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Increase in diabetes attributed to obesity

Research shows 76% more cases for people in 30s

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The incidence of diabetes increased markedly in the United States from 1990 to 1998, including a 76 percent rise in cases among people in their 30s, researchers reported Thursday, and they warned that the disease will take a harsh toll in disability, death and medical expenses in decades to come.

The increase is almost entirely in Type 2 diabetes, commonly called adult onset diabetes, which accounts for 90 to 95 percent of all cases of the disease. Inactivity and weight gain can bring on Type 2 diabetes, and doctors blame much of the current rise on obesity, which is also increasing steadily, with more than half of Americans now overweight. Type 1 diabetes, which accounts for most of the remaining 5 to 10 percent of cases, is caused by a malfunction of the immune system and is not linked to obesity.

Researchers predict that Type 2 diabetes will continue to snowball, because there is a delay between the development of obesity and the onset of diabetes.

"We're having enough trouble taking care of people with diabetes today," said Dr. Frank Vinicor, director of the diabetes division at the Centers for Disease Control and Prevention, and an author of the study, which was published Thursday in the journal Diabetes Care. "It's going to get considerably worse in the future."

Overall, the prevalence of diabetes rose from 4.9 percent of the population in 1990 to 6.5 percent in 1998, an increase of 33 percent, according to the study. Hispanics had a 38 percent increase in diabetes cases, compared to increases of 29 percent in whites and 26 percent in blacks. The percentages translate into 13 million cases of diabetes.

During the same period, the proportion of people who were overweight rose from 44 percent to 54 percent. The study showed that the risk of diabetes increased by 4 percent for every pound of excess weight.

Complications make diabetes a substantial public health problem. It is a major cause of blindness, kidney failure and leg amputations, and it greatly increases the risk of heart disease and stroke. Medical costs for diabetes are estimated at $98 billion a year.

"Expensive as we think health care is today, with these chronic conditions coming on it's going to be very threatening to quality of life as well as cost issues," said Vinicor.

"If we saw a 33 percent increase in infectious diseases like tuberculosis or AIDS, I believe there would be an understandable demand for action. We can't just view inactivity and overweight as purely a kind of cosmetic thing. It's got to be viewed as a serious public health issue."