New statistics out on the number of diabetics in America

Last month, the U.S. Centers for Disease Control and Prevention (CDC) updated statistics about diabetes. They estimate that 24 million Americans — 8% of the population — have diabetes as of 2007. That's 3 million more people than in 2005. The good news? About 25% of people with diabetes don't know they have it — a number that is down from 30% in 2005. But 25% is still a large portion of the people with diabetes — and knowing you have diabetes is the only way you can start taking advantage of the medicines and lifestyle changes that can help you keep control of your blood sugar and prevent complications.

Here, my colleague Dr. Mary Pickett comments on these new statistics:

If you aren't shocked that 8% of Americans have diabetes, remember that diabetes usually does not begin until mid-adulthood. This means the new statistic is watered down because it includes Americans of all ages.

The rate of diabetes among mature adults is even more alarming. Almost 25% of Americans age 60 or older had diabetes in 2007. This is a huge number, and it is unnecessary.

Diabetes runs in families, but most people agree that we are seeing so much more of it now because of bad habits. These include poor weight control, poor diet, and not enough exercise.

I take care of patients as a primary care doctor, and I specialize in preventive care. The trend toward obesity and diabetes makes me feel like a failure. We ought to be able to prevent diabetes. At the very least, we should be able to keep in check the number of new cases.

The CDC conducts state-by-state surveys of trends in preventive health statistics. This is called the Behavioral Risk Factor Surveillance System. Here are some survey results that compare the 1990s to 2002, the most recent year of analyzed data:

·         We are drinking more, exercising less, and gaining more weight.

·         We are doing better at getting Pap tests, colon tests, blood tests, shots, and mammograms.

Americans are putting their faith in medical technology. This is a terrific vote of confidence in our health care system, and is welcome. We are willing to put up with more and more screening tests and procedures. Americans seem to be getting these done despite occasional grumbling.

But we are relying on technology to substitute for healthy behavior. Quite frankly, there is no substitute for healthy behavior.

I am startled by the number of patients who enter my office and apologize: "I am overdue for my this-and-that," or "I haven't been to a doctor in years." I am left thinking, but what about the big stuff? When was the last time you exercised? And moreover, why apologize to me?

I hope all of us are thinking the same thing: "I don't want to be a statistic!" Certainly, none of us wants to be one of America's unnecessary cases of diabetes! Here are some of the best ways to guard your health:

·         Exercise regularly. Both aerobic and strengthening exercises can help to lower your diabetes risk. Try for 30 minutes of aerobic exercise, such as brisk walking, 5 to 7 days a week.

·         Avoid sodas. In America, we have tripled our soda consumption in the last 25 years. In 2004, for the first time, we drank more calories in soft drinks than in milk. This news is a liquid disaster for our health. Soft drinks are both calories and "carbs," so they contribute to obesity. Their sweeteners are easily digested. This puts a large spike of insulin into your bloodstream. When these spikes come and go repeatedly, your body changes. It becomes more resistant to the effects of insulin. For this reason, soft drinks are a major cause of diabetes.

The Nurses' Health Study looked at the health habits of more than 50,000 U.S. women for 8 years. Those who drank an average of one or more sugary drinks daily were nearly twice as likely to develop diabetes as women without this habit. They were also about 10 pounds more obese. Even if it sounds un-American, you should stop drinking sodas.

·         At meals, keep your portion size reasonable. No matter what our size, we don't need a "supersized" meal in order to be well nourished. Between 1977 and 1996, we dramatically increased our average portion size for every food except for pizza. Serve your meals on a small plate. Avoid going back for seconds.

·         Eat the right carbohydrates. Eat a balanced diet, following the recommendations of the U.S. Department of Agriculture's Food Pyramid. Emphasize whole-grain carbohydrates. These include whole wheat, oats, brown rice, barley, and other grains. Limit refined sugars in your diet. Also limit white bread, white rice, and pasta not made with whole grains. It is okay to mix some refined carbohydrates with your whole grain foods, but take a step in the right direction.

·         If you are overweight, aim to lose weight. Even a modest weight loss of 10 or 15 pounds can help. In a 200-pound person, this can dramatically reduce the risk of diabetes.

What do you think of these new statistics? Does it scare you that so many Americans have diabetes?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

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