Member Expert: Diabetes Mellitus Type 2
Overview: Type 2 Diabetes Mellitus is a disease of increasing frequency in the American population. Over 1.5 million new cases are diagnosed each year, while over 30 million Americans suffer from it currently. In the U. S. it has become largely a consequence of our diet and sedentary lifestyle. Its Pathophysiology is one of both decreased insulin production and decreased insulin sensitivity.
Cost: The economic implications of diabetes are enormous with an estimated $327 billion price tag for 2017 alone. On average people with diabetes spend $16,750 per year on their own medical care.
Morbidity: The complications of diabetes are extensive and affect virtually every organ system in the body. The complications of most concern are largely a consequence of poor blood sugar control, poor lipid control and poor blood pressure control. In 2016, 2.2 million deaths were attributable to complications from diabetes.
Risk factors: The risk of developing diabetes is increased in African American, Latino, Native American, and Pacific Islander populations. Also, a sedentary lifestyle, visceral obesity, and parental history of diabetes increase risk.
Treatment: The mainstay of treatment continues to be diet exercise and weight loss. Indeed, adequate glucose control can occasionally be obtained by a 7% weight loss. The pharmacologic treatment of diabetes has changed markedly in recent years. The approach has moved from increasing exogenous insulin to decreasing glucose production and increasing glucose elimination. Protection against complications from dyslipidemia and hypertension are also paramount to treatment.
Conclusion: Diabetes is a preventable disease. Primary care physicians should continue to encourage a healthy lifestyle. This includes a diet low in simple carbohydrate and aerobic exercise for one hour per day on most days.
Mark Lemmons, MD provides Family Medicine care at Ascension in Greenwood, IN.