American diabetes rates skyrocket

The Centers for Disease Control & Prevention reports that 24 million Americans – roughly 8 percent of the population – have diabetes. Another 57 million have increased risk of developing the disease, which can be linked to diet, exercise and the epidemic of obesity in the U.S. today. Dr. Ping Wang, director of UCI’s Center for Diabetes Research & Treatment, discusses this growing health problem.

Q. Has the growth of diabetes reached epidemic proportions?

A. Yes. The number of Americans with diabetes has tripled during the last 20 years. We are now approaching a diabetes pandemic, which means the disease will be occurring everywhere in the world at high frequency. Multiple factors contribute to the diabetes epidemic and impending pandemic. The exact genetic defects are not yet clear, but it appears that some genes promote diabetes, and others suppress. Other factors such as obesity, unhealthy eating, physical inactivity and aging put additional stress on our bodies, expose genetic imperfection, and eventually cause high blood sugar.

Q. What is the most prevalent form of diabetes?

A. Type 2 diabetes represents 90 percent of the cases in the U.S. It may affect anyone in any ethnic group and mainly occurs after adolescence. It is caused by resistance to insulin and insufficient insulin secretion. Type 1 diabetes involves auto-destruction of insulin-producing cells by the immune system and mainly occurs in children. However, recent research shows that there are some overlaps between the two types of diabetes. The symptoms of Type 1 diabetes are explosive, and these patients need insulin injections immediately. Type 2 diabetes develops more slowly and is a silent killer; it is associated with cardiovascular diseases without warning signs.

Q. How has this diabetes boom affected healthcare and society in general?

A. The annual cost of diabetes in the U.S. reached $174 billion last year. It has created a significant burden on the health economy and challenges a healthcare system that is already spread too thin. It is frightening to think we will have to spend even more on diabetes in the near future, on top of high gas prices and a troubled economy.

Q. What can people do to avoid developing diabetes?

A. We cannot choose our parents, so we cannot change our genes – at least not in 2008. But the good news is that if you exercise, eat right and stay fit, you can reduce your diabetes risk by 40 percent.

Q. You’re involved with studies of the genetics of diabetes. Is it possible that  human evolution cannot keep pace with our way of living, and diabetes is a result?

A. We have to make peace with our genes and the rapidly changing world. A major research team here at UC Irvine led by Douglas Wallace is trying to determine whether the genetic changes accompanying human evolution and migration contribute to the development of diabetes, obesity, high cholesterol and high blood pressure. These conditions are interlinked and are collectively called metabolic syndrome, which occurs when the modern society collides with our inner genetic codes. Once we know the genetic defects and how these defects interact with our world of physical inactivity, fast food and constant stress, we will better understand this 21st century diabetes epidemic.

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