Almost half of the U.S. population has diabetes or prediabetes, and many have no clue. Are you among them too?

“I felt dizzy and was urinating a lot,” he recalled. “Even if you know your diet is bad, if you don’t exercise, you’ll still lose weight.”

His dream trip to Mexico was put on hold because of his frequent trips to the bathroom. As he and his wife took a walk to find the restaurant they were looking for, he realized he could no longer read the road signs.

“Up until that point, I had no idea that I could get diabetes,” says Blue, a former Army personnel specialist who is currently pursuing a doctorate in criminal justice. luck.

Back home in North Carolina, while on patrol one night, he receives a call for service and again finds he can’t read road signs. Embarrassed and frightened, he asked his colleague to tail his car all night, promising to find out what was going on the next day.

That morning, he was diagnosed with type 2 diabetes, a condition in which cells don’t respond properly to insulin. With the help of an endocrinologist, insulin, other medications, diet, exercise, and continuous blood sugar monitoring, he now has better control over his blood sugar, blood pressure levels, and weight. But he admits that keeping all three in check is a daily struggle.

Although her vision has since improved, neuropathy, or nerve damage, a common complication of diabetes, appears to be permanent.

“When you’re trying to get your kids dressed, struggling to tie their shoelaces, you can’t even feel the zippers on their clothes,” he says. “I’ve lost grip strength and can’t feel surfaces. I drop things regularly. Everything feels like I’m running my hand through a cheese grater at times.”

Blue’s doctors had warned her that she could develop the disease in the future because of her weight, high blood pressure and family history of type 2 diabetes. However, his laboratory was never explained. And his symptoms never seemed alarming enough to warrant a diagnosis until 2017, when his blood sugar levels spiked into the 700s, about seven times the safe normal level.

“If anyone dropped the ball, it was me, because I was constantly being told to do things like ‘lose weight’ and ‘control my blood pressure’ and things got worse. I just ignored it until it happened,” Blue says.

But doctors diagnosed him with an increasingly common condition called prediabetes, where blood sugar levels are elevated but not high enough to warrant a formal diagnosis of diabetes. There wasn’t.

“I don’t think they were looking for that,” Blue says.

“It’s like a ticking time bomb.”

According to the Centers for Disease Control and Prevention, nearly 40% of Americans have prediabetes. As for diabetes itself, just over 10% of the US population has diabetes. Either type 2, the most common, or type 1, an autoimmune disease in which the body mistakenly destroys insulin-producing cells.

Overall, about half of the U.S. population has or has diabetes. Experts say it’s turning us into a nation plagued by disease, increasing the nation’s health infrastructure, staffing demands and health costs, and negatively impacting the economy in a way never before seen in American history.

Centers for Disease Control and Prevention

The numbers are alarming, but they no longer surprise Dr. Disha Narang, an endocrinologist and bariatric physician at Northwestern Medicine Lake Forest Hospital in Lake Forest, Illinois. Nor is Dr. Nisha Patel, a bariatric physician in San Francisco, surprised. Originally from California, he often teams up with Narang on projects.

Obesity is a major risk factor for metabolic diseases such as prediabetes and type 2 diabetes, and obesity statistics for Americans closely mirror those for people with diabetes.Almost 42% of the US population was obese As of March 2020. And by 2030, about half of Americans will be obese. researchers predict.

While not unexpected, the numbers are “very concerning,” Patel said. Not only because diabetes can wreak havoc on the body, but also because of other illnesses that can eventually accompany it. Prediabetes and diabetes are major risk factors for diseases such as fatty liver disease, metabolic cyanotic liver disease, and other chronic diseases, many of which, like diabetes, can be fatal.

Diabetes, whether diagnosed or not, can lead to complications such as the eye problems Blue experienced and neuropathy that persists despite improved blood sugar control. Countless Americans have prediabetes or diabetes but, like Blue, don’t know it.More than 80% of prediabetic patients are unaware they have diabetes According to the U.S. Centers for Disease Control and Prevention. And almost a quarter of people with diabetes don’t even know they have it.

They are walking around “like a ticking time bomb,” Patel said.

How we got here

It’s no surprise to experts that the US is grappling with an obesity epidemic luck I talked to him. But because obesity so often leads to prediabetes and type 2 diabetes, the country is also suffering from, or virtually ignoring, a cardiometabolic health crisis.

From 1999 to March 2020, obesity rates in the United States increased by 11%, from 31% to 42%, and severe obesity rates nearly doubled to 9%. According to the CDC. Number of Americans diagnosed with diabetes more than doubledfrom nearly 11 million to 23.4 million.

Centers for Disease Control and Prevention

Centers for Disease Control and Prevention

The situation was bleak and about to get worse. In the spring of 2020, the coronavirus disease (COVID-19) pandemic hit, upsetting the normal exercise plans of active Americans and plunging the nation into a mental health crisis.

