The actual cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity appear to play major roles. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. According to the Center for Disease Control, diabetes is the sixth leading cause of death in the United States. As of 2002, 18.2 million people in the U.S.--6.3 percent of the population--had diabetes, with 1.3 million new cases being diagnosed each year. The National Institutes of Health also estimate that an additional 5.2 million people have diabetes without actually being aware of it.



There are two main types of diabetes. Type 1 diabetes, which was previously called insulin-dependent diabetes or juvenile-onset diabetes, accounts for about 10% of all diagnosed cases of diabetes. Type 2 diabetes, which was called non-insulin-dependent or adult-onset diabetes, accounts for the remaining 90%. Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for both the baby and the mother. Gestational diabetes develops in 2% to 5% of all pregnancies, but usually disappears when the pregnancy is over.

Diabetes is a serious disease and phrases such as "a touch of diabetes" or "your blood sugar is a little high" tend to dismiss the fact that diabetes is a major killer of Americans. In addition to the lives that are lost, diabetes has a tremendous economic impact in the United States. The National Diabetes Education Program estimates the cost of diabetes in 2002 was $132 billion. Of this amount, $92 billion was due to direct medical costs and $40 billion due to indirect costs such as lost workdays, restricted activity, and disability due to diabetes. The average medical expenditure for a person with diabetes was $13,243, or 5.2 times greater than the cost for a person without diabetes. In addition, 11 percent of national health care expenditures went to diabetes care.

In response to this growing health burden of diabetes, the diabetes community has three choices: prevent diabetes; cure diabetes; and improve the quality of care of people with diabetes to prevent devastating complications. All three approaches are being actively pursued by the U.S. Department of Health and Human Services. Many government agencies, at all levels, are involved in educational campaigns in an attempt to prevent diabetes, especially type 2. Several approaches to "cure" diabetes are also being pursued: pancreas transplantation, islet cell transplantation (islet cells in the pancreas produce insulin), the development of an artificial pancreas, and genetic manipulation where fat or muscle cells that do not normally make insulin have a human insulin gene inserted and are then transplanted into people with type 1 diabetes.

While there is yet no cure for diabetes, healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. For those with type 2 diabetes, treatment includes healthy eating, physical activity, and blood glucose testing. Many people with type 2 may require oral medication to control their glucose levels. People with diabetes must take personal responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high. The key to living a long and healthy life with diabetes is to learn about the disease, exercise daily, follow a diabetes food plan (right portions of healthy foods, less salt and fat), stop smoking, take prescribed medications, get routine medical care, brush your teeth and floss every day, monitor your blood glucose the way the doctor tells you to and remain positive. Using the correct routines, thousands of people with diabetes have lived long, happy and productive lives.