A study published in the Lancet, a leading international medical journal, in August 2014 found that the risk of developing diabetes is increasingly rapidly among Americans.
The study also found that this risk depends on your race, your education and where you live, and that diabetics are living longer.
This study is the first in more than a decade to calculate the risk Americans face of developing diabetes during their life-time. It was conducted by epidemiologists at the US Centers for Disease Control and Prevention in Atlanta, Georgia, who have been tracking and analysing the prevalence of diabetes and the rate at which news cases are diagnosed for many years.
These researchers used mortality data for almost 600,000 persons from 1985 to 2011 (25 years) to assess the risk of developing type 1 or type 2 diabetes (excluding gestational diabetes).
Though the study only examined diabetes in the context of American people, it is likely that similar results would have been obtained had the study been conducted using European data or data from other countries where a Western-type diet and life-style is the norm.
The ever increasing risk of diabetes
The study revealed that there was a dramatic rise between 1985 and 2011 in the overall risk that an American will develop diabetes.
In 1985, American boys had a 21 percent chance of developing diabetes, and girls 27 percent. By 2011, however, that risk had jumped to 40 percent for both boys and girls. In other words, the risk for boys had almost doubled, while the risk for girls had gone up 50 percent.
The Lancet study did not analyse why this is so. But part of the reason could be the fact that people are living longer so that they have more years during which they can develop diabetes.
Diabetics are living longer
The good news is that America children diagnosed with diabetes can now expect to live more than 70 years with the disease.
Indeed, between 1985 and 2011, the number of years for which men diagnosed with diabetes can expect to survive increased by 156 percent. For women, the figure was 70 percent. Though no explanation was given by the researchers, this is probably due to advances in medical knowledge and treatments over the last 25 years.
Being diabetic shortens your life-span. Over the 25 year period examined by the researchers, the average number of years lost due to diabetes for the population as a whole increased by 46 percent in men and 44 percent in women. This is obviously due to the increasing prevalence of diabetes. It may also be partly due to the fact that there are probably fewer undiagnosed cases nowadays.
While the picture for the population as a whole seems to be getting bleaker, things are improving for the individual diabetic.
The number of years of his life a man diagnosed with diabetes can expect to lose on average decreased by almost two years (from 7.7 to 5.8 lost years) between the 1990s and the end of the 2000s. Women also gained an average of two years (their losses decreasing from 8.7 to 6.8 years) over the same time span. These improvements are probably due to better treatment regimes.
Race, gender and diabetes
While Americans overall have a gloomy 40 percent chance of developing diabetes, the outlook for Blacks and Hispanics is much grimmer.
White boys have a 37% and White girls a 34% risk of developing diabetes. By contrast, the chances for Black men are 44.7%, while for their sisters the risk is a whopping 55.3%. The chances of developing diabetes for Hispanic boys and girls are 51.8% and 51.5% respectively.
These figures, which refer to the risks of developing diabetes, reinforce the idea that diabetes has a genetic origin, at least to the extent that your genes can predispose you to diabetes. Most medical researchers agree that it’s your life-style that kicks it into action.
According to the researchers, they analysed race because that was the data they had available; but they did state that socio-economic status is probably as important as, if not more important than, race.
Nevertheless, the risk of developing diabetes for Whites is much less than it is for Blacks and Hispanics. Indeed, the risk for White girls is a third less than the risk for Black and Hispanic ladies.
As you can see, Hispanics of both sexes, as well as Black women, have a risk that exceeds 50 percent. But why Black men have a risk that is almost 10 percentage points less than Black women cannot be explained away by genetic differences.
Education and diabetes
The less educated you are, the greater your risk of developing diabetes.
According to the Lancet, in 1990 the number of new diagnoses among high-school drop-outs was 6.5 per thousand, while among high-school graduates it was 3.6 and for those who studied beyond high-school 3.2 per thousand.
This figure for the number of new diagnoses of diabetes among high-school drop-outs, high-school graduates and those who continued to study after high-school has been increasing steadily. In 2008 it peaked at 15.6, 9.4 and 6.5 per thousand respectively.
Since then the rate at which new diagnoses are being discovered has dropped off a bit. This may be due to improving life-styles.
At the same time, according to the latest statistics high-school dropouts are likely, on average, to develop diabetes at about twice the rate of persons who continued their education after graduating from high school.
It seems likely that the more educated you are, the more likely you are to live a healthy life-style and to take the threat of diabetes seriously.
Where you live and diabetes
The risk of developing diabetes also seems to vary from state to state in the USA.
In Mississippi, for example, 11.7 percent of the population have diabetes. In Louisiana, the figure is 11.5 percent. In South Dakota and Hawaii, by contrast only 7 percent of the population are diabetic.
The percentage of people with diabetes in the other states of the Union is between these two extremes of 7 to 11.7 percent.
What accounts for these differences is not known, though it’s probably a mixture of education, food cultures, exercise habits and genetics. Climate might also play a part, though this has not been investigated as far as I am aware.
Continuing increases in the numbers of new cases of diabetes diagnosed each year combined with longer life-spans have led to increases in the risk of developing diabetes and in the number of years spent coping with the disease. At the same time, the average individual is losing fewer years from his life-span due to the disease.
These findings of the Lancet study mean that there will be a continued need for health services and extensive funding to manage the disease. They also emphasise the need for effective interventions to reduce the incidence of diabetes, such as education in healthy life-styles and regular testing of the entire population to detect pre-diabetes.