Fact Sheet
FOR IMMEDIATE RELEASE
Jan 13, 2006 |
Contact: HHS Press Office
(202) 690-6343
|
HHS TARGETS EFFORTS ON DIABETES
Overview: Diabetes is a chronic disease that now affects 20.8 million people--about 7 percent of the U.S. population. Its prevalence has increased steadily since 1980. Diabetes is the leading cause of adult blindness, kidney failure, and non-traumatic amputations, and it is a major cause of heart disease and stroke. It is the sixth leading cause of death in the United States. Each year, the disease costs the nation an estimated $132 billion in direct medical costs as well as indirect costs, such as disability and premature death.
In addition, roughly 41 million more Americans ages 40 to 74 have pre-diabetes, a serious condition that increases the risk of developing type 2 diabetes, heart disease, and stroke. Research shows that many Americans can greatly lower their risk of developing type 2 diabetes through modest behavioral changes to improve their health. The HHS-funded Diabetes Prevention Program, a major clinical study involving more than 3,000 people at high risk for type 2 diabetes, found that diet and exercise resulting in a modest weight loss lowered the incidence of diabetes by nearly 60 percent.
Of the 20 million Americans with diabetes, more than one out of every 12 are aged 20 years and older. This includes over 10 million Americans aged 60 years and older, or about one in five senior citizens. Generally, blacks, Hispanics and American Indians and Alaska Natives are more likely to develop diabetes than non-Hispanic whites. In addition, the nation's youth are experiencing a dramatic increase in prevalence of diabetes. For more statistics about diabetes, see www.cdc.gov/diabetes/pubs/.
Efforts to improve diabetes prevention and management are a key part of HHS' broader goal to encourage a healthier America. With partners in the private and public sectors, HHS works to reduce the impact of diabetes across the country--in part by addressing its underlying preventable causes, obesity and lack of physical activity. HHS also conducts research into diabetes prevention and treatment, provides health coverage and services to millions of Americans with diabetes, and conducts targeted education and awareness efforts to help people manage the disease's effects and to prevent others from developing the disease.
BACKGROUND
Diabetes is actually a group of diseases that impair the body's ability to produce or respond to insulin, a hormone that allows the sugar glucose to enter the cells and be used for energy. When diabetes develops, glucose levels rise in the blood, damaging blood vessels and other tissues. Diabetes can lead to serious complications and premature death, but people with diabetes can take steps to control the disease and lower the risk of complications.
There are three major types of diabetes:
Type 1, formerly known as insulin-dependent diabetes mellitus or juvenile-onset diabetes, most often occurs in children and young adults. This form of diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin, which regulates blood glucose. To survive, people with type 1 diabetes must have insulin delivered by injection or a pump. Type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes. Risk factors for type 1 diabetes may be autoimmune, genetic, or environmental. There is no known way to prevent type 1 diabetes. Several clinical trials to prevent type 1 diabetes are currently in progress or are being planned.
Type 2, formerly known as non-insulin-dependent diabetes mellitus or adult-onset diabetes, is the most common form of diabetes, accounting for 90 to 95 percent of diagnosed cases. It often develops later in life and is associated with older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications. Clinically based reports and regional studies suggest that type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently, particularly in American Indians, African Americans, and Hispanic/Latino Americans.
Gestational diabetes is a form of glucose intolerance diagnosed in some women during pregnancy. Gestational diabetes occurs more frequently among African Americans, Hispanic/Latino Americans, and American Indians. It is also more common in obese women and women with a family history of diabetes. During pregnancy, gestational diabetes requires treatment to normalize maternal blood glucose levels to avoid complications in the infant. After pregnancy, 5 to 10 percent of women with gestational diabetes are found to have type 2 diabetes. Women who have had gestational diabetes have a 20 to 50 percent chance of developing diabetes in the next 5 to 10 years.
Treating diabetes
- For type 1 diabetes, healthy eating, physical activity, and insulin injections are the basic therapies. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.
