Why So Many Of Us Are Getting Diabetes

Hillary Carroll knew something was amiss. She had spent Memorial Day happily frolicking in her grandmother's swimming pool, but by that evening she was doubling over in pain every time she went to the bathroom. Her mother figured it was probably an infection and the next day took Hillary, then 10, to the pediatrician. Instead of getting a prescription for an antibiotic, however, the 220lb. youngster was immediately admitted to the hospital. Lab tests showed that she had something far more serious--Type 2 diabetes.

Hillary is not the first overweight child to learn she has this form of diabetes, a chronic metabolic disorder that used to be called adult onset but was renamed in part because so many kids Hillary's age were getting it. As doctors have repeatedly warned, the U.S. is experiencing a diabetes epidemic. Some 18 million Americans suffer from one form or another, with 1.3 million new cases diagnosed last year--up from 878,000 in 1997. And although Type 2 diabetes still tends to strike people in their fifth or sixth decade, more children are getting it, a fact of grave concern to health officials.

Not only are these kids likely to face a lifetime of problems--including higher risks of blindness, heart disease and stroke--they are also a warning sign that something in our way of life has gone terribly wrong.

And yet scientists in just the past decade have learned that the most devastating complications of diabetes--and in some cases the disease itself--are almost entirely preventable. There are better techniques for monitoring diabetes and more effective drugs for treating it, and a major study published last year shows that by making only modest changes in diet and exercise, people at high risk of Type 2 diabetes can stave off the disease for at least three years and perhaps a lot longer (more on Type 1 in just a bit).

It's a puzzle. Never have physicians known so much about Type 2 diabetes and how to control it, yet the number of cases is expected to rise at an alarming rate. Epidemiologists predict that by 2025 the incidence in the U.S. will double. Annual treatment costs are projected to rise, from $132 billion to $192 billion in 2020--not counting inflation. Hardest hit will be certain ethnic groups--including African Americans and Native Americans, Hispanics and Asians--that for complicated reasons are more prone to the disorder.

To the dismay of health experts, diabetes is becoming a global problem. In the next couple of decades, the prevalence of diabetes is expected to triple in Africa, the eastern Mediterranean, the Middle East and Southeast Asia, to double in the western Pacific and to nearly double in Europe. With an estimated 33 million cases, India has the most people with diabetes; China has 23 million.