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Year 2000 Babies High Risk for Diabetes

Posted: Tuesday, October 21, 2003

Bad news for the first Americans of the New Millennium: One in three babies born in 2000 will likely develop diabetes in their lifetime, new CDC calculations show. Women and minorities face the greatest risk.

These predictions, reported in this week's issue of the Journal of the American Medical Association, are part of the first-ever report that estimates Americans' lifetime risk of type 2 diabetes, researcher of the study, K.M. Venkat Narayan, MD, the CDC's chief of diabetes epidemiology says.

His report shows that between now and 2050, the number of Americans diagnosed with the disease will increase 165% from current rates. Today, nearly 17 million Americans -- that's about 7% of the population -- have the disease, says the American Diabetes Association. That figure includes nearly 6 million who are unaware of it.

"Obesity is the driving factor for the increase," Venkat Narayan tells WebMD. "In the last 10 years, the number of people with diabetes has increased by almost 50%, while the proportion of people who are obese has also increased greatly."

His study predictions are based on obesity and other lifestyle patterns that occurred in the U.S. between 1984 and 2000, along with U.S. Census Bureau population trends and estimates accounting for age, ethnicity, and gender.

According to his report, Hispanic babies face the greatest risk: Nearly 53% of girls and 45% of boys born in 2000 are expected to develop diabetes before they die. About 40% of male and female black babies born three years ago are predicted to develop diabetes, along with one in three white females and one in four white males.

"We're not saying these babies will get diabetes as children -- rather, they will develop it at some point in their life," says Venkat Narayan. "While type 2 diabetes is occurring more frequently in children than it used to, it's still a very rare disease in children."

But he tells WebMD that if current obesity levels continue, these kids may get the disease earlier than past generations. Venkat Narayan predicts that a diagnosis at age 40 would shave up to 15 years off a patient's life.

"The message here is for all Americans -- diabetes is an epidemic," he tells WebMD. "But the good news is that in the last few years, studies are showing that it can be prevented or at least delayed."

The Path to Prevention

The path to prevention -- as you probably already know -- is to lose excess weight and practice a healthy lifestyle. In one recent study, the Diabetes Prevention Program by the National Institutes of Health, researchers found that regular exercise and weight loss was the most effective way to lower diabetes risk. That finding, published last year in the New England Journal of Medicine, evaluated different options in more than 3,000 people at least 51 years old with a prediabetes condition called "impaired glucose intolerance" -- a condition that increases the risks for developing diabetes.

Those who began exercising about 30 minutes a day and lost 5% to 7% of their body weight (about 10 to 12 pounds in someone weighing 200 pounds) lowered their disease risk by 58% compared with a control group who did nothing. That reduction was twice as much as the 29% drop in risk seen in another group of patients, given the drug Glucophage, which lowers blood sugar levels by helping insulin work better.

Mayo Clinic endocrinologist and American Diabetes Association spokesman Robert A. Rizza, MD, who was not involved in the new study, says that "while the numbers are disturbing," he isn't surprised by the CDC calculations.  

"There have been a lot of hints that this is becoming a major problem, and the CDC did an excellent job at putting together a different way of looking at this," he tells WebMD. "Rather than just look at prevalence, it's easier for most of us to look at the lifetime risk.  

"But these numbers can be markedly changed. One of the dilemmas in having diabetes is that you're essentially told, bad things will happen to you. I think the message is that while the chances of bad things happening are increased, if you take care of it, you can reduce those chances dramatically."   

Source: WebMD: Venkat Narayan, K. The Journal of the American Medical Association, Oct. 8, 2003; vol 290: pp 1884-1890. Knowler, W. The New England Journal of Medicine, Feb. 7, 2002; vol 346: pp 393-403. K.M. Venkat Narayan, MD, chief, diabetes epidemiology, CDC, Atlanta; adjunct professor, epidemiology and international health, Emory University Rollins School of Public Health, Atlanta. Robert A. Rizza, MD, professor, medicine, Mayo Clinic College of Medicine, Rochester, Minn.; vice-president, American Diabetes Association.

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