Over 537 million adults (aged 20–79) worldwide have diabetes, projected to rise to 783 million by 2045.

Introduction

Diabetes is a chronic metabolic disorder characterized by elevated blood glucose levels due to insufficient insulin production, impaired insulin action, or both. It affects millions globally and poses a significant health and economic burden due to its complications and associated comorbidities.

 

The Burden of Diabetes

Global Impact

• Prevalence: Over 537 million adults (aged 20–79) worldwide have diabetes, projected to rise to 783 million by 2045.
• Morbidity and Mortality: Diabetes was responsible for 6.7 million deaths in 2021, with a significant proportion due to complications such as cardiovascular disease and kidney failure.
• Economic Impact: The global healthcare expenditure on diabetes exceeded $966 billion in 2021, driven by direct medical costs and productivity losses.

In the United States

• Prevalence: More than 37 million Americans (11.3% of the population) have diabetes.
• Prediabetes: An additional 96 million adults have prediabetes, a condition with elevated blood sugar levels but not yet in the diabetic range.
• Control Rates: Many individuals with diabetes struggle to maintain optimal blood sugar levels, increasing the risk of complications.

 

Etiology of Diabetes

Types of Diabetes

1. Type 1 Diabetes (T1D):
   • An autoimmune condition where the body destroys insulin-producing beta cells in the pancreas.
   • Typically diagnosed in childhood or adolescence.
2. Type 2 Diabetes (T2D):
   • Characterized by insulin resistance and a gradual decline in insulin production.
   • Strongly associated with obesity, sedentary lifestyle, and genetic predisposition.
3. Gestational Diabetes:
   • Occurs during pregnancy and increases the risk of developing T2D later.

Risk Factors for Type 2 Diabetes

• Modifiable:
  • Obesity (especially central or visceral adiposity)
  • Physical inactivity
  • Poor dietary habits (high in processed foods and added sugars)
  • Smoking and excessive alcohol intake
• Non-modifiable:
  • Family history of diabetes
  • Age (risk increases after age 45)
  • Ethnicity (higher prevalence in African Americans, Hispanics, Native Americans, and Asians)

Health Complications of Diabetes

Short-Term Complications

• Hyperglycemia: Can lead to diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) in severe cases.
• Hypoglycemia: Low blood sugar levels, often due to medication or inadequate food intake.

Long-Term Complications

1. Cardiovascular Disease:
   • Leading cause of death in people with diabetes.
   • Includes heart attack, stroke, and peripheral arterial disease.
2. Kidney Disease (Diabetic Nephropathy):
   • Diabetes is the leading cause of chronic kidney disease and end-stage renal disease.
3. Nerve Damage (Diabetic Neuropathy):
   • Affects peripheral and autonomic nerves, leading to symptoms such as pain, tingling, and digestive issues.
4. Eye Damage (Diabetic Retinopathy):
   • Leading cause of blindness in working-age adults.
5. Foot Complications:
   • Poor wound healing and infections can lead to amputations.
6. Increased Risk of Infections:
   • Due to immune system impairments.

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What is Diabetes Remission?

Diabetes remission refers to maintaining blood sugar levels within the non-diabetic range for an extended period without the use of glucose-lowering medications.

Criteria for Remission (T2D)

• HbA1c (Glycated Hemoglobin): Below 6.5% (48 mmol/mol) for at least three months.
• Fasting Blood Glucose: Below 126 mg/dL (7.0 mmol/L).
• Oral Glucose Tolerance Test (OGTT): Below diabetic thresholds.

Is Remission Possible?

Yes, remission is achievable, particularly for individuals with T2D, through significant dietary and lifestyle changes. Early intervention, especially within the first few years of diagnosis, improves the likelihood of remission.

 

Dietary and Lifestyle Changes to Reduce or Put Diabetes in Remission

1. Dietary Changes

Adopt a Low-Carbohydrate or Ketogenic Diet

• Mechanism: Reduces glucose load, lowers insulin levels, and improves insulin sensitivity.
• Foods to Focus On: Non-starchy vegetables, healthy fats, lean proteins, and low-glycemic fruits.

Embrace the Mediterranean Diet

• Components: High in vegetables, whole grains, healthy fats (olive oil, nuts), and lean proteins (fish, poultry).
• Benefits: Improves glycemic control and cardiovascular health.

Increase Fiber Intake

• Sources: Whole grains, legumes, vegetables, and fruits.
• Effect: Slows glucose absorption and promotes satiety.

Reduce Added Sugars and Processed Foods

• Limit sugary beverages, baked goods, and ultra-processed snacks.

Portion Control and Calorie Restriction

• Weight loss is a key driver of remission, with even a 5–10% reduction in body weight significantly improving outcomes.

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2. Lifestyle Modifications

Increase Physical Activity

• Guidelines:
  • 150 minutes of moderate-intensity aerobic activity per week (e.g., brisk walking, cycling).
  • Incorporate resistance training at least twice per week to improve insulin sensitivity.

Stress Management

• Techniques: Yoga, meditation, and deep breathing exercises help lower cortisol levels, which can impair glucose regulation.

