Dr. Clare Bradley: Hello! My name is Dr. Clare Bradley. I serve as Senior Vice President and Chief Medical Officer of IPRO; New York's Medicare quality improvement organization.
Today, I am talking about diabetes. Most people know someone who has diabetes. Actually, 24 million Americans have this disease. Diabetes is the sixth leading cause of death in the United States. It is a chronic disease with many risk factors, including many that can be changed.
A risk factor is a characteristic that increases the chance of developing diabetes. Diabetes can lead to many complications if left untreated. There are an estimated one-and-a-half million newly diagnosed cases per year. More than five-and-a-half-million people age 20 years and older remain undiagnosed even though they have diabetes. So let me explain what diabetes is.
Most of the food we eat turns into glucose, a type of sugar that is a source of energy or fuel for the body. After food is digested, the glucose is transported into the blood, and then enters cells. Insulin is a hormone produced by the body that helps the body use sugar as a source of energy. In diabetes, the body fails to produce insulin or does not use it properly. When there is no insulin or not enough insulin, the glucose cannot enter the cells. This leads to high sugar levels in the blood.
While the exact causes are not known, various factors make some people more likely to get diabetes. These factors are a combination of genetics, excess weight, and sedentary lifestyle. There are three main types of diabetes; Type 1, Type 2, and gestational diabetes.
Type 1 makes up about 5-10% of all cases of diabetes. In Type 1, the pancreas fails to produce insulin. This is because the insulin producing cells known as beta cells are damaged and ultimately destroyed. This happens when the body attacks itself in what is known as an autoimmune reaction. Type 1 diabetes is usually found among children or adolescents, but can also happen at a later age; family history maybe a factor in these cases.
The most common type of diabetes is Type 2; 90-95% of all diabetes cases are Type 2. Type 2 diabetes usually appears after the age of 40. There is a higher risk of Type 2 diabetes among African-Americans, Latinos, Native Americans, and Pacific Islanders. Type 2 Diabetes is increasing among children and adolescents because of an alarming trend of increasing rates of obesity and sedentary lifestyles. Family history plays a major role in the development of this type of diabetes as well.
In Type 2 diabetes, the pancreas does produce some insulin, but the cells cannot use the insulin normally, and sugar is prevented from entering the cells. This is called insulin resistance. The third type of diabetes is gestational diabetes which occurs in 2-5% of pregnant women. It occurs more frequently in African-American, Hispanic, and Native American women with a family history of diabetes. It starts during pregnancy, and usually ends after delivery of the baby. Obesity increases the risk for gestational diabetes, 40% of women with gestational diabetes progress to Type 2 if not treated with proper diet and weight loss.
Before we continue, let me tell you a little about myself and IPRO. IPRO is an independent and non-profit organization that works to improve the quality of healthcare delivered to Americans.
One of the areas we work in is helping Medicare beneficiaries in New York to manage their own diabetes, and improving the quality of diabetes care received by patients. I am an internist, and have cared for patients with diabetes earlier in my career. I now work with providers and healthcare systems to improve the quality of care received by individuals and communities. If you want to learn more, check out our other videos on diabetes including common symptoms and diagnosis.