Diabetes

Diabetes and a little about Anti-Infectives

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SCOPE AND IMPACT OF DIABETES IN THE U.S.: PREVALENCE

Diabetes mellitus is a chronic disorder that is seen with increasing frequency. Prevalence rises with age (Fig. U Approximately 20% (7 million) of people over age 65 have diabetes. In the United States, prevalence estimates are made by the Centers for Disease Control and Prevention and state health departments, using a yearly cross-sectional telephone survey. This method, the Behavioral Risk Factor Surveillance System (BRFSS), obtains a representative sample of each state’s nonin-stitutionalized civilian residents, aged 18 years or older. Prevalence estimates of diagnosed diabetes by this system rose 50% in the 1990s, from 4.9% in 1990 to 6.5% in 1998 and 7.3% in 2000. The census in the year 2000 estimated that there were about 196 million adults over the age of 18 in the U.S. It is suggested that there were at least 14 million adults with known diabetes in 2000. Epidemiologic surveys have generally shown that for every two people with known diabetes there is at least one person who has diabetes and does not know it. Thus, approximately 10% of the adult population, or 20 million adults in the U.S., may have diabetes mellitus. The majority of these cases are type 2 diabetes. Finally, if one includes the 15.6% of adults who are estimated to have impaired glucose tolerance (IGT), more than 25% of the U.S. population over the age of 18 has abnormal glucose metabolism.
The American Diabetes Association gives a more conservative estimate: 17 million people with diabetes in the U.S. with 11.1 million diagnosed and 5.9 million undiagnosed. An additional million people have a condition called “pre-diabetes,” which is defined as either impaired glucose tolerance or impaired fasting glucose (IFG). These terms are described in Chapter 2. Whatever the true frequency, it is clear that diabetes is a major public health issue.
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Diabetes