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
Beta-Cells
- 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