- Many people with type 2 diabetes can control their blood glucose by following a healthy meal plan and exercise program, losing excess weight, and taking oral medication. Some may also need insulin to control their blood glucose levels.
- Many people with diabetes also need to take medications to control their cholesterol and blood pressure.
- Diabetes self-management education is a key part of medical care.
- People with diabetes must take responsibility for their day-to-day care and keep blood glucose levels from going too low or too high.
Pre-diabetes
Pre-diabetes is an increasingly common condition in which blood glucose levels are higher than normal but not high enough to be classified as diabetes. Pre-diabetes causes no symptoms, but it is serious for several reasons. Many people with pre-diabetes will develop type 2 diabetes within the next 10 years. Also, if you have pre-diabetes, you have a 50 percent higher risk of having a heart attack and stroke than people with normal blood glucose levels.
HHS-funded research has clearly shown that people with pre-diabetes can often prevent or delay diabetes by losing 5 to 7 percent of their body weight through cutting fat and calories and increasing physical activity, such as walking 30 minutes a day 5 days a week. The modest weight loss from diet and increased physical activity lowered diabetes onset by nearly 60 percent in study participants, who were at high risk for developing type 2 diabetes. Treatment with metformin, an oral diabetes medication, lowered the risk of developing diabetes by 31 percent in the study.
For more diabetes statistics, see http://www.cdc.gov/diabetes/pubs/factsheet05.htm
RESEARCH
HHS sponsors extensive research in diabetes prevention, treatment and management. In fiscal year 2005, HHS' National Institutes of Health (NIH) will spend about $1.014 billion for diabetes research, including an estimated $508 million through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The NIH is helping researchers take full advantage of compelling scientific opportunities to better understand how diabetes arises and to improve ways to prevent it, treat it, and ultimately to cure it. The NIH's research agenda addresses five areas of special opportunity identified by a congressionally established Diabetes Research Working Group: genetics, autoimmunity and the beta cell, cell signaling and cell regulation, obesity, and clinical research and clinical trials. The NIH is also pursuing the group's recommendations regarding the populations most affected by diabetes and regarding complications.
In addition, Congress has enacted legislation that provides the DHHS Secretary $1.14 billion in special funding for research on the prevention and cure of type 1 diabetes for FY 1998 through FY 2008. The Secretary has designated NIDDK as the lead organization to plan, implement, and evaluate this program. The research being undertaken with this special funding addresses six broad goals:
- to identify the genetic and environmental contributors to type 1 diabetes;
- to prevent or reverse type 1 diabetes;
- to develop cell replacement therapy;
- to prevent or reduce hypoglycemia in type 1 diabetes;
- to prevent or reduce the complications of type 1 diabetes; and
- to attract new talent to research on type 1 diabetes.
More information about diabetes research is available at www.niddk.nih.gov or by calling the National Diabetes Information Clearinghouse at 1-800-860-8747. Information about HHS-funded clinical studies in diabetes can be found at www.clinicaltrials.gov/.
The Centers for Disease Control and Prevention (CDC) also conducts applied research to identify the public health implications of results from clinical trials and other scientific studies and to apply those findings effectively and efficiently to health care practices. See www.cdc.gov/diabetes/projects/research.htm.
PREVENTION AND EDUCATION
HHS and its agencies promote diabetes prevention as the most effective way to minimize the impact of the disease nationally. HHS also conducts outreach and education activities to help consumers manage their diabetes, and to help clinicians diagnose and treat diabetes and pre-diabetes. Major efforts include:
National Diabetes Education Program. Cosponsored by NIH and CDC, the National Diabetes Education Program (NDEP) conducts diabetes awareness and education activities, develops and disseminates educational tools and resources, and promotes initiatives to improve the quality of and access to diabetes care, with an emphasis on reducing disparities in health in racial and ethnic populations disproportionately affected by diabetes. The program has more than 200 private and public-sector partners. See www.ndep.nih.gov. One NDEP effort is called "Small Steps, Big Rewards. Prevent type 2 diabetes." The first national diabetes prevention campaign, it spreads the important message of hope to the millions of American with pre-diabetes. See http://www.ndep.nih.gov/campaigns/SmallSteps/SmallSteps_index.htm.
