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
- Type 1 Diabetes (T1D):
- An autoimmune condition where the body destroys insulin-producing beta cells in the pancreas.
- Typically diagnosed in childhood or adolescence.
- Type 2 Diabetes (T2D):
- Characterized by insulin resistance and a gradual decline in insulin production.
- Strongly associated with obesity, sedentary lifestyle, and genetic predisposition.
- 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
- Cardiovascular Disease:
- Leading cause of death in people with diabetes.
- Includes heart attack, stroke, and peripheral arterial disease.
- Kidney Disease (Diabetic Nephropathy):
- Diabetes is the leading cause of chronic kidney disease and end-stage renal disease.
- Nerve Damage (Diabetic Neuropathy):
- Affects peripheral and autonomic nerves, leading to symptoms such as pain, tingling, and digestive issues.
- Eye Damage (Diabetic Retinopathy):
- Leading cause of blindness in working-age adults.
- Foot Complications:
- Poor wound healing and infections can lead to amputations.
- Increased Risk of Infections:
- Due to immune system impairments.
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.
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.
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.
