26 million Americans diabetic: study

Nearly 26 million Americans of all ages are diabetic and 79 million people have what doctors call "prediabetes," according to 2011 estimates released by the US Centers for Disease Control and Prevention (CDC) Wednesday.

Prediabetes, which the CDC says affects 35 per cent of adults, is a condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes.

Prediabetes greatly boosts a person`s odds for type 2 diabetes, heart disease and stroke.

Diabetes is the seventh leading cause of death in the United States and now costs USD 174 billion a year, including USD 116 billion in direct medical expenses, according to the CDC.

People with diabetes are at increased risk for heart attack, stroke, high blood pressure, kidney failure, blindness and amputation of feet and legs.

The vast majority of cases of diabetes are type 2, which develops when the body`s cells gradually lose sensitivity to insulin.

According to experts, weight gain is a very big reason for type 2 diabetes` continuing rise among Americans.

"The percentage of the US adults who are overweight or obese has also risen dramatically, and there is no doubt that rising rates of obesity are linked to the rising rates of diabetes," said Christine Resta, an expert on diabetes in the division of endocrinology at Maimonides Medical Centre in New York city.

But changes in the way doctors diagnose the illness may have played a role in rising numbers, too, another expert said.

"One of the reasons the incidence of diabetes has been increasing in the last few years is because the American Diabetes Association (ADA) lowered the guidelines for diabetes diagnosis," explained Dr Jacob Warman, chief of endocrinology at The Brooklyn Hospital Centre in New York City.

"Last year, the ADA recommended using [hemoglobin] A1c levels to diagnose both diabetes and prediabetes. This change in criteria resulted in a great increase in the number of patients diagnosed with the condition. The decision to change the criteria remains controversial, but the guidelines to increase exercise and decrease carbohydrate intake are valid."

In its report, the CDC agreed that the switch to hemoglobin A1c testing -- which measures levels of blood glucose (sugar) over a period of two to three months – could help account for at least some of the rising numbers.

But the CDC`s National Diabetes Fact Sheet for 2011 also notes that about 27 per cent of Americans with diabetes, or about 7 million people, still do not know they have the disease.

Nine million American adults were diagnosed with diabetes last year, the study said adding that its rates continue to soar among racial and ethnic minorities and if the current trend continues as many as one in three US adults could have diabetes by 2050.

Among adults, diabetes rates were about 16 per cent for American Indians/Alaska Natives, 12.6 per cent for blacks, nearly 12 per cent for Hispanics, 8.4 per cent for Asian Americans, and just over 7 per cent for whites, the study said.

Half of Americans aged 65 and older have prediabetes and nearly 27 per cent have full-blown diabetes, the study noted.

Around 215,000 Americans younger than age 20 have diabetes, including type 1 diabetes, it said. The 2011 diabetes incidence estimates mark a continued rise in the disease over the past few years.

In 2008, for example, the CDC estimated that 23.6 million Americans (7.8 per cent) had diabetes and 57 million adults had prediabetes.

Besides the obesity epidemic and the switch to A1c-based diagnosis, the agency said that improvements in diabetes management may mean that many people with the disease are living longer, raising the total number affected.

Still, "these distressing numbers show how important it is to prevent type 2 diabetes and to help those who have diabetes manage the disease to prevent serious complications such as kidney failure and blindness," Ann Albright, director of CDC`s Division of Diabetes Translation, said in an agency news release.

"We know that a structured lifestyle programme that includes losing weight and increasing physical activity can prevent or delay type 2 diabetes," she added.