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Phillips L.S.,Atlanta Medical Center | Phillips L.S.,Emory University | Ratner R.E.,American Diabetes Association | Buse J.B.,University of North Carolina at Chapel Hill | And 2 more authors.
Diabetes Care | Year: 2014

As diabetes develops, we currently waste the first ∼10 years of the natural history. If we found prediabetes and early diabetes when they first presented and treated them more effectively, we could prevent or delay the progression of hyperglycemia and the development of complications. Evidence for this comes from trials where lifestyle change and/or glucose-lowering medications decreased progression from prediabetes to diabetes. After withdrawal of these interventions, there was no "catch-up"-cumulative development of diabetes in the previously treated groups remained less than in control subjects. Moreover, achieving normal glucose levels even transiently during the trials was associated with a substantial reduction in subsequent development of diabetes. These findings indicate that we can change the natural history through routine screening to find prediabetes and early diabetes, combined with management aimed to keep glucose levels as close to normal as possible, without hypoglycemia. We should also test the hypothesis with a randomized controlled trial. © 2014 by the American Diabetes Association.

Hsu W.C.,Harvard University | Araneta M.R.G.,University of California at San Diego | Kanaya A.M.,University of California at San Francisco | Chiang J.L.,American Diabetes Association | Fujimoto W.,University of Washington
Diabetes Care | Year: 2015

According to the U.S. Census Bureau, an Asian is a person with origins fromthe Far East (China, Japan, Korea, and Mongolia), Southeast Asia (Cambodia, Malaysia, the Philippine Islands, Thailand, Vietnam, Indonesia, Singapore, Laos, etc.), or the Indian subcontinent (India, Pakistan, Bangladesh, Bhutan, Sri Lanka, and Nepal); each region has several ethnicities, each with a unique culture, language, and history. In 2011, 18.2 million U.S. residents self-identified as Asian American, with more than two-thirds foreign-born (1). In 2012, Asian Americans were the nation's fastestgrowing racial or ethnic group, with a growth rate over four times that of the total U.S. population. International migration has contributed >60% of the growth rate in this population (1). Among Asian Americans, the Chinese population was thelargest (4.0 million), followed by Filipinos (3.4 million), Asian Indians (3.2 million), Vietnamese (1.9 million), Koreans (1.7 million), and Japanese (1.3 million). Nearly three-fourths of all Asian Americans live in 10 statesdCalifornia, New York, Texas, New Jersey, Hawaii, Illinois,Washington, Florida, Virginia, and Pennsylvania (1). By 2060, the Asian American population is projected to more than double to 34.4 million, with its share of the U.S. population climbing from 5.1 to 8.2% in the same period (2). © 2015 by the American Diabetes Association.

Kohrman D.B.,American Diabetes Association
Journal of Diabetes Science and Technology | Year: 2013

Safety issues posed by driving with diabetes are primarily related to severe hypoglycemia, yet some public authorities rely on categorical restrictions on drivers with diabetes. This approach is misguided. Regulation of all drivers with diabetes, or all drivers using insulin, ignores the diversity of people with diabetes and fails to focus on the subpopulation posing the greatest risk. Advances in diabetes care technology and understanding of safety consequences of diabetes have expanded techniques available to limit risks of driving with diabetes. New means of insulin administration and blood glucose monitoring offer greater ease of anticipating and preventing hypoglycemia, and thus, limit driving risk for persons with diabetes. So too do less sophisticated steps taken by people with diabetes and the health care professionals they consult. These include adoption and endorsement of safety-sensitive behaviors, such as testing before a drive and periodic testing on longer trips. Overall, and in most individual cases, driving risks for persons with diabetes are less than those routinely tolerated by our society. Examples include freedom to drive in dangerous conditions and lax regulation of drivers in age and medical cohorts with elevated overall rates of driving mishaps. Data linking specific diabetes symptoms or features with driving risk are quite uncertain. Hence, there is much to recommend: a focus on technological advances, human precautions, and identifying individuals with diabetes with a specific history of driving difficulty. By contrast, available evidence does not support unfocused regulation of all or most drivers with diabetes. © Diabetes Technology Society.

