As public health issues go, diabetes is both one of the most common and most costly to our medical system: 11.3 percent of Americans are diabetic, according to the Centers for Disease Control and Prevention (CDC). Regulators, and the largely private American health care system, have been incapable of controlling the costs of insulin, particularly for people under 65. Diabetes' toll on American lifespans and quality of life is staggering, and despite hopes that the crisis is treatable, data shows things trending in the opposite direction. In fact, a recent report from the CDC reveals that childhood diabetes rates are rising so fast that they are expected to increase by 60% by 2060.
According to a mathematical model created by the CDC, the number of youths who have diabetes will increase from 213,000 in 2017 to 239,000 in 2060 as long as current trends continue. The incidence remains constant as observed in 2017. This includes a 3 percent increase for type 1 diabetes and a 69 percent increase for type 2 diabetes. They also projected that, if the trends observed within the period from 2002 to 2017 continue, the growth will be even greater: 526,000 youths will have diabetes, including 306,000 with type 1 diabetes and 220,000 with type 2 diabetes.
"In both scenarios, substantial widening of racial and ethnic disparities in type 2 diabetes prevalence are expected, with the highest prevalence among non-Hispanic Black youth," the authors add.
Want more health and science stories in your inbox? Subscribe to Salon's weekly newsletter The Vulgar Scientist.
According to the World Health Organization (WHO), there were 422 million people with diabetes in 2014, nearly quadruple the 108 million people diagnosed with the condition in 1980. When the pancreas does not produce enough insulin, or the blood is unable to properly use the insulin, people develop high blood sugar level with a disease known as hyperglycemia. It remains one of the chief causes today of heart attacks, kidney failure, strokes, blindness and lower limb amputation.
Dr. Sheldon Zablow, a nutritional psychiatrist from San Diego, said this is a serious concern because it puts additional stress on young people's future physical and mental health, as well as the additional health costs to their families and society.
"It is important to understand that parents are not to blame for the limited choices available to them and their children," Zablow told Salon in an email. "For all parents, it is a struggle to make it through their day just caring for one or more children while working and completing all the other daily personal and emotional requirements."
Zablow added that affordable daycare could make a huge difference for families.
"Just a few hours, at least one day per week to allow for food shopping and preparation," Zablow said. "Parent (and grandparent) cooperatives could be started with minimal financial support for mutual cooperation of healthier food purchase and preparation while other parents are caring for the children."
"The 'Diabesity' epidemic (obesity and type 2 diabetes) is likely to be the biggest epidemic in human history."
"One important technique parents should be taught is how to implement limiting the hours of food intake to allow blood sugar levels to normalize," Zablow added. "Snacking with high glycemic foods that raise blood sugar levels quickly should be limited and parents taught where foods fall on the glycemic load scale."
Of course, Zablow noted, socio-economic factors play a big role in all of this.
"The best interventions to reduce weight gain and the complications of diabetes are the development of programs that improve access to health care, mental health treatment, a greater variety of food choices, and B vitamin supplementation," Zablow said. "Processed foods are inexpensive with mass production removing natural nutrients and substituting them back in with artificial ones that cannot be utilized efficiently. A specific low-cost intervention to reduce the hazards of weight gain and diabetes should be made available to every child with the minimum daily requirements of B12 and folate to compensate for the lack of nutrients in processed food diets."
A 2017 article in the journal Clinical Diabetes and Endocrinology declared that "the 'Diabesity' epidemic (obesity and type 2 diabetes) is likely to be the biggest epidemic in human history." Adding that "diabetes has been seriously underrated as a global public health issue and the world can no longer ignore 'the rise and rise' of type 2 diabetes," the authors argued that there needs to be a better understanding of the factors driving the rise in diabetes. In addition to encouraging healthy lifestyle choices, scientists are examining genetic predispositions, the role played by the intra-uterine environment and breaking inter-generational cycles that fuel the diabetes epidemic.
"History provides important lessons and there are lessons to learn from major catastrophic events such as the Dutch Winter Hunger and Chinese famines," the authors write. "The Chinese famine may have been the trigger for what may be viewed as a diabetes 'avalanche' many decades later. The drivers of the epidemic are indeed genes and environment but they are now joined by deleterious early life events."