Diabetes Diagnoses Have Doubled

You've probably seen the headlines or the TV news stories about how the incidence Diabetes has Doubled in the past ten years.

Here, from U.S. News and World Report is a typical version of this story:

Rate of Diabetes Cases Doubles in 10 Years: CDC--The obesity epidemic is fueling the type 2 disease epidemic, officials say

As is the case with just about all reporting about Type 2 Diabetes this story neglects to mention some very important facts that explain some of this rise as being in truth a rise in diabetes diagnoses which is NOT the same as a rise in the actual incidence.

The Diagnostic Criteria were Improved in 1998

In 1998, before the ADA revised its document setting out the Diagnostic Criteria for Diabetes Mellitus, most doctors only diagnosed diabetes when people's fasting blood
sugar was over 140 mg/dl.

In 1998, the fasting cutoff was changed to 125 mg/dl.

This change resulted in people getting earlier diagnoses and earlier treatment. This is good, not bad!

Doctors are Screening More Aggressively

There are a lot more drug companies pushing a lot more diabetes drugs now than there were in 1998, and one side effect of this is that doctors are being urged to screen patients more aggressively. In 1998 many doctors were still screening patients for diabetes with a urine dip test which often misses evidence of high blood sugars.

Back in 1998, I did not test positive on a urine dip test until my blood sugar was 240 mg/dl three hours after eating (and that reading was taken with a blood calibrated meter, so the actual plasma reading would have been 12% higher.)

More Doctors are Finally Taking "Pre-Diabetes" Seriously

Fifteen years ago I was told that "pre-diabetes" was a "fad diagnosis" even though I'd been diagnosed years before with "pre-diabetes" on a glucose tolerance test. Even when she learned that my blood sugars were going into the 200s after ever meal, my doctor back in 1998 told me it was "nothing to worry about" because the blood sugars eventually came down to around 100 mg/dl by the next morning.

Since then, many, though not all, doctors have come to realize that pre-diabetes and what they used to consider "Mild" diabetes imply the presence of blood sugars high enough to cause "diabetic complications" and need to be diagnosed and treated.

The Baby Boom is Aging

The incidence of Diabetes rises as people get older. It always has. Women, in particular, become much more insulin resistant after menopause, unmasking blood sugar abnormalities that were hidden until then.

What is changing is that there are a lot more people now in the age group where these diagnoses start to rise since the huge population mass we call the "Baby Boom" is now mostly in its 50s.

So we might just as honestly ascribe the increase in diabetes to an "epidemic of menopause" as to the "obesity epidemic." This isn't a real epidemic, it's a well-understood demographic change.

Given these facts, the increase in diabetes diagnosis may be good news, because it means people are getting diagnosed earlier and with blood sugar levels that were ignored in the past to the point where many a person died of a diabetic heart attack without ever learning they were diabetic.

In addition, earlier diagnosis makes it possible for people with diabetes to avoid the horrible complications that were the fate of people a generation ago who were diagnosed only after they had already developed neuropathy, retinopathy, and early signs of kidney damage.

The growth in the incidence in Type 2 diabetes that is not accounted for by the above factors is probably explained by these:

1. There is a huge, not well-understood explosion in the incidence autoimmune diseases of all kinds. A surprising number of those diagnosed with "Type 2" diabetes have antibodies characteristic of autoimmune diabetes.

2. Toxic chemicals like the Bisphenol-A that lines our tin cans are now known to promote insulin resistance and obesity. Other chemicals known to cause diabetes are PCBs and pesticides, both of which are found in human bodies at alarming rates. The chemical industry would prefer that you keep blaming people for causing their obesity and their diabetes through gluttony because it would be very expensive for them to remove these chemicals from our environment.

3. The Drugs Used to Treat Depression Cause Weight Gain, Insulin Resistance, and Diabetes. The overmarketing of psychiatric drugs to people with normal, if unpleasant, human emotions is a major, unexplored, cause for our current "obesity" epidemic. If the people reporting about health in the media ever did anything more than read press releases you'd learn about this. But because these drugs are so profitable, the drug companies have kept this information out of the news.