Trends in Prevalence of Diabetes Among US Adults, 1999-2018
Cross-sectional study
n=28,143 participants from NHANES
Estimated age-standardized prevalence of diabetes increased significantly, from 9.8% in 1999-2000 to 14.3% in 2017-2018 jamanetwork.com/journals/jama/…
Cross-sectional study
n=28,143 participants from NHANES
Estimated age-standardized prevalence of diabetes increased significantly, from 9.8% in 1999-2000 to 14.3% in 2017-2018 jamanetwork.com/journals/jama/…
This is data where diabetes is overt. There are stages of T2 diabetes:
stage 1: hyperinsulinemia with normal glucose levels,
stage 2: hyperinsulinaemia with mildly elevated glucose levels (aka pre-diabetes),
stage 3: hyperinsulinemia with hyperglycaemia (full blown T2DM),…
stage 1: hyperinsulinemia with normal glucose levels,
stage 2: hyperinsulinaemia with mildly elevated glucose levels (aka pre-diabetes),
stage 3: hyperinsulinemia with hyperglycaemia (full blown T2DM),…
…stage 4: hyperinsulinaemia with hyperglycaemia and progression into pseudo-type 1 beta cell failure.
Hyperinsulinaemia may precede hyperglycaemia by up to 24 years. Meaning, if we wait till a person is at stage 2 Type2DM (aka pre-diabetes), it is already very late.
Hyperinsulinaemia may precede hyperglycaemia by up to 24 years. Meaning, if we wait till a person is at stage 2 Type2DM (aka pre-diabetes), it is already very late.
Earlier diagnosis enables earlier intervention and prevention of developing a chronic disease and risk of poorer outcomes from acute diseases, such as respiratory infections!
Highly digestible (starchy/farinaceous/sugary) carbohydrates foods, lifestyle habits (eg lack of sleep/stress) and certain medications substantially increase blood glucose which stimulates extra (bolus) insulin secretion above basal (fasting/background) insulin secretion.
Repeated regularly, and chronically, leads to hyperinsulinemia, as the pancreas is burdened to work harder to maintain blood glucose levels.
Bolus insulin regulation is overtaking basal.
Bolus insulin regulation is overtaking basal.
The most effective intervention that has the greatest impact on reducing external pressure on blood glucose levels and subsequently the pancreas to increase insulin demand, is restricting dietary carbohydrate.
Other interventions will also help, but when it comes to which intervention provides the greatest impact, it is the dose and frequency of dietary carbohydrate intake.
Carbohydrate restriction should be the first intervention recommended to patients and the population at large.
Carbohydrate restriction should be the first intervention recommended to patients and the population at large.
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