Introduction

Diabetes mellitus (DM) encompasses a heterogeneous group of disorders that result in chronic hyperglycemia. The hyperglycemia occurs due to insufficient insulin production and/or resistance to the effects of insulin. Absent the effect of insulin, cells of the liver and skeletal muscle are unable to efficiently take-up and store excess glucose leading to hyperglycemia.

The 2020 National Diabetes Statistics Report reviewed data through 2018. In 2018, 34.2 million Americans, or 10.5% of the population, had diabetes. Nearly 1.6 million Americans have type 1 diabetes, including about 187,000 children and adolescents.

• 88 million American adults, approximately 1 in 3—had prediabetes
  
• New diabetes cases were higher among non-Hispanic blacks and people of Hispanic origin than non-Hispanic Asians and non-Hispanic whites.
  
• Approximately. 7.3 million people with diabetes that are undiagnosed and there are 1.5 million new cases diagnosed every year.
  https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html
• Incidence of new adult cases of DM significantly decreased during 2008 through 2018.
• Newly diagnosed cases of type 1 (T1DM) and type 2 (T2DM) diabetes have significantly increased among US youth.
• For ages 10 to 19 years, incidence of type 2 diabetes remained stable among non-Hispanic and whites but increased for all others, especially non-Hispanic blacks.

More people are developing type 1 and type 2 diabetes during youth, and racial and ethnic minorities continue to develop type 2 diabetes at higher rates. Likewise, the proportion of older people in our nation is increasing, and older people are more likely to have a chronic disease like diabetes.  https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Chronic hyperglycemia of DM is a leading cause of cardiovascular disease, blindness, kidney failure, and lower-limb amputation.

Types of Diabetes

• Type 1 – about 5 % - occurring during childhood or adolescence - do not produce any insulin, require exogenous insulin.
• Type 1.5 Latent Autoimmune diabetes in Adults (LADA) prone to misdiagnosis, may accounts for 15-25% of DM cases
• Type 2 –highest prevalence occurring after the age of 45 – insulin deficiency or insulin resistance causes hyperglycemia
• Pre-diabetes – higher than normal blood glucose levels but not high enough to be diagnosed as diabetes
• Gestational – a form of diabetes that develops during pregnancy. https://www.cdc.gov/diabetes/basics/diabetes.html

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