Diabetes Mellitus

Diabetes mellitus is a common metabolic disorder resulting from defects in insulin action, insulin production, or both. Insulin, a hormone secreted by the pancreas, helps the body use and store glucose produced during the digestion of food. Characterized by hyperglycemia, symptoms of diabetes include frequent urination, increased thirst, dehydration, weight loss, blurred vision, fatigue, and, occasionally, coma. Uncontrolled hyper-glycemia over time damages the eyes, nerves, blood vessels, kidneys, and heart, causing organ dysfunction and failure. A number of risk factors are attributed to the incidence of diabetes, including family history, age, ethnicity, and social group characteristics, as well as behavioral, lifestyle, psychological, and clinical factors.

The World Health Organization estimates that 150 million people had diabetes worldwide in 2002. This number is projected to double by the year 2025. Much of this increase will occur in developing countries and will be due to population growth, aging, unhealthful diets, obesity, and sedentary lifestyles. In the United States, diabetes is the sixth leading cause of death. While 6.2 percent of the population has diabetes, an estimated 5.9 million people are unaware they have the disease. In addition, about 19 percent of all deaths in the United States for those age twenty-five and older are due to diabetes-related complications.

The prevalence of diabetes varies by age, gender, race, and ethnicity. In the United States, about 0.19 percent of the population less than twenty years of age (151,000 people) have diabetes, versus 8.6 percent of the population twenty years of age and older. In addition, adults sixty-five and older account for 40 percent of those with diabetes, despite composing only 12 percent of the population. Considerable variations also exist in the prevalence of diabetes among various racial and ethnic groups. For example, 7.8 percent of non-Hispanic whites, 13 percent of non-Hispanic blacks, 10.2 percent of Hispanic/Latino Americans, and 15.1 percent of American Indians and Alaskan Natives have diabetes. Among Asian Americans and Pacific diabetes: inability to regulate level of sugar in the blood metabolic: related to processing of nutrients and building of necessary molecules within the cell insulin: hormone released by the pancreas to regulate level of sugar in the blood hormone: molecules produced by one set of cells that influence the function of another set of cells glucose: a simple sugar; the most commonly used fuel in cells hyperglycemia: high level of sugar in the blood dehydration: loss of water fatigue: tiredness incidence: number of new cases reported each year social group: tribe, clique, family, or other group of individuals behavioral: related to behavior, in contrast to medical or other types of interventions psychological: related to thoughts, feelings, and personal experiences obesity: the condition of being overweight, according to established norms based on sex, age, and height sedentary: not active prevalence: describing the number of cases in a population at any one time

The standard method of measuring blood glucose level is called a fingerstick, which is a small blood sample taken from the fingertip. Diabetics must monitor their blood glucose levels daily in order to avoid dire complications such as kidney disease, blindness, stroke, and poor blood circulation. [Photograph by Tom Stewart. Corbis. Reproduced by permission.]

The standard method of measuring blood glucose level is called a fingerstick, which is a small blood sample taken from the fingertip. Diabetics must monitor their blood glucose levels daily in order to avoid dire complications such as kidney disease, blindness, stroke, and poor blood circulation. [Photograph by Tom Stewart. Corbis. Reproduced by permission.]

Islanders, the rate of diabetes varies substantially and is estimated at 15 to 20 percent. The prevalence of diabetes is comparable for males and females—8.3 and 8.9 percent respectively. Nevertheless, the disease is more devastating and more difficult to control among women, especially African-American and non-Hispanic white women. In fact, the risk for death is greater among young people (3.6 times greater for people from 25 to 44 years of age) and women (2.7 times greater for women ages 45 to 64 than men of the same age).

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