Diabetes a growing problem in Maine Number of afflicted has doubled since ’94

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It’s something people in Maine and the nation don’t readily acknowledge, but inactivity and overeating are pushing up diabetes rates.

In fact, in the past decade, the number of diabetics in Maine has jumped so fast state health officials predict that children born after 2000 will have shorter life spans than their parents and will have a 1-in-3 chance of getting the disease.

According to Jim Leonard, director of Maine’s Diabetes Prevention and Control Program, “The number [of diabetics in Maine] has, in fact, doubled” since 1994.

“This is a much bigger deal than people realize,” he cautioned. “Diabetes does not have a cure.” Diabetes is a disease in which blood glucose or sugar levels are above normal. In most cases, the disease can be regulated with diet, exercise and medication.

The U.S. Centers for Disease Control and Prevention Web site explains: “When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugar to build up in your blood.”

In 1994, 3.4 percent of adult Mainers had been diagnosed with diabetes. Within the last decade that has jumped to 7.6 percent, according to figures provided by the CDC.

Maine’s diabetes prevention program falls under the CDC, which estimates that more than 100,000 Mainers have diabetes, but one-third of that population is unaware they have the disease.

There are two types of diabetes – Type 1 and Type 2 – and specialists say the big increase Maine is experiencing is a result of growth in the Type 2 category.

Type 1, once referred to as “juvenile-onset” diabetes, accounts for 5 percent to 10 percent of all diagnosed cases of diabetes and occurs when the pancreas, which makes insulin, the hormone used by cells to get energy from food, does not work. Because the body doesn’t make insulin, Type 1 diabetics must inject insulin to regulate their sugar levels.

Most diabetics fall in the Type 2 category and have an overworked pancreas or the insulin their bodies make is not working correctly. “Type 2 diabetes seems to develop as a result of the body not getting enough exercise and getting too much nutrition,” Leonard said. Heredity can play a role, too.

The good news is that studies show positive lifestyle changes can lower a person’s chances of getting the disease and can reduce or eliminate treatments needed to manage Type 2 diabetes.

“Weight loss resulting from diet and increased physical activity may lower diabetes risk by improving the ability of muscle cells to use insulin and to handle glucose more efficiently,” the Web site for the National Institute of Diabetes and Digestive and Kidney Diseases says. Healthful eating and physical activity are the top two treatments for Type 2 diabetes, but oral medication, insulin, or both may be added to control blood glucose levels.

Being overweight can keep a diabetic’s body from making and using insulin properly, and also can cause high blood pressure.

Without management of diabetes, the disease can cause serious health complications including blindness, kidney failure, nerve damage that sometimes requires amputations of lower extremities, and heart disease, which kills 75 percent of diabetics.

Maine is not alone in the battle against diabetes, which is the sixth-leading cause of death in the United States. In the last decade, 23 states have doubled their diabetes rates. Puerto Rico has the highest rate, at 10.8 percent, and Colorado has the lowest, at 4.8 percent.

As of 2002, 18.2 million people nationwide – 6.3 percent of the population – had diabetes, and another 1.3 million new cases are expected each year.

Lack of physical activity and overeating also have led to obesity issues, which parallel diabetes rates, Leonard said.

“As the level of obesity in the population has increased, the trend of diabetes has increased as well,” he said.

Another tragic correlating factor is that now children are being diagnosed with Type 2 or adult-onset diabetes, Leonard said.

“Type 2 diabetes used to occur [with adults] in their mid-40s,” he said. “But now we’re beginning to see children – this was unheard of in the past.”

With the growing number of diabetics and overweight people in Maine, there is a growing belief, even with modern technology’s medical advances, that children born today will not live as long as their parents.

“It’s expected that one of every three children born in 2000 or after will develop diabetes in their lifetime,” Leonard said. “This will be the first generation where the expected life span will be less than their parents’. It really does come back to those issues [with diabetes].”

Dr. Dora Anne Mills, director of Maine’s Bureau of Health, describes obesity in the state as an epidemic. She warns today’s youngsters to reduce their weight, saying obesity rates among children have nearly quadrupled in the last 30 years.

“Poor nutrition, physical inactivity and being overweight or obese are major public health problems,” she said in the October 2004 Maine Policy Review.

The doubling of Maine’s diabetes rate is “just the tip of the iceberg,” Mills said Monday. “It’s one of the many problems associated with obesity.”

It’s fairly easy to see, just by looking at who is being picked up by local ambulances, that diabetes is on the rise, but also has changed in the last decade, said Chuck McMahan, director of Capitol Ambulance in Bangor.

He said that with the increase in self-monitoring with hand-held blood-glucose monitors, “we don’t have people going unconscious out shopping” anymore because of low blood sugars.

“We are seeing increases in the related long-term chronic diseases – cardiac, retinopathy and end-stage renal disease,” McMahan said. “It’s a much more common complicating factor.”

People with diabetes also are more susceptible to other illnesses and have a harder time overcoming them, he said. The good news is that with self-management and preventive care, diabetics can and do live long and healthy lives, McMahan said.

“Keeping on track with treatments and following the doctor’s orders and other health profession instructions and advice will mean they will be less likely to see us,” the ambulance operator said.

Diabetes-related hospitalizations increased by 13 percent between 1996 and 2002, and the number of deaths associated with the disease skyrocketed by 62 percent between 1979 and 2002, according to a Diabetes in Maine health fact sheet issued in February.

The United States, with its on-the-go, high-fat/low-nutrition diet, is not the only country seeing increases in diabetes, Leonard said.

“Over the last 50 years, food has become more available” all around the globe, he said. “There are very large increases in diabetes” worldwide.