From 1997 to 2003, the incidence of self-reported, diagnosed type 2 diabetes rose 41 percent in almost all groups of people, but was most prominent among the obese. Other groups at risk were those with little education, older populations and minorities.
"I'm concerned if we don't do something about this problem now, we're going to have bigger problems in the future," said lead author Linda Geiss, a statistician for the CDC. The study was published this week in the American Journal of Preventive Medicine.
Geiss and colleagues looked at data from the 1997-2003 National Health Interview Study, a program of the CDC's National Center for Health Statistics. The survey asked nearly 31,000 women aged 18 to 79 annually whether a health professional had ever told them they had diabetes. Each year about 2,000 people reported new cases of diabetes.
Since past research data published on diabetes took place in selected locations, Geiss and colleagues initiated the study so they could view diabetes from a national perspective. This way, Geiss observed trends in the new cases, and not just the disease's overall growth.
For instance, Geiss found the diabetes boom could be attributed to other factors, such as changes in the diagnostic criteria for diabetes or a better track record of detection. The authors cite a recent European study that suggests fasting glucose tests may diagnose diabetes in younger people more effectively than oral glucose-tolerance tests.
The researchers broke down their analyses into two groups: 1997-1998 cases and 2002-2003 cases. No significance was found in either group in terms of the rate of self-reported hypertension, coronary heart disease, stroke or poor or fair health status. In addition, from 1997 to 2003 the people being diagnosed with diabetes were not remarkably healthier or younger -- an outcome one might have expected if the diabetes explosion were a product of improved diabetes detection, the authors wrote.
Also, a diabetes diagnosis does not necessarily whip people into shape, Geiss found -- paralleling the general population, the diabetes population also became more obese. Among new cases of diabetes in 2003, 59 percent were obese and almost 90 percent were overweight and obese.
Diabetes has emerged as a major health problem in recent years -- in the United States in 2005, 20.8 million people had diabetes, and 6.2 million of them didn't know they had it, according to the American Diabetes Association. The sixth leading cause of death in the country, diabetes leads to heart disease, high blood pressure and blindness, among other conditions.
Minorities, particularly African-Americans, Hispanics and American Indians, are also more predisposed than whites to develop the disease.
Internationally, the scenario is bleak -- in an estimate by the World Health Organization the worldwide rate of diabetes will rise to 366 million in 2030, an increase from 171 million in 2000. The disease will hit hard in the Middle East, sub-Saharan Africa and India.
The good news is just minor lifestyle modifications can make a big difference, Geiss said. By increasing activity -- just 30 minutes a day -- and losing a little bit of weight, people can reduce their chances for developing diabetes.
Geiss conceded that's not always simple.
"Our environment works against us. It's too easy to sit in front of the TV, too easy to eat too much, too easy to get fast food that's high in fat," Geiss said.
But a person needs only to lose 5 percent to 7 percent of their body fat to protect themselves from not only diabetes, but cardiovascular diseases, said Martin Abrahamson, medical director of the Joslin Diabetes Center in Boston. "We're not talking about wearing bikinis," he said.
Maggie Powers, a registered dietician at the International Diabetes Center at Park Nicollet in Minneapolis, agreed, emphasizing that a 200-pound person would only have to lose 10 pounds to greatly improve his or her health.
Powers also stressed how easy it is to point fingers at the obese. As a dietitian, she tries to emphasize the victories in her patients' battle against weight. For instance, if someone quits smoking but gains weight, Powers praises the act of quitting -- a difficult lifestyle choice by itself.
"My hope is this will bring attention to the concerns we have with the increasing incidence in diabetes. Sometimes it takes articles like this that throw it in your face, that say, 'This is the reality, and we need to do something.'"
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