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“The future holds a lot of promise where technology can support people with diabetes to live fuller lives.”
Dr. Nuha Ali El Sayed, Endocrinologist & Vice President of Healthcare Improvement for the American Diabetes Association
According to the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the United States, but that figure is likely underreported. While over 34 million Americans are living with diabetes, one in five of them don’t know they have it. The numbers are increasing: in the last 20 years, the number of adults diagnosed with diabetes has more than doubled, as the population has, on average, grown older and more overweight.
While there is still no cure for diabetes, there is an increasing number of ways to effectively prevent and manage it. Patients at risk for diabetes can cut their risk in half by eating healthy and being more active, and lifestyle change programs have reduced the incidence of type 2 diabetes in long-term participants by 27 percent.
Advances in technology have made it easier to manage one’s own insulin levels, and emerging research has provided even more reasons to be hopeful. Still, the biggest weapon against diabetes is a greater awareness of the subject, and thus in the continued education of both the public and the medical community.
November is American Diabetes Month. It’s a time for those who are at risk for diabetes to get educated and find resources to support them, but it’s also an opportunity for healthcare professionals to renew their understanding of diabetes.
To learn more about the state of diabetes today and where it’s going, read on.
Meet the Expert: Nuha Ali El Sayed, MD, MMSc
Dr. Nuha Ali El Sayed is an endocrinologist at Joslin Diabetes Center, an Instructor in Medicine at Harvard Medical School, and the Vice President of Healthcare Improvement for the American Diabetes Association. She completed her clinical training in Endocrinology, Diabetes, and Metabolism as a Friedman Fellow at Tufts Medical Center and the Jean Mayer USDA Center in 2009. She also earned a Master of Medical Sciences in Medical Education at Harvard Medical School.
At Joslin, Dr. El Sayed sees patients at high risk to develop type 1 and type 2 diabetes, with a focus on lifestyle medicine, weight management, complications prevention, and the use of technology in diabetes care. She also oversees the clinical training program for medical students, residents, and visitors. Dr. El Sayed is the Chairwoman and Founder of Diabetes Education For All (DEFA).
Understanding Common Types of Diabetes
There are two common types of diabetes: type 1 and type 2. In type 1 diabetes, a person’s body makes little to no insulin and that person will need to use insulin therapy and other treatments to manage their condition. Type 1 diabetes affects people of every race, shape, and size, but those with appropriate medical management and a healthy lifestyle can still live a long and normal life.
Type 2 diabetes is slightly different and it affects a wider range of the population: “Type 2 diabetes is the most common form of diabetes,” Dr. El Sayed says. “It is a disease where our bodies have a combination of two issues: an inability to utilize insulin and in some cases, loss of ability to make enough insulin. This results in an inability to regulate and use glucose (sugar) as a fuel. Long-term exposure to these high levels of glucose can lead to many complications. There are genetic and environmental reasons why people develop type 2 diabetes and there are ways to prevent and manage it. Some of these ways include healthy eating and being more active.”
Another common health condition associated with diabetes is prediabetes, where one’s blood glucose (sugar) levels are high, but not yet high enough to be considered type 2 diabetes. It affects over 88 million Americans, which represent over a third of the population. But of those 88 million, more than 84 percent don’t know they have prediabetes. Prediabetes doesn’t mean someone will definitely develop diabetes, but it does increase their risk for diabetes; it also increases their risk of heart disease and stroke.
People can have prediabetes for years without any clear symptoms, which is one of the reasons why it often goes undetected until more serious health problems emerge. For patients with risk factors for prediabetes—being overweight, being 45 years or older, being physically active less than three times a week, and/or having a close relative with type 2 diabetes—it’s a good idea to have their blood glucose (sugar) levels tested. While type 2 diabetes can affect anyone, the CDC does identify African Americans, Hispanic and Latino Americans, Native Americans, Pacific Islanders, and some Asian Americans as having a higher risk.
It’s important that healthcare professionals help educate their patients and communities about common types of diabetes, but it’s also important that those healthcare professionals continue to educate themselves on the latest research, treatments, and best practices around diabetes.
