WASHINGTON – Diabetes cases increased more than threefold from 1993 to 1999 among Marylanders in their 30s, according to a survey by the state health department.
The Maryland Behavioral Risk Factor Surveillance System telephone survey showed the rate of diabetes in this age group increased from 1.2 percent in 1993 to 4 percent in 1999.
Poor eating habits and lack of exercise are primary causes for the increase, experts agreed.
“We as a society are becoming more sedentary. This is resulting in more obesity at younger and younger ages,” said Dr. Alan Shuldiner, director of the Joslyn Diabetes Center at the University of Maryland. Obesity is the most accurate predictor of whether someone will develop diabetes.
“Television is a major factor in the recent explosion” in diabetes cases, Shuldiner said. He said the couch-potato lifestyle, along with the messages glamorizing fast food and other high-fat, low-nutrient food have created much of the problem.
Health officials said the “extremely alarming” increase in diabetes group threatens to overwhelm a healthcare system not ready to accommodate them.
The numbers may be even higher, because the survey counted only those who had been diagnosed, said Helio Lopez, research statistician in the Office of Public Health Assessment. About one third of those with diabetes don’t realize they have it, according to the U.S. Centers for Disease Control and Prevention.
The Maryland Diabetes Control Program estimated that while 382,000 Marylanders have diabetes, over 1.3 million are at risk because of poor diet and exercise.
Minorities continued to suffer disproportionately from diabetes, according to the survey. While the rate for whites in their 30s grew from 0.8 percent in 1993 to 1.8 percent in 1999, the rate for blacks went from 2.2 percent to 4.7 percent in the same period.
Blacks are significantly more obese than whites in Maryland. While the obesity rate has hovered around 14 percent for whites, it reached as high as 26.9 percent for blacks, according to the survey.
The sample size for other minorities was too low to be included in the Maryland report, but national studies have shown those groups are more likely to have diabetes than their white peers.
The biggest change was the increasing numbers of diabetics under age 40.
Earl Schurman, of the Maryland Division of Diabetes Control, said the proliferation of those cases is “extremely alarming.” Type II diabetes, formerly known as “adult onset,” traditionally afflicted adults older than 40 but is becoming more common in younger adults, he said.
While diabetes among 30-year-olds made the most remarkable gains, Shuldiner said the increase is starting to be seen in children.
“What was once a clean separation between childhood and adult diabetes is becoming clouded,” Shuldiner said.
He said earlier onset of diabetes causes greater and more expensive Complications: “The duration of diabetes is directly related to its Complications.”
Although diabetes usually is controllable through insulin doses, it can lead to a number of serious complications including high blood pressure, kidney and heart disease, amputations and strokes.
It is also often preventable, said experts, and now is the time to act.
“If we can’t address the problem through the root issues, it’s going to be an incredible economic and medical burden on our entire society,” Schurman said. “If we don’t do something about this now. . .it’s going to affect everyone who pays taxes.”
Pam Minter, executive director for the Maryland chapter of the American Diabetes Association, said health groups “are constantly trying to educate the public” about healthy lifestyles.
“It really starts from grammar school. Parents have to teach their kids to eat right and other healthy habits,” Minter said.
The survey was part of a study released last month by the CDC, which found a 6 percent increase in 1999 alone in diabetes cases among all age groups nationwide. A September study by the CDC found diabetes rates rose 70 percent among people ages 30 to 39 from 1990 to 1998.
Although the biggest increases were among young people, cases increased in every category examined in the national study, including sex, age, race, education, weight and smoking status.
More than 16 million Americans have diabetes with 800,000 new cases diagnosed a year. Diabetes is the seventh-leading cause of death in both Maryland and the United States, killing 180,000 nationwide. The state’s Community and Public Health Administration estimated it is a contributing factor in more than 7,000 Maryland deaths every year.