Two out of three Americans with type-2 diabetes do not have their disease under control

May 18 2005

According to a new survey two out of three Americans with type-2 diabetes do not have their disease under control and are putting themselves at risk of early deaths from stroke, heart attack or kidney failure as well as blindness and limb loss.

The survey which was commissioned by the American Association of Clinical Endocrinologists and the American College of Endocrinologists, found that doctors and patients alike need to do more to test for diabetes and then to control it with diet, exercise and, if necessary drugs.

Dr. Jaime Davidson, a diabetes expert at the University of Texas Southwestern Medical School in Dallas, says the management of Diabetes has worsened in the past 10 years.

Type-2 diabetes, unlike juvenile or type-1 diabetes, is almost exclusively caused by poor diet and a lack of exercise,and as many as 18 million Americans now have it, including a growing number of children and young adults.

Although it may involve a genetic susceptibility, type-2 diabetes can be prevented with improved diet and exercise. It can also be controlled with diet and exercise but many people also need medications to control it and some may eventually need insulin.

The survey looked at 157,000 people with type-2, or so-called adult-onset diabetes, and examined a blood sugar reading called A1C in each patient, and found 67 percent of the patients did not have an adequate A1C level.

The A1C test indicates average blood sugar levels over the past two months or so by measuring how much glucose is attached to red blood cells.

The average lean, healthy young American adult has an A1C of about 5.1 percent and the highest desirable level is 6.5 percent. An A1C reading of 6 percent correlates to an average daily blood sugar reading of 135, while 7 percent indicates an average of 170 over the preceding weeks.

Blood sugar should be below 110 before eating and no higher than 140 after eating.

This means, says Dr. Lawrence Blonde of the Ochsner Clinic in New Orleans, a member of the American College of Endocrinologists, that two out of every three people analysed in this study were not in control of their blood sugar.

The researchers found that in every state, only 50 percent or even fewer patients had adequate blood sugar control.

Another survey, the Harris Interactive survey, supports this claim. The Harris team looked at 501 adults with diabetes and found that more than 60 percent did not know what A1C was, and 84 percent believed they were doing a good job of controlling their blood sugar.

When glucose levels are too high, they can damage the insides of the blood vessels, leading to heart attacks and stroke, and they can also damage the tiny capillaries inside the eyes and kidneys, causing blindness and kidney failure.

Singer and actress Della Reese, who has type-2 diabetes, says people need to do more to make sure they are screened for diabetes, and to take care of themselves if they have it.

Surgeon-General Dr. Richard Carmona said 40 percent of Americans aged 40 to 74 now have pre-diabetes, but they can still avoid diabetes itself if they exercise and eat more healthily.

Dr. Paul Jellinger, president of the American College of Endocrinologists says drugs can help manage diabetes but cannot cure it, and once complications have set in, it cannot be magically reversed.