Women and diabetes. In May 2002, HHS' Food and Drug Administration (FDA) launched a new campaign to raise awareness among women about preventing and managing diabetes. As the family's primary caregivers, women can make a positive difference to the whole family's health, including their own. See www.fda.gov/womens/taketimetocare/diabetes/. CDC also cosponsors the National Public Health Initiative on Diabetes and Women, which is pursuing steps to improve women's health. See www.cdc.gov/diabetes/projects/women.htm.
Older Adults and diabetes. The NDEP and HHS' Centers for Medicare & Medicaid Services (CMS) and Administration on Aging (AoA) work together on a campaign to remind older adults with diabetes about the importance of keeping their blood sugar levels under control by routine blood sugar monitoring and following the ABCs of diabetes care to manage their disease. The campaign also promotes the newest Medicare benefits available to help them do so. See http://www.ndep.nih.gov/campaigns/Power/Power_index.htm .
Healthy People 2010. HHS' Healthy People 2010, the nation's broad-based national health agenda, targets obesity, lack of physical activity and other health issues related to diabetes. See www.health.gov/healthypeople/.
Targeting diabetes disparities. Diabetes is one of the major focus areas for HHS' Closing the Health Gap campaign, which aims to bring the best health information to African-American communities and help consumers take charge of their health. For more information on diabetes and minorities, see www.omhrc.gov.
American Indian and Alaska Native programs. Through the Indian Health Service's (IHS) National Diabetes Program, HHS promotes collaborative strategies to prevent diabetes and its complications among native populations. These efforts include grants to over 300 Tribes and Indian organizations to increased availability of services including basic clinical exams, newer treatment medications, laboratory tests for improved diabetes control, screening for diabetes and pre-diabetes, nutrition education and physical fitness. See www.ihs.gov/MedicalPrograms/Diabetes/.
Diabetes Care
HHS and its agencies also help to ensure people who are diagnosed with diabetes get appropriate, quality care. Examples include:
Medicare. Medicare covers a wide range of treatment and services for the estimated 4.5 million beneficiaries who have been diagnosed with diabetes. Diabetes-related benefits that Medicare may cover include diabetes self-management training; glucose monitors, test strips and other self-testing equipment; nutrition therapy services; therapeutic shoes; and glaucoma screenings. See www.medicare.gov/health/diabetes.asp.
Diabetes prevention and control control programs. CDC funds programs in all 50 states, the District of Columbia, and U.S. territories to improve access to affordable, quality diabetes care and services, with priority on reaching high-risk individuals and disproportionately affected populations. See www.cdc.gov/diabetes/pubs/.
Community-based health centers. HHS' Health Resources and Services Administration (HRSA) supports an effort to reduce diabetes by working with HHS-funded community-based health centers to improve the effectiveness of health care services provided in underserved communities. The effort is part of a broader campaign to reduce health disparities. See www.healthdisparities.net.
The National Diabetes Quality Improvement Alliance. The National Diabetes Quality Improvement Alliance is a collaboration of private and public national organizations dedicated to improving the quality of diabetes care. The Alliance works to identify, maintain, and promote the use of a single national performance measurement set for diabetes. See http://www.nationaldiabetesalliance.org/.
Consumer information about diabetes is available at www.niddk.nih.gov and www.cdc.gov/diabetes/pubs/ or 1-877-CDC-DIAB (1-877-232-3422) and through the National Diabetes Education Program at www.ndep.nih.gov, a joint effort involving HHS and more than 200 private organizations, at www.ndep.nih.gov
###
Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.
Last Revised: February 21, 2006
|