Diabetes: Difference between revisions

For at least 20 years, diabetes rates in North America have been increasing substantially. In 2010, nearly 26 million people have diabetes in the United States, of whom 7 million people remain undiagnosed. Another 57 million people are estimated to have prediabetes.<cite>41</cite><cite>42</cite>

The Centers for Disease Control and Prevention (CDC) has termed the change an epidemic.<cite>43</cite> The National Diabetes Information Clearinghouse estimates diabetes costs $132 billion in the United States alone every year. About 5%–10% of diabetes cases in North America are Type 1, with the rest being Type 2. The fraction of Type 1 in other parts of the world differs. Most of this difference is not currently understood. The American Diabetes Association (ADA) cites the 2003 assessment of the National Center for Chronic Disease Prevention and Health Promotion (Centers for Disease Control and Prevention) that one in three Americans born after 2000 will develop diabetes in their lifetimes.<cite>44</cite><cite>45</cite>

According to the ADA, about 18.3% (8.6 million) of Americans age 60 and older have diabetes.<cite>46</cite> Diabetes mellitus prevalence increases with age, and the numbers of older persons with diabetes are expected to grow as the elderly population increases in number. The National Health and Nutrition Examination Survey (NHANES III) demonstrated, in the population over 65 years old, 18% to 20% have diabetes, with 40% having either diabetes or its precursor form of impaired glucose tolerance.<cite>47</cite>

Diabetes was one of the first diseases described,<cite>48</cite> with an Egyptian manuscript from Circa 1500 BCE mentioning ''too great emptying of the urine''.<cite>49</cite> The first described cases are believed to be of Type 1 diabetes.<cite>49</cite> Indian physicians around the same time identified the disease and classified it as ''madhumeha'' or ''honey urine'', noting the urine would attract ants.<cite>49</cite> The term ''diabetes'' or ''to pass through'' was first used in 230 BCE by the Greek Appollonius of Memphis.<cite>49</cite> The disease was considered as rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career.<cite>49</cite> This is possibly due the diet and life-style of the ancient people, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease ''diarrhea of the urine'' (diarrhea urinosa). The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd c. CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of  the ''Pneumatic School''. He hypothesized a correlation of diabetes with other diseases and he discussed differential diagnosis from the snakebite which also provokes excessive thirst. His work remained unknown in the West until the middle of the 16th century when, in 1552, the first Latin edition was published in Venice.<cite>50</cite>

Type 1 and Type 2 diabetes where identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400-500 CE with Type 1 associated with youth and Type 2 with being overweight.<cite>49</cite> The term ''mellitus'' or ''from honey'' was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination.<cite>49</cite> Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922.<cite>49</cite> This was followed by the development of the long-acting insulin NPH in the 1940s.<cite>49</cite>

The word ''diabetes'' comes from Latin diabētēs, which in turn comes from Ancient Greek διαβήτης (diabētēs) which literally means ''a passer through; a siphon.''<cite>51</cite> Ancient Greek physician Aretaeus of Cappadocia (fl. 1st century CE (Common Era)) used that word, with the intended meaning ''excessive discharge of urine'', as the name for the disease.<cite>52</cite><cite>53</cite> Ultimately, the word comes from Greek διαβαίνειν (diabainein), meaning ''to pass through,''<cite>51</cite> which is composed of δια- (dia-), meaning ''through'' and βαίνειν (bainein), meaning ''to go''.<ref name=OnlineEtymology_diabetes/> The word ''diabetes'' is first recorded in English, in the form ''diabete'', in a medical text written around 1425.

The 1990 ''St. Vincent Declaration''<cite>57</cite><cite>58</cite> was the result of international efforts to improve the care accorded to those with diabetes. Doing so is important not only in terms of quality of life and life expectancy, but also economically—expenses due to diabetes have been shown to be a major drain on health- and productivity-related resources for healthcare systems and governments.

Several countries established more and less successful national diabetes programmes to improve treatment of the disease.<cite>59</cite>

Diabetic patients with neuropathic symptoms such as numbness or tingling in feet or hands are twice as likely to be unemployed as those without the symptoms.<cite>60</cite>