Young Adult Diabetes - ABC News

A study that suggests half of American adults have diabetes or prediabetes may not be as clear-cut as it seems.

The Glycemic Load Diabetes Solution: Six Steps to Optimal Control of Your Adult-Onset (Type 2) Diabetes

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  • Diabetes is an important health condition for the aging population; at least 20% of patients over the age of 65 years have diabetes, and this number can be expected to grow rapidly in the coming decades. Older individuals with diabetes have higher rates of premature death, functional disability, and coexisting illnesses such as hypertension, CHD, and stroke than those without diabetes. Older adults with diabetes are also at greater risk than other older adults for several common geriatric syndromes, such as polypharmacy, depression, cognitive impairment, urinary incontinence, injurious falls, and persistent pain.

    Though scientific evidence continues to be limited, it is clear that early and ongoing attention be given to comprehensive and coordinated planning for seamless transition of all youth from pediatric to adult health care (,). A comprehensive discussion regarding the challenges faced during this period, including specific recommendations, is found in the ADA position statement “Diabetes Care for Emerging Adults: Recommendations for Transition From Pediatric to Adult Diabetes Care Systems” ().

  • All adults with diabetes should undergo a comprehensive foot examination to identify high-risk conditions at least annually. Clinicians should ask about history of previous foot ulceration or amputation, neuropathic or peripheral vascular symptoms, impaired vision, tobacco use, and foot care practices. A general inspection of skin integrity and musculoskeletal deformities should be done in a well-lit room. Vascular assessment would include inspection and assessment of pedal pulses.

    Information on presence of abnormal urine albumin excretion in addition to level of GFR may be used to stage CKD. The National Kidney Foundation classification () is primarily based on GFR levels and may be superseded by other systems in which staging includes other variables such as urinary albumin excretion (). Studies have found decreased GFR in the absence of increased urine albumin excretion in a substantial percentage of adults with diabetes (). Substantial evidence shows that in patients with type 1 diabetes and persistent albumin levels 30–299 mg/24 h, screening with albumin excretion rate alone would miss >20% of progressive disease (). Serum creatinine with estimated GFR should therefore be assessed at least annually in all adults with diabetes, regardless of the degree of urine albumin excretion.

  • In 2010, a position statement of the ADA, the American Heart Association (AHA), and the American College of Cardiology Foundation (ACCF) recommends that low-dose (75–162 mg/day) aspirin for primary prevention is reasonable for adults with diabetes and no previous history of vascular disease who are at increased CVD risk (10-year risk of CVD events over 10%) and who are not at increased risk for bleeding. This generally includes most men over age 50 years and women over age 60 years who also have one or more of the following major risk factors: 1) smoking, 2) hypertension, 3) dyslipidemia, 4) family history of premature CVD, and 5) albuminuria ().

Do Half Of American Adults Have Diabetes

The individual shown below knows that he has to follow a diet low in processed carbohydrates and exercise. But in his mid-50's, he isn't going to change. He did start testosterone replacement with injections and then long-acting pellets. His fasting insulin levels dropped in half and the amount of stored sugar in his cells as related to Hemoglobin A1C improved dramatically. He has continued on this regimen for three years. His has been able to decrease his oral medication for adult onset diabetes in half while losing 20 pounds. He feels well enough to work long hours as a truck driver and enjoys his time with his wife and grandchildren. As long as his disease is stable, we feel we are positively impacting on his disease. We reinforce his need for dietary change (low carbohydrate), exercise and regular physician monitoring.