Yang W.,Lewin Group Inc. | Dall T.M.,IHS Global Inc. | Halder P.,Lewin Group Inc. | Gallo P.,IHS Global Inc. | And 3 more authors.
Diabetes Care | Year: 2013

OBJECTIVE-This study updates previous estimates of the economic burden of diagnosed diabetes and quantifies the increased health resource use and lost productivity associated with diabetes in 2012. RESEARCH DESIGN AND METHODS-The study uses a prevalence-based approach that combines the demographics of the U.S. population in 2012 with diabetes prevalence, epidemiological data, health care cost, and economic data into a Cost of Diabetes Model. Health resource use and associated medical costs are analyzed by age, sex, race/ethnicity, insurance coverage, medical condition, and health service category. Data sources include national surveys, Medicare standard analytical files, and one of the largest claims databases for the commercially insured population in the U.S. RESULTS-The total estimated cost of diagnosed diabetes in 2012 is $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity. The largest components of medical expenditures are hospital inpatient care (43% of the total medical cost), prescription medications to treat the complications of diabetes (18%), antidiabetic agents and diabetes supplies (12%), physician office visits (9%), and nursing/residential facility stays (8%). People with diagnosed diabetes incur averagemedical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes. For the cost categories analyzed, care for people with diagnosed diabetes accounts for more than 1 in 5 health care dollars in the U.S., and more than half of that expenditure is directly attributable to diabetes. Indirect costs include increased absenteeism($5 billion) and reduced productivity while at work ($20.8 billion) for the employed population, reduced productivity for those not in the labor force ($2.7 billion), inability to work as a result of diseaserelated disability ($21.6 billion), and lost productive capacity due to early mortality ($18.5 billion). CONCLUSIONS-The estimated total economic cost of diagnosed diabetes in 2012 is $245 billion, a 41% increase from our previous estimate of $174 billion (in 2007 dollars). This estimate highlights the substantial burden that diabetes imposes on society. Additional components of societal burden omitted from our study include intangibles from pain and suffering, resources from care provided by nonpaid caregivers, and the burden associated with undiagnosed diabetes. © 2013 by the American Diabetes Association.

News Article
Site: news.yahoo.com

By taking a 1-minute quiz, you can find out if you're at risk for prediabetes. The quiz is part of a new public service campaign that aims to increase awareness of the condition. The government-backed campaign also includes TV ads that let people take the quiz in real time. The goal is to give people an idea of their prediabetes risk, according to the Centers for Disease Control and Prevention, which put together the campaign in partnership with the American Diabetes Association, the American Medical Association, and the Ad Council. More than 1 in 3 U.S. adults (86 million people) have prediabetes — meaning their blood sugar levels are abnormally high, but not high enough to be classified as diabetes. However, just 10 percent of these people are aware that they have the condition. Prediabetes can be reversed with weight loss and changes in diet and exercise, the CDC says. But up to 30 percent of people whose prediabetes goes untreated will go on to develop type 2 diabetes within five years, and they also may be at increased risk of a heart attack or stroke, according to the CDC. "I think the scary thing is that this really touches everyone — 1 in 3 could be your brother or sister, your best friend or partner," Lisa Sherman, president and CEO of the Ad Council, said in a statement. "Our hope is that this online test and other campaign materials make it easy for people to know where they stand and will motivate them to take steps to reverse their condition." [The Best Way to Lose Weight Safely] People can take the prediabetes quiz online, or by texting "RISKTEST" to 97779. The quiz has seven questions, including the following: "Are you a man or a woman?", "Do you have a mother, father, sister or brother with diabetes?" and "How old are you?" People who are older or male, or who have family members with diabetes are at higher risk for prediabetes. As soon as you finish the quiz, you are given a score from 0 to 10. A score of 5 or higher means that it's likely that you have prediabetes, but you'll need to visit your doctor and take a blood test to find out for sure, the CDC says. There are several tests for diabetes, including the A1C test, which measures a person's average blood sugar level; the fasting plasma glucose test, which measures blood sugar levels after an 8-hour fast; and the oral glucose tolerance test, which checks blood sugar levels before and after people drink a special sugar solution. According to the American Diabetes Association, people have prediabetes if they meet one of these criteria: The prediabetes quiz is available here. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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