Quit Smoking and Limit Alcohol Consumption

• Smoking exacerbates insulin resistance, while excessive alcohol adds empty calories and can destabilize glucose levels.

Prioritize Sleep

• Aim for 7–9 hours of high-quality sleep per night. Poor sleep can worsen insulin resistance.

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Conclusion

Diabetes remains a significant public health challenge, but it is a manageable and potentially reversible condition. With targeted dietary and lifestyle interventions, individuals with T2D can reduce complications and, in many cases, achieve remission. Early diagnosis and consistent efforts toward a healthier lifestyle are key.

Get Support

Medela Numen Wellness offers personalized hypertension management programs, including nutritional counseling, fitness plans, and stress management techniques. Contact us at (213) 732-6477 or send HEALTH INQUIRY to start your journey toward better health.

Around 30–45% of adults worldwide have hypertension, with higher rates in low- and middle-income countries

Introduction

Hypertension, or high blood pressure, is a leading global health concern. It affects over 1.3 billion people worldwide and is often referred to as the “silent killer” due to its lack of symptoms until complications arise. Hypertension is a major risk factor for cardiovascular diseases (CVD), stroke, kidney failure, and premature mortality.

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Burden of Hypertension

Global Impact

• Prevalence: Around 30–45% of adults worldwide have hypertension, with higher rates in low- and middle-income countries.
• Morbidity and Mortality: Hypertension is responsible for an estimated 10.8 million deaths annually.
• Economic Impact: The condition imposes substantial healthcare costs due to its complications, including hospitalizations, medications, and lost productivity.

In the United States

• Nearly half of all adults (116 million) have hypertension.
• Only about 1 in 4 individuals have their condition under control.

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Etiology of Hypertension

Hypertension arises from a combination of genetic, environmental, and lifestyle factors.

Primary (Essential) Hypertension

• Definition: Accounts for 90–95% of cases with no identifiable medical cause.
• Risk Factors:
  • Age: Blood pressure typically increases with age.
  • Genetics: Family history of hypertension increases risk.
  • Lifestyle factors: Poor diet, sedentary lifestyle, and obesity.

Secondary Hypertension

• Definition: Caused by an underlying condition, accounting for 5–10% of cases.
• Common Causes:
  • Kidney disease
  • Hormonal disorders (e.g., Cushing’s syndrome, hyperaldosteronism)
  • Sleep apnea
  • Certain medications (e.g., oral contraceptives, NSAIDs)

Health Complications of Hypertension

Chronic high blood pressure can damage organs and lead to severe health conditions:

1. Cardiovascular Disease

• Heart Attack and Heart Failure: Excessive pressure strains the heart, leading to left ventricular hypertrophy and eventual heart failure.
• Aneurysms: Persistent high pressure can weaken arterial walls.

2. Stroke

Hypertension increases the risk of ischemic and hemorrhagic strokes by damaging blood vessels in the brain.

3. Chronic Kidney Disease (CKD)

Elevated blood pressure damages the renal arteries, impairing kidney function and potentially leading to kidney failure.

4. Vision Loss

Hypertension can damage the blood vessels in the eyes, leading to hypertensive retinopathy and, in severe cases, blindness.

5. Cognitive Decline

High blood pressure is associated with an increased risk of vascular dementia and Alzheimer’s disease.

 

Dietary and Lifestyle Changes to Manage or Eliminate Hypertension

1. Dietary Interventions

Adopt the DASH Diet

• Overview: The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes heart-healthy eating.
• Key Components:
  • Fruits, vegetables, whole grains, and lean proteins
  • Low-fat dairy products
  • Reduced sodium intake
  • Limited saturated fats and trans fats

Reduce Sodium Intake

• Recommendation: Limit sodium to less than 2,300 mg/day; ideal intake is 1,500 mg/day.
• Sources to Avoid: Processed foods, canned soups, and salty snacks.

Increase Potassium-Rich Foods

• Sources: Bananas, spinach, sweet potatoes, and avocados.
• Mechanism: Potassium helps balance sodium levels and reduce blood pressure.

Limit Alcohol Consumption

• Guideline: No more than one drink per day for women and two for men.

Maintain a Healthy Weight

• Mechanism: Weight loss reduces strain on the cardiovascular system and lowers blood pressure.

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2. Lifestyle Modifications

Increase Physical Activity

• Guidelines:
  • 150 minutes of moderate-intensity aerobic exercise per week.
  • Include resistance training to improve overall heart health.
• Examples: Brisk walking, cycling, swimming, and strength training.

Stress Management

• Techniques:
  • Meditation, yoga, or deep breathing exercises.
  • Engaging in hobbies and maintaining social connections.

Quit Smoking

• Smoking damages blood vessels and exacerbates hypertension risks.

Improve Sleep Quality

• Recommendations:
  • 7–9 hours of restful sleep per night.
  • Address sleep disorders like sleep apnea.

Limit Caffeine

• While effects vary, reducing caffeine can benefit those sensitive to its blood-pressure-raising effects.

Get Support

Medela Numen Wellness offers personalized hypertension management programs, including nutritional counseling, fitness plans, and stress management techniques. Contact us at (213) 732-6477 or send HEALTH INQUIRY to start your journey toward better health.