Special Populations: Diabetes

By | November 29, 2010

Diabetes



Diabetes is a disease in which the body does not produce insulin or uses insulin insufficiently. Insulin is a natural hormone released by the pancreas that controls the level of glucose in the blood. Insulin permits cells to use glucose for energy. Insulin causes most of the body’s cells to extract glucose from the bloodstream and prohibits the use of fat as a primary energy source. When insulin levels are low, glucose is not taken up by most body cells and the body begins to use fat as an energy source. Diabetes can lead to serious health complications and premature death.



Type 1 diabetes (insulin dependent) is an autoimmune disease that destroys the insulin-producing beta cells of the pancreas. The pancreas secretes insulin in moderately low quantities. When food is ingested, sugar stimulates the pancreas to release insulin. The amount of insulin released is proportional to the amount of sugar ingested. Insulin’s main role is to help move certain nutrients, especially glucose, into the cells of the body’s tissues. The amount of sugar in the blood decreases once it enters the cells. Normally, that signals the beta cells in the pancreas to lower the amount of insulin secreted, to help prevent hypoglycemia.



Possible Risks of uncontrolled Type 1 Diabetes



Poor blood circulation. Poor blood circulation can damage nerves and harden arteries. In addition, it can lead to increased risk of injury and a decreased ability to heal open wounds or cuts. Damage to nerves may also lead to digestive problems such as nausea, vomiting, and diarrhea.



Kidney damage. Kidney damage is true in roughly half of all who have Type 1 diabetes. Kidney damage can lead to kidney failure and heart complications.



Retinopathy. This eye condition is almost certain in those who have uncontrolled Type 1 diabetes for a period of more than 15 years. Diabetic retinopathy is damage to the blood vessels of the retina. It can cause vision problems and eventually lead to blindness.



Type 2 diabetes, often called non-insulin dependent diabetes, is the most common form of diabetes. Individuals with Type 2 diabetes can produce insulin. In all cases, the pancreas secretes an insufficient amount of insulin, or the insulin released is insufficiently utilized. This condition is known as insulin-resistance.



Possible Risks of uncontrolled Type 2 Diabetes



Dehydration. High levels of blood sugar can trigger frequent urination. This is the body’s way of excreting excess sugar. During this process, frequent water loss will cause dehydration.



Diabetic Coma. Caused from severe dehydration.



Damage to the body. Left untreated, Type 2 diabetes can cause damage to the nerves and small blood vessels of the eyes, kidneys, and heart. 



Total Prevalence of Diabetes Among People Aged 20 Years or Older, United States, 2008



Non-Hispanic whites: 13 million; 9 percent of all non-Hispanic whites aged 20 years or older have diabetes.



Non-Hispanic blacks: 3 million; 13 percent of all non-Hispanic blacks aged 20 years or older have diabetes. After adjusting for population age differences, non-Hispanic blacks are 2 times as likely to have diabetes as non-Hispanic whites of similar age.



Latino Americans: After adjusting for population age differences, Mexican Americans, the largest Hispanic/Latino subgroup, are 2 times as likely to have diabetes as non-Hispanic whites. If the prevalence of diabetes among Mexican Americans was applied to the total Hispanic/Latino population, about 2.5 million (10 percent) Hispanic/Latino Americans aged 20 years or older would have diabetes. Sufficient data is not available to derive estimates of the total prevalence of diabetes (both diagnosed and undiagnosed diabetes) for other Hispanic/Latino groups. However, residents of Puerto Rico are 2 times as likely to have diagnosed diabetes as non-Hispanic whites in the United States.



American Indians and Alaska Natives who receive care from the Indian Health Service (IHS): 99,500; 13 percent of American Indians and Alaska Natives aged 20 years or older who received care from the Indian Health Service (IHS) in 2008 had diagnosed diabetes. Applying the rate of undiagnosed diabetes in the total U.S. population to the American Indians and Alaska Natives who receive care from IHS gives an estimate of 118,000 (15 percent) American Indians and Alaska Natives aged 20 years or older with diabetes (both diagnosed and undiagnosed diabetes). After adjusting for population age differences, the total prevalence of diabetes in this group is lowest among Alaska Natives (8 percent) and highest among American Indians in the southern United States (27 percent) and in southern Arizona (28 percent). Taking into account population age differences, American Indians and Alaska Natives are twice as likely to have diabetes as non-Hispanic whites.



Asian Americans and Native Hawaiians: The total prevalence of diabetes (both diagnosed and undiagnosed diabetes) is not available for Asian Americans or Pacific Islanders. In Hawaii, however, Asians, Native Hawaiians, and other Pacific Islanders aged 20 years or older are more than 2 times as likely to have diagnosed diabetes as whites after adjusting for population age differences. Similarly in California, Asians were 1.5 times as likely to have diagnosed diabetes as non-Hispanic whites. Other groups within these populations also have increased risk for diabetes.

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