An Evolution of Diabetes

EVOLUTION

Diabetes is a major public health problem with a rapid increase in prevalence globally. Twelve percent of all health care spending is related to diabetes. The diagnosis and treatment of diabetes has evolved extensively over the last century. Although there is still no cure for the disorder, diabetes is much more manageable due to advancement in medicine and technology. In the beginning of the 20th century, Edward Schafer concluded that the pancreas of diabetics was unable to produce insulin and therefore excess sugar was found in their urine.

In 1936, Harold Himsworth distinguished between the two types of diabetes calling them "insulin-sensitive" and "insulin-insensitive" which is today known as type 1 and type 2 diabetes. By the 1960s the development of urine strips helped diagnose diabetes and improve management of blood sugar levels. Soon after, the creation of the single-use syringe for insulin, and the large portable glucose meters to monitor blood sugar were designed. By the 1970s, insulin pumps were developed to normalize the release of insulin in the body. These are still used daily worldwide and are modified to be light and portable. The medical advancement of treating diabetes can reveal the evolution of this disorder which has become so prevalent in today's world. Before the obesity epidemic in the USA, type 2 diabetes was known as "adult-onset" because it was unheard in people under the age of thirty. This is sadly no longer true. The number of children and teenagers with type 2 has skyrocketed over the past two decades due to lack of exercise, poor eating habits, and weight gain.

The diabetes epidemic is largely focused around the increasing rates of obesity, sedentary lifestyle, and unhealthy dieting. Currently, around 285 million people are affected and at this rate could reach 480 million by the year of 2030. Type 2 diabetes is a highly multifactorial disorder and American diet, lifestyle (exercise, smoking, alcohol consumption etc.) and genetic content are large contributing factors. Epidemiologic studies depict that a sedentary lifestyle increases risk of diabetes but more exercise reduces (image to the right for reference). For example, every 1 hour per day spent walking was associated with a 34% reduction in risk. Overweight and obesity drives this global epidemic as they affect the majority of adults in most developed countries. The number of overweight people is projected to increase from 1.3 billion in 2005 to nearly 2 billion by 2030. Several meta-analysis conducted by Frank B. Hu conclude that diet and lifestyle modification is a highly effective method to prevent type 2 diabetes and thus healthy habits should be implemented early on in life. Public policies and health systems must be shifted in order to put these findings in to practice.

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