In a sign that Americans may finally be turning the corner in the fight against diabetes – and possibly obesity – federal health statistics released on Tuesday show that the number of new cases of diabetes has dropped for the first time in decades.
A little surprising
The decline wasn't sudden or dramatic. But, the number of new diabetes cases went from 1.7 million in 2009 to 1.4 million in 2014, according to the U.S. Centres for Disease Control and Prevention.
"It seems pretty clear that incidence rates have now actually started to drop. Initially it was a little surprising because I had become so used to seeing increases everywhere we looked," CDC researcher Edward Gregg told The New York Times.
The proportion of Americans with diabetes is still twice what it was in the early 1990s. And not every racial group has made strides against the blood sugar disease, which is often triggered by obesity and lack of exercise.
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Also, another report released Tuesday at the World Diabetes Congress in Vancouver, Canada, shows that the United States still has the highest diabetes rate among 38 developed nations. However, the CDC report offers some encouraging indications that Americans may finally be adopting healthier lifestyles.
For example, fewer whites are now being diagnosed with diabetes – typically type 2 diabetes – by far the most common form of the disease. But, blacks and Hispanics haven't seen significant declines in diagnoses even though a downward trend is starting to emerge, the CDC report showed.
A more sobering assessment
Educated Americans also have seen improvements in diabetes diagnoses, while the less educated have only seen a flattening in the number of new cases, the report found.
"It's not yet time to have a parade," Dr David Nathan, director of the Diabetes Centre and Clinical Research Centre at Massachusetts General Hospital in Boston, told the Times. But, "it has finally entered into the consciousness of our population that the sedentary lifestyle is a real problem, that increased body weight is a real problem".
The World Diabetes Congress report offered a more sobering assessment of diabetes in the United States.
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The report found that 11 percent of Americans between the ages of 20 and 79 have diabetes. The 30 million Americans who have diabetes equal roughly two-thirds of the 46 million people who have the disease in the other 37 nations combined.
Other developed nations with high rates of diabetes include Singapore (10.5 percent), Malta and Portugal (10 percent each), and Cyprus (9.5 percent).
The lowest rates are in Lithuania, Estonia and Ireland – about 4 percent each, according to the report.
Contributing lifestyle factors
"The prevalence of type 1 and type 2 diabetes is increasing worldwide," said Dr Nam Cho, chairman of the International Diabetes Federation (IDF) Diabetes Atlas committee. Cho is a professor of preventative medicine at Ajou University School of Medicine in South Korea.
"While the exact cause of type 1 diabetes is currently unknown, trends such as urbanisation, unhealthy diets and reduced physical activity are all contributing lifestyle factors that increase the risk of type 2 diabetes," Cho said in an IDF news release.
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An estimated 415 million people worldwide have diabetes, and about 47 percent remain undiagnosed.
While the United States has the highest diabetes rate among developed nations, it ranks 60th worldwide. China and India have the highest total number of people with diabetes – 110 million and 69 million, respectively – but not the highest rates, with 10 percent and 9 percent, respectively, according to the World Diabetes Congress report.
About 90 percent of Americans with diabetes have type 2 diabetes, which causes a buildup of glucose (sugar) in the blood. It's typically treated with lifestyle changes, oral medications and insulin, the hormone that transports blood sugar to cells in the body for energy.
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When too much glucose accumulates in the blood, it can cause two problems: cells in the body may be starved for energy, and over time the condition can damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA).
Type 1 diabetes is usually diagnosed in children and young adults, although more older adults are being diagnosed with the disease.
In type 1 diabetes, the body does not produce insulin. With the use of insulin therapy and other treatments, even young children can manage the condition and live long, healthy lives, according to the ADA.
Type 1 complications can include kidney failure, blindness and foot amputations.
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