- The Washington Times - Thursday, May 19, 2005


Two out of three Americans with Type-2 diabetes do not have the disease under control and risk early deaths from stroke, heart attack or kidney failure as well as blindness and limb loss, according to a report published yesterday.

Doctors and patients alike need to do more to test for diabetes and to control it with diet, exercise and, if necessary, drugs, the report said.

“Diabetes management actually worsened in the past 10 years,” Dr. Jaime Davidson, a diabetes specialist at the University of Texas Southwestern Medical School in Dallas, said at a press conference.

“We have the tools, but we are not doing better.”

Unlike juvenile or Type-1 diabetes, Type-2 diabetes is almost exclusively caused by poor diet and a lack of exercise, although it may involve a genetic susceptibility. As many as 18 million Americans have it, including a growing number of children and young adults.

Type-2 diabetes can be prevented with improved diet and exercise. It also can be controlled by doing the same, but many people also need medications to control it and some eventually may need insulin.

The American Association of Clinical Endocrinologists and the American College of Endocrinology commissioned a survey of 157,000 people with Type-2, or adult-onset, diabetes.

The researchers looked at a blood sugar reading called A1C, and found that 67 percent of the patients did not have an adequate A1C level.

“Two out of every three people analyzed in this study were not in control of their blood sugar,” said Dr. Lawrence Blonde of the Ochsner Clinic in New Orleans.

In every state, 50 percent or fewer patients had adequate blood sugar control, they found.

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

A separate, Harris Interactive survey of 501 adults with diabetes showed that more than 60 percent don’t know what A1C is. And 84 percent think they are 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. They can damage the tiny capillaries inside the eyes and kidneys, causing blindness and kidney failure.

Surgeon General Richard Carmona said 40 percent of Americans ages 40 to 74 have pre-diabetes. They still have a chance to prevent diabetes if they begin to exercise and eat more healthily. “We must do something about this now,” he said.

“Every single year, we add 1.2 million Americans with this problem,” Dr. Davidson said. “It cost us in 2002 about $132 billion.”

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