Diabetes: Basic Information and Federal Funding Page: 3 of 6
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Diseases (NIDDK), tested 1,441 Type 1 patients to determine if strictly controlled blood
glucose levels over several years could delay the onset of complications. In the DCCT,
diabetics who maintained near normal blood sugar levels could dramatically reduce onset
and progression of long-term diabetes complications. For example, there were 40% to
70% reductions in the incidences of kidney, eye, and nerve diseases. The cost for this
close glucose-monitoring approach was double the cost of other treatments, however. The
test group also experienced more hypoglycemia, and showed modest weight gain, so this
strict protocol might not be suitable for patients under 13, the elderly, or overweight
diabetics.7 Any sustained normalization of blood sugar helps slow the progression toward
diabetic complications, and possible side effects must be balanced against the great
benefit in delaying such complications.
Public Health Impact and Cost
Diabetes is the seventh leading cause of death in the United States, the leading cause
of adult-onset blindness, and a significant contributor to debilitating health complications,
including heart disease, stroke, kidney disease (nephropathy), nerve disease (neuropathy),
and amputations. Half of the lower limb amputations in the United States are among
diabetics; diabetes also predisposes people to periodontal (gum) disease, tooth loss, and
skin infections. About a third of diabetics remain undiagnosed, and therefore are not
receiving treatment for their condition, putting them at risk for long term adverse health
Estimates of economic costs of diabetes vary considerably, and its contribution to
other diseases makes cost estimating difficult. The American Diabetes Association
estimated for 1997 that the direct and indirect cost of diabetes mellitus in the United
States exceeded $98.2 billion annually. This total contains estimates of $44.1 billion in
direct medical costs, for treatment and monitoring, and $54.1 billion in lost productivity
due to illness and premature death.'
In the United States, African-Americans, Hispanics, Native Americans, Asian
Americans and Pacific Islanders, have a greater likelihood of developing Type 2 diabetes.
White Americans are more likely to get Type 1 diabetes than are non-whites. In 1997, the
total prevalence of known, diagnosed cases of diabetes was estimated to be between 8-10
million. At the same time, undiagnosed cases are estimated to be between 4-5 million.
An additional 13 million people are estimated to have impaired fasting glucose (glucose
of between 110 and 126 mg/dl) and 21 million to have impaired glucose tolerance (a
precursor to Type 2 diabetes.)
Risk factors for diabetes include a varied ethnic and racial background, being
overweight, having a family member with diabetes, physical inactivity, and increasing
age. In the United States, increasing numbers of people are overweight, and elderly and
' The Diabetes Control and Complications Trial Research Group, "The Effect of Intensive
Treatment of Diabetes on the Development and Progression of Long-Term Complications," New
England Journal of Medicine, v. 329, 30 September 1993, 977-86.
8 American Diabetes Association, "Economic Consequences of Diabetes Mellitus in the
U.S. in 1997," Diabetes Care 21(1998):296-309.
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Vogt, Donna U. Diabetes: Basic Information and Federal Funding, report, July 15, 1998; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc807815/m1/3/: accessed June 19, 2021), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.