The Diabetes Explosion

By Jeffrey Kluger

Americans are pretty much fed up with being carped at about their waistlines. There are only so many lectures an increasingly plump public wants to hear about hypertension, heart disease and other consequences of obesity before simply tuning it all out and popping another Pringle's. Now, however, there's one more reason to listen to the seeming scolds: the danger of diabetes. According to a report published last week in the journal Diabetes Care, as a fat and happy U.S. gets fatter still, the incidence of diabetes is rising too, striking more and more people in younger and younger age groups--and threatening them with everything from blindness to amputations to heart attacks.

The study involved a survey of 150,000 U.S. households, and the figures it produced were staggering. In the past eight years, the number of Americans found to have Type 2 (or adult-onset) diabetes--the type commonly associated with obesity--has jumped a whopping 33%, from 4.9% of the population to 6.5%. Though the disease has traditionally been seen in grayer age groups--those 45 or older--the greatest increase appears to be occurring among 30- to 39-year-olds, who have seen a stunning 70% jump. Among racial groups, Hispanics were hit hardest of all, with a 38% increase. Whites came in next at 29%, and African Americans were last at 26%. "If that were to happen in a disease like tuberculosis, syphilis or AIDS, I think there would be a public outcry, and understandably," says Dr. Frank Vinicor, director of the Centers for Disease Control and Prevention's diabetes division and one of the authors of the study. "These trends are very disturbing."

While most such public-health threats require a bit of epidemiological sleuthing to determine the cause, this one's a no-brainer. In the same period in which the diabetes numbers have been climbing, so have the numbers on many people's scales. In 1991 just 12% of the U.S. population was considered obese; by 1998 it was 20%. Meanwhile, the share of people considered to be at least "overweight" climbed from 44% to 54%. All the added fat appears to make the body steadily less responsive to sugar-processing insulin, causing the pancreas to compensate by producing more and more of that essential hormone. Ultimately the body becomes so unresponsive that injected insulin supplements or other medication may become necessary.

Doctors fix at least some of the blame for the growing problem on those other great phenomena of the 1990s: the infatuation with the Internet and the proliferation of cable-TV channels. An increasingly wired country is also becoming an increasingly sedentary one, with Web-surfing kids leading the way. The answer, as always, is to shut down the computer, turn off the TV and try regular exercise and eating smart. The lecture may be the same as it's always been, but the stakes are becoming higher than ever.

--By Jeffrey Kluger