“Much of what we learn in medical schools becomes unusable information by the time we are in practice, and updating our knowledge is important,” Dr. El Sayed says. “It is critical for healthcare professionals to engage in professional education activities, and be aware of clinical practice guidelines. Annually, the American Diabetes Association publishes standards of care for caring for people with diabetes. It is a helpful resource for healthcare professionals to stay informed and up to date in the field of diabetes.”
Research and Technology Related to Diabetes
Since 1952, the American Diabetes Association (ADA) has invested $834 million in more than 4,800 diabetes research projects. In 2018 alone, they supported nearly 300 scientists at over 100 institutions working on over 300 different projects—all dedicated to progressing the fight against diabetes.
In addition to core training, core research, and core development, a significant portion of the ADA’s research budget is dedicated to Pathway to Stop Diabetes, an initiative that seeks to find a new generation of scientists who are at the peak of their creativity and provide them with the freedom, autonomy, and resources to drive breakthrough discoveries.
“There is a lot of new technology and medical therapy that is exciting,” Dr. El Sayed says. “We have excellent data from medication classes such as SGLT2 inhibitors and GLP1 receptor analogues when it comes to kidney and heart protection. Also, there are great advances in insulin delivery and closed-loop systems.”
Management of diabetes also looks much different than it once did. The first insulin pumps came on the market in 1974, offering an alternative to self-injection; today’s computerized pumps can be slimmer than a deck of cards. Wearable (and implantable) continuous glucose monitors (CGMs) provide an easy and consistent method of tracking glucose levels. And patients with diabetes can find more support from the healthcare community today than ever before.
“The future holds a lot of promise where technology can support people with diabetes to live fuller lives,” Dr. El Sayed says.
Resources for American Diabetes Month
To learn more about the fight against diabetes, and how you can help as a healthcare professional, check out some of the resources below.
- American Diabetes Association (ADA): The ADA is leading the fight against the deadly consequences of diabetes, and fighting for those affected by diabetes. They fund research to prevent, cure, and manage diabetes. They deliver services to hundreds of communities, provide objective and credible information on diabetes, and give a voice to those denied their rights because of diabetes.
- American Diabetes Month: Taking place every November, this year’s American Diabetes month is broken down into four weeks, each with its own focus: awareness, detection, management, and thriving. This year’s overarching theme is #TheBigStepUp, and challenges both the public and healthcare professionals to take steps to help everyone reduce our risk and ease the burden of diabetes.
- Diabetes Care: With the highest-ever impact score for an ADA journal, Diabetes Care is consistently ranked as one of the top journals devoted to diabetes research.
- Diabetes Core Update: The ADA’s monthly podcast for busy healthcare professionals, Diabetes Core Update discusses how the latest research and information published in ADA journals are relevant to today’s clinical practice.
- Know Diabetes By Heart: A partnership between ADA and the American Heart Association, Know Diabetes By Heart seeks to reduce cardiovascular deaths, heart attacks, heart failure, and strokes in people with type 2 diabetes. The initiative focuses on improving outcomes through a long-term consumer activation campaign, quality and systems improvement efforts, professional resources and education, and patient resources and support.
- National Diabetes Statistics Report (2020): Published by the CDC, the National Diabetes Statistic Report provides information on the prevalence and incidence of diabetes and prediabetes, risk factors for complications, acute and long-term complications, deaths, and costs.
- Standards of Medical Care in Diabetes (2021): The most recent Standards of Medical Care in Diabetes includes all of ADA’s current clinical practice recommendations and is intended to provide clinicians, patients, researchers, payers, and others with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The recommendations are based on an extensive review of the clinical diabetes literature, supplemented with input from ADA staff and the medical community at large.
Matt is a writer and researcher from Southern California. He’s been living abroad since 2016. Long spells in Eastern Europe, Southeast Asia, and Latin America have made the global mindset a core tenet of his perspective. From conceptual art in Los Angeles, to NGO work on the front lines of Eastern Ukraine, to counterculture protests in the Southern Caucasus, Matt’s writing subjects are all over the map, and so is he.