Beloit College Magazine

Beloit College Magazine

Summer 2010 (July 21, 2010)

Diabetes Rising

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July 21, 2010
By Dan Hurley'79

Most of us know the conventional wisdom about diabetes. It’s pretty simple: Type 1 is rare and strikes out of the blue, due in part to a genetic risk, set off by perhaps a virus or some other kind of stress. To treat it, you take insulin, test your blood sugars, and carefully watch what you eat. Self-management is the key to good control.

Type 2 is far more widespread, and spreading fast along with America’s waistline. It’s caused by eating too much and exercising too little. To treat it, you eat less and exercise more. If that fails, you take pills and perhaps insulin. As with type 1, self-management is the key to good control.

It turns out that this conventional wisdom is mostly misleading, mistaken, or outdated.

Diabetes RisingType 1, it’s true, used to be rare. Today, however, it’s about twice as common among children as it was in the 1980s, about five times more common than in the years following World War II, and perhaps ten times more common than 100 years ago, if early statistics are to be believed. Genes have not changed; lifestyle and environmental risk factors have.

Type 2 is also rising, of course, but far faster than the rate of obesity. In fact, the rate of new type 2 cases has doubled in the past decade, according to the U.S. Centers for Disease Control and Prevention. Shockingly, the CDC now projects that 33 percent of all boys and 39 percent of all girls born in the year 2000 will develop type 2 in their lifetimes. That’s more than one in three overall. For blacks and Hispanics, the projections are even worse, tipping to over half—53 percent—of all Hispanic women, meaning that more of them will eventually have diabetes than do not.

Already, many people are developing the disease long before middle age. At Children’s Hospital in Cincinnati, the rate of new diagnoses of type 2 in adolescents grew tenfold between 1982 and 1994. More recently, in the five years between 2001 and 2006, the percent of adolescent girls receiving prescription medications for type 2 nearly tripled—in just five years. Reports of kids dying from diabetes have even made their way into medical journals. Dying of type 2 diabetes in childhood? That’s like getting Alzheimer’s disease in high school.

It is worth stepping back to look at the big picture and consider what an aberration the rise of diabetes is in modern medicine. By contrast, cancer rates in the United States fell by 18.4 percent among men and by 10.5 percent among women between 1991 and 2005, according to the American Cancer Society. Heart disease death rates fell by just over 25 percent between 1999 and 2005, according to the American Heart Association. Deaths due to stroke are likewise way down. Even the percentage of Americans ages 70 and over with dementia (ranging from mild memory loss to full-blown Alzheimer’s disease) fell by 29 percent between 1993 and 2002. Diabetes, it would seem, is going the wrong way down a one-way street.

But take another step back: Diabetes is growing at epidemic proportions not only in the United States. Rather, it can be fairly called a global pandemic, afflicting every continent and nearly every country.

Now take one final step back and ask yourself: 88 years after the discovery of insulin, with all the dozens of pills available for type 2, all the high-tech treatments available for type 1, and the estimated $116 billion per year spent on the medical treatment of diabetes in the United States alone, why the heck do more people get diabetes, and more people die of it, each year?

I ask these questions with more than the usual curiosity of a medical journalist. I was diagnosed with type 1 more than 30 years ago, at the age of 18. My late father had type 2, my mother’s mother had it, and one of my older brothers was recently diagnosed with type 2 as well. So when I read yet another article or book about how we diabetics should just try harder and test our blood sugars more often and try some nifty new diet, I know enough to say that surely there has got to be a better way.

Dan Hurley’79 developed type 1 diabetes in 1975, his first year at Beloit. At the time it was called “juvenile” diabetes, and it was so rare he didn’t meet anyone else with the disease until he was in his 20s. This text was excerpted with permission from Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do About It (2010), published by Kaplan Publishing.

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