In contrast to Washington's sunny skies, the forecast put forth at the 66th Annual Scientific Sessions of the American Diabetes Association (ADA) in June was gloomy, for the second consecutive year.
The global epidemic.
World-wide, over 230 million adults (5.6% of the world's population between the ages of 20 and 79 years) now have diabetes. And that number will grow to 350 million (6.7%) in 20 years, according to Martin Silink, president-elect of the International Diabetes Federation (IDF), an advocacy organization representing over 150 countries. The Pacific Island nations have the highest rate: 30% of adults suffer from diabetes.
Silink called diabetes "a global catastrophe," causing a death every 10 seconds. "To do nothing is no longer an option," he said. At a June 10 press conference, the IDF launched their campaign, Unite for Diabetes, urging a United Nations (UN) resolution on diabetes by November 14, International Diabetes Day. Silink said that a UN resolution, requiring 46 cosponsoring nations, "would put diabetes on the annual agenda of the UN General Assembly, and governments would implement awareness activities in their own countries."
The UN resolution was the idea of Clare Rosenfeld, a 20-year-old college student from Oregon who has had type 1 diabetes since age seven. When visiting several underdeveloped countries as an IDF youth ambassador, she was appalled by the sparse resources available for treating diabetes. "No one should die from a treatable disease. That's the ultimate injustice," she said. For more information, go to http://www.unitefordiabetes.org.
Antidepressants and diabetes.
Richard Rubin, a psychologist and the president-elect of health and education of the ADA, reported two important findings of a study of 3,000 people who were obese and had impaired glucose tolerance. Subjects were assigned to one of three diabetes-prevention intervention groups: placebo, metformin (Glucophage), or lifestyle modification. The researchers found that people with depressive symptoms were no more likely to develop diabetes than others were. They also found that subjects in the placebo or the lifestyle intervention group who took antidepressants were two to three times more likely to develop diabetes than those not taking antidepressants, regardless of the type of antidepressant taken. Those in the metformin group who were taking antidepressants did not show this effect.
Rubin emphasized that it remains unknown why the antidepressants might have this effect and that these results might not occur in people who aren't at high risk for diabetes. He especially cautioned that "people should not stop taking antidepressant medications based on these findings, but they should have their blood glucose checked periodically."
If only.
The epidemic of "diabesity" (a term coined to represent the combined problems of diabetes and obesity) continues. In his address, Robert Rizza, the ADA's president of medicine and sciences, noted that one-third of all children born in the United States in 2000 will develop diabetes; for blacks, half of all children born in 2000 will. He adds that we are "tantalizingly close" to a cure. But for now, if people with diabetes received the correct treatment, billions could be saved nationally.
"If we do what we know we should do," he said, "over the next 30 years there'd be 8 million fewer heart attacks, 1.8 million fewer strokes, over 2 million fewer cases of blindness and renal failure, 100,000 fewer amputations, and we'd save $325 billion."
Rizza said the U.S. health system must change its focus: "Not to pay for prevention and to treat only complications is folly."
Maureen Shawn Kennedy, MA, RN, news director
National Institute of Nursing Research Celebrates 20 Years
Putting research into practice was the focus of this conference.
As one of the events marking the 20th anniversary of the National Institute of Nursing Research (NINR), the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland (which is celebrating its 50th anniversary) cosponsored a clinical research conference on June 16. Christine Miaskowski, professor and chairperson of the Department of Physiological Nursing at the University of California-San Francisco, was the keynote speaker and headed a program on implementing research into practice, which included assessing wounds, reducing risk in patients with HIV, and enhancing the lives of transplant recipients.