The Triangle Physician October 2011

Page 9

Cary Internal Medicine offers a full range of

third is undiagnosed and untreated.)

medical services, including routine physical

•T ype 2 diabetes accounts for 95

and gynecologic examinations. Patients

percent of all diabetes cases.

have in-office access to the latest diagnostic

vascular) complications. Unlike patients with type 1 diabetes, the majority of patients with type 2 do not need insulin to survive.

•A pproximately 20.6 million Americans

tests and treatments, such as: • Cardiovascular risk assessment, using treadmill stress testing,

age 20 and older, or 9.6 percent of the

According

population, have diabetes.

Education Program, heart disease and stroke

•A mong those age 65 and older 10.9

electrocardiograms and lipid profiles; • Pulmonary function testing, using spirometry, and nebulizer treatments; skin tag, wart and mole removal, biopsies and laceration repairs;

the

National

Diabetes

accounted for about 65 percent of deaths in

million, or 26.9 percent are diagnosed

people with diabetes in 2002. Adults with

with diabetes.

diabetes had heart disease death rates two

•O f those younger than 20,

• Minor surgical procedures, such as

to

to four times higher than adults without

approximately 215,000 have diabetes

diabetes. Their risk for stroke also was two to

(type 1 or type 2).

four times higher.

•A bout 79 million Americans over age

• Bone density testing; and

20 (50 percent of adults age 65 and

Obesity and age are major risk factors for

• Vision testing.

older) have pre-diabetes.

diabetes. Abdominal obesity is an indicator of insulin resistance. The abdominal fat is

Medical care is expedited and convenience

Type 1 diabetes can occur at any age, most

thought to prohibit insulin from converting

is enhanced by onsite laboratory services.

commonly in juveniles but also in adults,

sugar, starches and other food into energy needed for daily life.

“Diabetes is, as yet, incurable, but it is manageable with aggressive lifestyle changes and medication. Because diabetes and prediabetes are associated with the myriad health problems that internists treat, helping patients effectively manage diabetes and pre-diabetes to reduce complications has always been central to our practice.” – Prashant Patel, M.D., F.A.C.P.

“The epidemic of obesity in America and our aging population, coupled with lack of awareness, assure the incidence of diabetes will increase,” says Dr. Patel. NDEP estimates the total number of people with diabetes in the United States will be 30.3 million in 2030, which will place the United States third in global prevalence, after India and China. “If recent trends in diabetes and pre-diabetes prevalence rates continue linearly over the next 50 years, future changes in the size and demographic characteristics of the U.S.

State of Diabetes in Nation a Concern

especially in their late 30s and early 40s.

population will lead to dramatic increases

Unlike people with type 2 diabetes, those

in the number of Americans with, or at risk

The statistics for diabetes are grim. Diabetes

with type 1 generally are not obese. The

for, diabetes,” says Dr. Juneja. “The current

– a group of diseases marked by high levels

distinguishing characteristic of a patient with

increase in the number of new cases in

of blood glucose resulting from defects in

type 1 diabetes is that ketosis and eventually

people age 40 to 59 raises the need for

insulin production, insulin action or both –

ketoacidosis develop if insulin is withdrawn.

interventions focused on this segment of the

ranks seventh as the leading cause of death

Therefore, these patients are dependent on

population.”

by disease in the United States. According

exogenous insulin.

to the Centers for Disease Control and

NDEP estimated the cost of diabetes in 2010

Prevention, the risk for death among people

Type 2 diabetes comprises an array of

at $174 billion. The total includes direct

with diabetes is about twice that of people of

dysfunctions resulting from the combination

medical costs ($116 billion) and indirect

similar age who do not have diabetes.

of

and

costs ($58 billion), those associated with

inadequate insulin secretion. Its disorders

loss of work, disability and premature

are

hyperglycemia

death. After adjusting for population age

• Diabetes affects 25.8 million people in

and associated with microvascular (i.e.,

and gender differences, the average medical

the United States, or 8.3 percent of the

retinal, renal, possibly neuropathic) and

expenditures among people with diagnosed

population. (Of that total, about one-

macrovascular (i.e., coronary, peripheral

diabetes were 2.3 times higher than what

Its 2011 fact sheet also reports:

resistance

to

characterized

insulin by

action

October 2011

7


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