Every day in the United States, 4,700 people learn they have diabetes and more than 200 people have a limb amputated because of the disease. Diabetes also is the leading cause of kidney failure.

Although the number of people with the chronic disease is skyrocketing, there is still a lack of public understanding of it. Ann Albright, who directs the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC), says that 1 in 9 or 10 people now have diabetes and that of the 29 million with it, about 8 million don’t even know they have it. That means, she says, they are not receiving treatment and making lifestyle changes that could help stave off life-threatening complications.

Even more worrisome, Albright says, is the estimated 86 million Americans with pre-diabetes, those whose blood sugar is higher than normal but not yet high enough to constitute diabetes. “Anybody think of the Titanic? We’ve got this looming iceberg. . . . It can be as many as 1 in 3 to 1 in 5 people by the time we’re hitting 2025,” she says.

Albright and some other of the nation’s leading diabetes experts spoke at the Washington Post forum “Diabetes: Slowing the Epidemic” on Nov. 13 and they are excerpted in this special report.

There are two distinct forms of diabetes: Type 1, which is an autoimmune disease whose trigger is not known and which accounts for about 5 percent of the cases, and Type 2, which is often associated with obesity, a lack of physical activity and personal history. In many cases, the right diet and exercise can prevent or delay the onset of Type 2 diabetes.

Researchers at the National Institutes of Health are racing to try to find a vaccine for Type 1 diabetes and slow the rate of those developing Type 2.

“The first thing we need to do is find everybody who has diabetes and who has pre-diabetes, because there are so many effective things that they can do to change the course of their health,” said Judith Fradkin, who runs NIH’s Division of Diabetes, Endocrinology and Metabolic Diseases.

Robert Ratner, chief medical officer at the American Diabetes Association, says that diabetes must not be treated only as a medical condition, but also as a public health problem caused by environmental factors.

“It used to be that food was expensive and exercise was part of your daily living,” he says. “Now, food is cheap and you have to pay a membership to go to the gym because you don’t walk to work.”

Given the rising human toll of diabetes, along with its astronomical cost to the health-care system, workplaces, YMCAs and other community centers are starting promising programs to educate people on how to prevent it, delay it and better manage it. Those programs are urgently overdue.


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