The second resource comes from the National Institute of Diabetes and Digestive and Kidney Diseases, "Guiding Principles for the Care of People with or at Risk for Diabetes". This PDF aims to identify and synthesize areas of general agreement among existing guidelines to help guide primary care providers and health care teams to deliver quality care to adults with or at risk for diabetes. We've included the introduction below, you can download the entire PDF here.
Today, 29.1 million people (9.3 percent of the U.S. population) have diabetes, including 8.1 million who are undiagnosed. A major cause of blindness, renal failure, amputation, and cardiovascular disease, diabetes also increases the risk of cancer and dementia and more than doubles individual health care costs. The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity.
Twenty-one million U.S. adults have diagnosed diabetes, and of this population, about 90 to 95 percent have type 2 diabetes. Another 86 million Americans have prediabetes and are at high risk of developing type 2 diabetes.
Proper nutrition and physical activity are the cornerstone of treatment and prevention of type 2 diabetes. In addition to lifestyle modifications, controlling blood glucose, blood pressure, and cholesterol dramatically improves health outcomes. As a result of improved risk factor control, rates of complications, particularly for cardiovascular disease, have declined.
The National Institutes of Health–sponsored Diabetes Prevention Program clinical trial proved that type 2 diabetes can be delayed or prevented in high-risk individuals with prediabetes through lifestyle changes, such as improved nutrition and physical activity that result in modest weight loss, or the drug metformin. An estimated 93 percent of Americans with prediabetes are unaware of the condition. People at high risk for type 2 diabetes must be identified and targeted for ongoing diabetes primary prevention efforts if society is to realize the benefits of therapies proven to delay or prevent the disease. Otherwise, diabetes prevalence will continue to rise; one study projected the lifetime risk of diabetes diagnosis for Americans adults is 40 percent, meaning 2 out of every 5 American adults may be diagnosed if current trends continue.
Because type 2 diabetes comprises such a large proportion of people with or at risk of diabetes, these Guiding Principles focus primarily on prevention and management of type 2 diabetes in adults. While much of the material is also relevant to type 1 diabetes, gestational diabetes, type 2 diabetes in children, and other rarer forms of the disease, specific management of these forms is outside the scope of this resource. The principles highlight the generally agreed-upon elements of current evidence-based diabetes management and prevention. Continue reading.