially troubling is the fact that although this epidemic is reversible, there are few signs that the twin trends of obesity and inactivity are slowing down, experts say.

The study showed that the average American female born in 2000 has a 38.5 percent risk of developing diabetes, which will cut her life short by 14.3 years if she is diagnosed with the disease by age 40, the authors said, and will reduce her quality of life for 18.6 years.

For males born in 2000, the risk of developing diabetes is 32.8 percent. The disease will shorten their lives by an average of 11.6 years if diagnosed by 40 and reduce the quality of their lives by 22 years.

Minority groups fare the worst, the study found. Female Hispanics run a 52.5 percent risk of diabetes from birth, while the risk for black women is 49 percent. The risk for male Hispanics is 51.9 percent and for black males 41.4 percent. The rate for white females was 31.2 percent; for men, 26.7 percent.

In addition to a greatly increased risk of dying, diabetics develop serious health problems at much younger ages - including heart disease, kidney disease, blindness and amputation - that diminish a person's quality of life.

Diabetes is a disease of modern lifestyle, said Dr. K.M. Venkat Narayan, chief of the CDC's diabetes epidemiology section. "Essentially the problem now is the excess supply of food plus inactivity," he said.

Diabetes has reached epidemic proportions because it is directly related to America's obesity epidemic, Narayan said. The human body was not built to be consistently overweight, he said. For many people that creates an inability to properly process sugar, which can then accumulate in the body and cause damage.

"Diabetes is a fairly alarming situation in terms of years of life lost, years of suffering and the economic and social costs," Narayan said. Diabetes currently costs the nation $132 billion annually in medical care and lost productivity, he said.

Public health officials are particularly alarmed at the big increase in diabetes rates among children, a dangerous trend linked to the skyrocketing obesity rates in youngsters.

Recent studies show that 8 to 45 percent of the new cases of diabetes in children are Type 2. The rate varies depending on ethnic group, with Hispanics and blacks having the highest numbers.

Two decades ago children were diagnosed almost solely with Type 1 diabetes (commonly called juvenile diabetes), which is caused by the death of insulin-producing cells in the pancreas. Type 2 diabetes (commonly called adult-onset diabetes), which results from faulty metabolism usually associated with obesity, previously occurred almost exclusively in adults.

"There's a major change in the appearance of Type 2 diabetes in children as obesity has begun to become a bigger and bigger problem in young people," said Dr. Boyd Metzger, professor of medicine and endocrinology at Northwestern University.

For Dorothy Woodbury, 50, the risks are all too real. Somewhat overweight because of an activity-limiting back injury, she has borderline diabetes. Her daughter Jillian, 16, is obese and was diagnosed with Type 2 diabetes at age 12. Woodbury's grandmother died of diabetic complications, and a sister and aunt have the disease.

Woodbury has become an activist in her community to raise community awareness about the risks of obesity and diabetes. Her daughter is enrolled in La Rabida Children's Hospital's FitMatters program, where children are taught how to eat 1,000 to 1,200 calories and no more than 20 grams of fat a day, and to walk 10,000 steps. Since June, Jillian has lost 37 pounds and Woodbury 11.

"At first she missed eating what she wanted," Woodbury said. "She wanted chips and french fries. Now we read all the labels. She puts back things she used to love if they have too much fat. We've learned to buy fat free; we substitute one food for another, and we don't cook anything fried."

"We've changed the eating habits of our household," Woodbury said. "It's a message that people in the black community need to know, especially young people and their parents."

Diabetes, a major risk factor for heart disease and other life-limiting problems, increased 40 percent between 1990 and 1999 to 1 of every 15 Americans. It is projected to increase 165 percent between 2000 and 2050 at the current rate of diagnosis.

The CDC study involved 360,000 Americans who participated in the National Health Interview survey between 1984 and 2000.

The huge increase in diabetes has caused doctors to develop a highly medicalized approach to a disease that is largely preventable, said Dr. Louis Philipson of the University of Chicago.

"Fifty years from now, people will look back on today and think that we're absolutely nuts," he said. "All of these drugs, costing thousands of dollars a year, are replacing a healthy lifestyle."


(c) 2003, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.

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