Introduction To Diabetes

Diabetes, sometimes referred to as diabetes mellitus, is one of the most common medical conditions around the world, and this is true for both modern times as well as historically. Diabetes, or the symptoms of frequent urination and thirst, was recognized as early as 1550 BC in ancient Egypt. Other early physicians, specifically in India, recognized that patients that were most prone to the symptoms were those that were overweight or obese, and they recommended increased activity and weight loss. Early diagnosis in this same culture was done by noting if ants were attracted to the urine, which we now know is due to high levels of glucose (blood sugar) in the urine eliminated from the body.

The early Greek physician Aretaeus of Cappadocia was the first individual to list the symptoms and connect the dots to create a clinical description of the condition. It included the high volume of sweet urine that was produced. He coined the term diabetes, meaning siphon, as he perceived that the body fluids were literally draining away. In these early times diabetes was virtually always fatal since there was no understanding of the role of insulin and knowledge of the role of diet, exercise and lifestyle changes was limited. The term mellitus, referring to honey or sweetness, was added much later.

Today diabetes is still an incurable disease, but it is manageable through a variety of different medical, lifestyle and diet choices.  In some cases early determination of a condition known as prediabetes can be completely controlled which can prevent the development of type 2 diabetes at a later point in time. Modern medical advances, starting with the discovery of insulin in 1921 by Canadians Banting and Best, have given those individuals diagnosed with diabetes a whole new lease on life. The various options to treat diabetes continue to expand with implantation of replacement cells in the pancreas to the development of insulin pumps that can sense and respond to blood sugar levels in the body.

The Growing Problem Of Diabetes

Although there has been a detailed understanding of the symptoms of diabetes since the first days of civilization and medicine, there continues to be an increase in the number of individuals diagnosed worldwide. According to the World Health Organization (WHO) there are over 346 million people around the world that have been diagnosed and, in the year 2004 alone, 3.4 million died because of diabetes or complications related to high blood sugar.1  Increasing the concern over this condition is the estimate by the World Health Organization that the number of cases of diagnosed and undiagnosed diabetes will double by the year 2030.

Type 2 diabetes is a major factor in this growing trend. It is estimated that 80-90% of all diabetes cases worldwide are type 2 diabetes which is also known as insulin resistant diabetes. In this type of diabetes the pancreas produces insulin; however, the cells of the body are just resistant to the hormone. Type 1 diabetes, also known as juvenile or insulin dependent diabetes is less common and only occurs when the pancreas is not capable of producing insulin due to disease or destruction of the islet cells of the pancreas.

In addition to an overall increase in diabetes globally, there are other issues that are causing concern. Minority groups tend to have a higher prevalence of type 2 diabetes and also tend to have a higher mortality rate from the condition. Precursor signs of diabetes, including impaired fasting glucose, were seen higher in males than females across all populations. 2

Why Diabetes Numbers Are On The Rise

The number of people diagnosed with diabetes continues to rise each year, yet more and more is known about the risk factors for developing the disease and the options that people can use to combat the precursor condition of prediabetes. One of the major factors that is noted as an impediment to reducing the rates of diabetes is the lifestyle that people now live. Low labor intensive lifestyles without structured, routine and lifelong physical exercise programs have certainly contributed to the problem. Sedentary lifestyles that include jobs and recreational time that require little if any activity are also seen as a major factor in developed and developing countries.

Other factors that are considered to add to the risk of developing diabetes in today’s society include food choices and the increased number of individuals in a population that are overweight or obese. In fact diabetes and obesity are sometimes considered to be interlocked epidemics. According to a study in the United States involving adults over the age of 18 it was found that the prevalence of obesity, defined as a BMI (Body Mass Index) of greater than or equal to 30 was 20.9%, up a total of 5.6% from the year before. 3 This was linked to an increased risk of the development of diabetes.

The Costs of Diabetes

Besides the health costs of diabetes, the monetary costs for both individuals and society as a whole are staggering.  In a study projecting the costs of caring for obesity and diabetes in the United States and the United Kingdom for 2030 it was predicted that the combined costs of patient care for the population would be 48-66 billion dollars per year in the USA alone. In addition 26-55 million quality-adjusted life years would be lost for those diagnosed with obesity and diabetes and the related conditions of cancer, heart disease and stroke.4

The good news is that these trends can be reversed both on an individual and societal level. By learning about diabetes, choosing healthier, more active lifestyles and choosing nutritional and healthy food choices many people can avoid developing prediabetes or type 2 diabetes at any point in their life. Those that have type 2 diabetes may be able to control their diabetes through diet and exercise without the need for insulin. Learning the simple steps that you can take to make these positive changes takes only a few minutes but, when used routinely, will allow you to live a healthy, happy life.

References

1 Diabetes. (2011, August). Retrieved from World Health Organization: http://www.who.int/mediacentre/factsheets/fs312/en/

2 Cowie, C. C., Rust, K. F., Byrd-Holt, D. D., et al. (2006). Prevalence of Diabetes and Impaired Fasting Glucose in Adults in the U.S. Population. Diabetes Care , 1263-1268.

Mokdad, A. H., Ford, E. S., Bowman, B. A., et al. (2003). Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001. Journal of the American Medical Association , 76-79.

4 Wang, Y. C., McPherson, K., Marsh, T., et al. (2011). Health and economic burden of the projected obesity trends in the USA and the UK. The Lancet , 815-825.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.