Diabetes Mellitus

General Problem

  • 9% of the U.S. population has type 2 diabetes
    • 10% of middle-aged Americans have diabetes
    • 20% over age 59 have diabetes
    • 25% between 65 and 75 years have type 2 diabetes
  • 26% of the U.S. adult population has impaired fasting glucose. often a precursor to diabetes
  • An estimated 20 million American have type 2 diabetes. and about one-third of them don’t even know they have the disease. Some estimates suggest roughly one-third of the total adult population may already have diabetes or be on the way to developing it
  • 6th leading cause of death
  • 2-4 times greater mortality
  • Current economic costs of diabetes is $132 billion, including medical expenses and loss of productivity (Diabetes Care, 2002)
  • The annual incidence of diabetes (new diagnoses) among the Medicare population increased 23% between 1995 and 2004, while the prevalence (those living with the disease) increased by 62%
  • Most individuals with diabetes have at least one complication within six years of diagnosis. Almost half of Medicare diabetics have congestive heart failure

Related Morbidity for Diabetics

  • Risk for MI or CVA: 2-4 times higher (20% higher for pre-diabetics)
  • 33-50% of pre-diabetics will develop diabetes within 5-10 years
  • Colon cancer risk is 3 times greater if they have been on insulin replacement at least 3 years
  • Diabetic men > 45 years old have 2 times greater risk of hypogonadism or low testosterone
  • People with diabetes and high blood pressure have approximately twice the risk of complications compared with people who have high blood pressure alone
  • Alzheimer’s disease
    • Diabetics are at 83% greater risk
    • Pre-diabetics are at 70% greater risk
Test Optimum Normal Pre-diabetes Diabetes
Fasting BS <86 mg/dL <100 mg/dL > 99 mg/dL >125 mg/dL
OGTT > 139 mg/dL >199 mg/dL

Risk Factors for Developing Diabetes

  • At least 45 years of age
  • Overweight (the strongest risk factor; 80% of people with type II diabetes are overweight – particularly visceral fat)
  • African American, Hispanic/Latino American, Asian American, Pacific Islander, or American Indian (Native Americans have 27% incidence)
  • Parent or sibling with diabetes
  • High blood pressure
  • Low HDL cholesterol: < 40 for men and < 50 for women
  • High triglycerides: > 249 (fat in the blood feeding the liver causes insulin resistance, which causes elevated insulin levels, which cause the fat cells to build even more abdominal fat, which raises triglycerides; high carbohydrate intake is the cause of elevation of triglycerides)
  • Had diabetes during pregnancy or gave birth to a large baby (> 9 Ibs)
  • Physically active fewer than 3 times/wk
  • Magnesium deficiency
    • 39% of type II diabetics are magnesium deficient
    • up to 10% of seemingly healthy individuals
    • up to 65% of ICU patients • High iron (Ferritin) levels
  • High iron (Ferritin) levels

Sources of High Insulin Levels 

  • Stress
  • Dieting
  • Caffeine
  • Alcohol
  • Aspartame
  • Tobacco
  • Steroids
  • Lack of exercise
  • Stimulants and other recreational drugs
  • Excessive and/or unnecessary thyroid replacement
  • Numerous over-the-counter and prescription drugs
  • Eating a diet insufficient in proteins and fats while eating excess carbohydrates

Effects of Insulin Resistance 

  • Increase in blood sugar
  • Increase in arachodonic acid levels
  • Increased production of pro-inflammatory cytokines, resulting in increased conversion of cortisone to cortisol and more visceral adipose tissue
  • Increased mitogenesis (cell division)
  • Decreased HGH and Progesterone levels
  • Increased Estradiol an androgen levels


  • Gradually and continuously, decline in numbers.
  • At the time of diagnosis of diabetes 50% of the B-cells are already gone; the decline started many years earlier
  • Diet and exercise can slow down B-cell decline by 58%
  • Exercise increases B-cell and insulin receptors efficacy
  • Conventional therapies do not influence B-cell failure