News Review From Harvard Medical School -- Diabetes Rates Double, Triple in Some States
U.S. diabetes rates are getting worse faster in some states than others, a study shows. The fastest growth was in Oklahoma. Diabetes rates there tripled in 15 years. Southern states also had big increases. The Centers for Disease Control and Prevention (CDC) did the study. It was based on phone surveys of adults done in 1995 and 2010. People were asked if a doctor had ever told them they had diabetes. Nationwide, about 8% said yes. Several states exceeded that nationwide average. Mississippi, which has the nation's highest obesity rate, also had the top diabetes rate, almost 12% in 2010. Oklahoma's rate jumped to 10% in 2010. In several Southern states, the rates doubled. They rose to more than 9% in Kentucky, 10% in Georgia and 11% in Alabama. The CDC's Morbidity and Mortality Weekly Report published the study. The Associated Press wrote about it November 15.
By Lori Wiviott Tishler, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
The Centers for Disease Control and Prevention (CDC) is reporting an increase in diabetes across the United States, and I'm not surprised. The number of people with diabetes is extremely high. We have been working recently to address this increase in our urban medical practice.
In 1995, the CDC reports, 6% of the populations of 3 states, Washington, D.C., and Puerto Rico had diabetes. By 2010, the entire nation's rate of diabetes was over 6%. Six states and Puerto Rico had diabetes rates of greater than 10%!
In the state-by-state breakdown, residents of Southern states had the highest risk of having diabetes. The numbers for Alabama rose from 4.7% in 1995 to 11.3% this year. The South wasn't alone, however, in having a doubled risk of diabetes during this 15-year period. Doubling occurred in 18 states. Oklahoma's risk tripled.
The study was not complicated. People with a landline telephone were asked: "Has a doctor ever told you that you have diabetes?" Those who answered "yes" were considered to be diabetic.
These numbers are huge. Keep in mind that about one-quarter of adults with diabetes have not yet been diagnosed. This would increase the numbers. Some biases exist. For example, households with only cell phones were not counted in this survey.
The CDC thinks that the following may be driving the increase in diabetes:
- Aging of the population
- Increases in minority groups who are at higher risk for diabetes
- Increases in major factors that increase the risk of diabetes, including lack of exercise and obesity
As a doctor, I am not surprised by these results. But I find them very worrisome. A person with diabetes is at risk for serious complications of the disease. These can include heart attack and stroke, kidney disease and eye disease. People with diabetes are also at higher risk of everyday infections such as influenza (flu) or pneumonia.
The CDC has done an excellent job of showing us what the problem is. Now, as a society, we need to find ways to turn those numbers back!
What Changes Can I Make Now?
We can't prevent some of our risk factors for diabetes. We can't stop getting older or change a family history of diabetes. Nor can we stop being a member of a group that has a higher risk of diabetes. But we can often delay the development of diabetes with lifestyle changes.
What can you do to lower your risk of diabetes?
- Walk. Some studies have shown that people at high risk of diabetes can cut their risk of diabetes in HALF by walking up to 30 minutes a day. They may lose weight as well, which doesn't hurt!
- Lower your body mass index (BMI). The risk of diabetes for people considered obese is many times the risk for people at a normal weight. And the weight loss doesn't have to be extreme. People who lose about one kilogram (2.2 pounds) each year for 10 years can decrease their risk of developing diabetes by one-third!
If you already have diabetes, don't despair. Do continue to make efforts to lose weight and to exercise. Weight loss and exercise help your body to control sugar levels better and with less medicine. Talk to your doctor about avoiding complications. Aim for the best control of your diabetes that is also safe for you.
What Can I Expect Looking to the Future?
If we don't act, one by one and as a nation, Americans are going to get fatter, have more diabetes and use more of the world's resources. If we do act as individuals who try to care for our own health, then our risk gets better. We also can act collectively to change food policy and promote exercise for both children and adults. If we do, then I think there is a chance to reduce the rate of diabetes in our communities and our nation.