DIABETES FACTS
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THE DANGEROUS TOLL OF DIABETES

• Over 15 million persons have diabetes in U.S.

• One third are not aware that they have the disease.

• Every 60 seconds at least one person is diagnosed with diabetes.

• About 798,000 people will be diagnosed this year.

• Diabetes is the sixth leading cause of death by disease in the U. S.

• 193,000 will die from the disease and its related complications this year.

• Diabetes is a chronic disease that has no cure.

DIABETES IS A SILENT KILLER

Developing one of its life-threatening complications is often the first indication.

• BLINDNESS. In people ages 20–74, the leading cause of blindness is diabetes. 12,000 to 24,000/yr.

• KIDNEY DISEASE. 10 % of diabetics develop kidney disease.
27,900 kidney failure/yr.

• AMPUTATIONS. Non-traumatic lower limb amputations most frequent cause is diabetes. 56,000 amputations/yr.

• HEART DISEASE AND STROKE.
2 to 4 times more likely to have heart disease. 77,000 deaths/yr.
2 to 4 times more likely to suffer a stroke. 11,000 deaths/yr.

DIRECT AND INDIRECT COSTS OF DIABETES

• Health care and related costs for treatment, as well as the cost of lost productivity nearly $98 billion /yr.

Source: AMERICAN DIABETES ASSOCIATION
Used with permission from © 2001 UTHSCSA "Positively Aging®"

DIABETES FACTS
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WHO IS AT RISK?

• OVER 30 AND OVERWEIGHT, AND/OR FAMILY HISTORY

• WOMEN WITH HIGH BIRTH WEIGHT BABY

• AFRICAN AMERICANS-- 1.6 times as likely as general population

• HISPANICS-- Over 2 times as likely as general population

• NATIVE AMERICANS-- 2.7 times as likely as the general population

WHAT IS DIABETES?

• Disease--body does not produce or properly use insulin

• Insulin--hormone needed to convert sugar and starches into energy

• Cause--a mystery--both genetics and environment seem to have roles

Two major types of diabetes:

• INSULIN DEPENDENT (Type I)
o Autoimmune disease - body does not produce any insulin
o Most often occurring in children and young adults
o Daily insulin injections to stay alive

• NON-INSULIN DEPENDENT (Type II)
o Metabolic disorder - body unable to make enough or properly use insulin
o Most common form of the disease

WARNING SIGNS OF DIABETES

Source: AMERICAN DIABETES ASSOCIATION
Used with permission from © 2001 UTHSCSA "Positively Aging®"

DIABETES AMONG HISPANICS

Hispanics are the fastest growing population in the country. There are more than 22 million Hispanics in the United States, an increase from close to 15 million in 1980.

• Over 1 million Hispanics in U. S. have diabetes.

• About one in every 10 Hispanic adults has diabetes.

• Over 10% of all Mexican-Americans have diabetes.

• Nearly 16 % of Cuban-American ages 45-74 have diabetes

• Approximately 25 % of Mexican Americans & Puerto Ricans between ages 45–74 have diabetes.

• Hispanic women with diabetes --significantly higher death and complication rates during pregnancy.

• Cuban Americans -- 1 1/2 times more likely to have diabetes.

• Both Mexican Americans & Puerto Rican Americans are twice
as likely to have diabetes.

Source: AMERICAN DIABETES ASSOCIATION
Used with permission from © 2001 UTHSCSA "Positively Aging®"

CULTURAL DIFFERENCES:

Cuban Americans are one and a half times more likely to get diabetes than the general
population. Both Mexican Americans and Puerto Rican Americans are twice as likely as the general population to have diabetes. For Native Americans, the chances jump to 2.7 times greater. The increased risk for developing Type II diabetes in these groups is linked to diet, exercise, and genetics.
First, the traditional diets of Native Americans and Hispanics who trace their origins to those Native Americans who crossed the Siberian land bridge from the continent of Asia thousands of years ago have changed. (These peoples include Mexican Americans, Cuban Americans, and Puerto-Rican Americans, not Hispanics from European descent such as from Spain or the Canary Islands. ) The first native peoples to come to the Americas relied on large game animals, such as the Woolly Mammoth, to survive. When those large game animals were no longer to be found, the peoples turned to small game animals, and supplemented their diets with nuts and plants that they gathered. Eventually, they moved to a system of agriculture, in which they grew their own food sources. Items that grew well were maize, beans, and squashes. This diet would be supplemented by nuts, cactus, acorns, mesquite pods, or whatever else grew or could be hunted in the area. Unlike today’s foods, excess fats and oils were not added to their dishes, so they ate very lean and healthy meals.
Today Hispanic and Native Americans may eat fast foods, or dishes prepared with added fats. For example, refried beans often contains animal fat (lard ), and tortilla chips are often fried in oil. These modern foods add fat to the diet, and too much fat can lead to obesity, which can contribute to Type II Diabetes. Next, look at the amount of exercise that the historical Native Americans did compared to Americans today. Hunting, gathering, and farming burned up a great deal of calories, and would keep the Native Americans lean and muscular. The play activities of Native Americans also provided exercise. Games often focused on hunting skills, such as running, archery, canoeing, and horseback riding.
Today, many Americans lead a sedentary lifestyle, meaning that they get little or no exercise. Pushing buttons on a remote control does not burn up too many calories. Once the calorie level consumed exceeds the amount of calories burned, the person will experience weight gain. If a person is 20% overweight, they are considered obese, and at higher risk of developing Type II diabetes.
Lastly, it is thought by scientists that these descendents of historical Native Americans are genetically predisposed to obesity. Often, these historical Native Americans went through times in which there were no animals to hunt and other sources of food were too scarce. Their bodies eventually evolved to adapt to these tough situations by storing fat more easily in times of plentiful food. By storing this extra fat in times of feast, the peoples could survive through times of famine. Scientists have named this gene the thrifty gene. Since many Hispanic Americans are descendents of these Asiatic Native Americans, they also have this gene. Today, most people do not experience times of starvation, but instead have an adequate food supply. If that food supply contains too many fats and a person does not get enough exercise, there will be weight gain. The thrifty gene further complicates matters. Since the thrifty gene promotes weight gain, it also stimulates increased insulin production. This overproduction of insulin leads to high concentrations of insulin in the blood, which leads to impairment of insulin action. Since the insulin does not work properly, Type II diabetes results.
For these descendents of Native Americans, it is highly recommended that a low-fat diet supplemented with exercise be utilized to keep weight within normal limits. Type II
diabetes can be prevented, if one takes care of him/herself, and does not become obese.

Used with permission from © 2001 UTHSCSA "Positively Aging®"

CULTURAL DIFFERENCES: DISCUSSION QUESTIONS

Refer to the reading, "Cultural Differences" to answer the following questions.

1. Why do Hispanic and Native Americans have an increased risk of developing
Type II diabetes?

2. According to this article, how have lifestyles changed (since the historical Native
American s) to lead to the development of Type II Diabetes?

3. How do today’s foods differ than the foods of historical Native Americans?

4. How have leisure activities changed over time?

5. What is the gene that descendents of Native Americans have, and what does
that gene do to promote Type II diabetes?