“I often hear people say that their weight was stable, but then 2020 hit and they gained 50 pounds,” Narang says. “People’s activities have changed a lot. Stressors have changed a lot. The way we do things has changed a lot. answered It was very different from stress factors. People often turn to food when they’re stressed, and all of that combined. ”

This is the pattern that forever changed American lifestyles with app-based fast food and grocery delivery Are you still awakedaily steps still falling— perhaps permanently.Aside from increased calorie consumption and decreased physical activity, experts believe the coronavirus has inadvertently caused an increase in diabetes diagnoses due to inflammation, stress and cell death. During cytokine stormor Other mechanisms not yet fully understood—This can be said to be a typical symptom of a long-term coronavirus infection.

Since the pandemic began, new diagnoses of type 2 diabetes among young Americans have increased by 62%, while new diagnoses of type 1 diabetes have increased by 17%, according to the study. 2023 survey was announced on JAMA network open. While the jury is still out on how and to what extent the new coronavirus contributes to the diagnosis of diabetes, studies suggest that approximately 1% to 4% of people infected with the virus develop symptoms within months of acute infection. It is estimated that he was diagnosed with diabetes. And since virtually everyone in the United States has been infected with the coronavirus at least once, 1% is no small number, and when you consider the population of the United States, he is more than 3 million people.

Desolation spreading before my eyes

The country’s cardiometabolic crisis is certain to involve not only an ever-increasing number of deaths, but also a reduction in life expectancy and longevity. Diabetes also develops early, so prevention must start early. Type 2 diabetes was traditionally thought to occur in people over the age of 45, but due to overnutrition, obesity, and decreased physical activity levels, it is increasingly being diagnosed in teenagers and children.

“This is really very concerning because it means their bodies have to deal with the exposure for an even longer period of time,” Patel said, adding that the number of young Americans being diagnosed is increasing. About. This means more people will have more comorbidities at a younger age. “The domino effect it creates is huge. What the outcome will be is astronomical.”

But there’s also an economic cost, Patel said. With nearly one in two Americans having diabetes or pre-diabetes, employers are responding to an increasingly sick workforce.

“If you look at the health care costs associated with people with diabetes, it’s billions in indirect costs,” Patel said. People with diabetes are more likely to miss work, resulting in lower productivity and higher medical costs, which burden both people with diabetes and their employers.

Economics aside, the American health care system is unprepared for an influx of diabetic patients with additional medical needs.Apart from a nationwide shortage of hospital beds, the country Crisis of medical personnel shortagetoo.

“Who will take care of this aging and sick population?” Patel asks. “If we don’t figure this out or find a solution, there are big consequences.”

How to solve the problem

There is no silver bullet when it comes to tackling the diabetes and obesity epidemic, experts say. luck.

“I don’t see a one-size-fits-all solution,” Patel said. “There’s no end in sight.”

meanwhile Malnutrition definitely remains a problem Experts say overnutrition is a bigger problem in the United States. Ironically, these two issues are often related.A person may suffer from symptoms such as: both malnutrition and obesity if they are Unable to find or buy healthy food.

Keys to tackling both issues: nutritious foodFruits, vegetables, plant-based proteins, seafood, and low-fat or fat-free dairy products are available to the masses. However, about 10% of Americans struggle with food security, and many live in food deserts, or areas where they cannot access food due to proximity or price. In these areas, most of the food available at gas stations, dollar stores, etc. is highly processed and far from fresh.

Even with nutrient-dense foods now available in large quantities through food pantries and other outlets, busy Americans struggle to find the time and sometimes the knowledge to cook.

“When you give someone a box of vegetables, they don’t know what to do with it,” Patel says. “They’re not going to eat it, enjoy it.”

Middle- and high-income Americans may not have difficulty obtaining nutritious foods. But when convenience is promoted, nutrition is often sacrificed.

“This country has more processed food than any other country in the world,” Narang said. Patel wonders why food manufacturers aren’t making it easier for ordinary Americans to make healthier choices. “I don’t see widespread efforts,” she says.

Demand for injectable weight loss “miracle drugs” like Wigoby has skyrocketed this year, and Narang worries manufacturers won’t be able to keep up. Disparities already exist between people who have access to medicines. As a result, the drug is in short supply among diabetics who need it. Furthermore, many people around the world could benefit from so-called “miracle drugs” but are unable to access them due to poverty.

But Narang cautions that such drugs are “simply a tool for weight loss.” They are not the last resort in treating diabetes or even the solution to obesity. Manufacturing and access issues aside, users of injectable drugs like Wegovy still need to eat and exercise for the drugs to be effective. What’s more, once you stop using it, you often regain the weight you lost, potentially turning a nation of obese workers into a nation of workers indefinitely dependent on drugs to keep their weight down.

“People are promoting this as if it’s the second coming of Christ or something, but it’s not,” Narang said. “I think there’s a lot of hype on social media. We’ve been using GLP1 for over 10 years at this point.”

While such drugs can be a game-changer for people with diabetes, they are “not a long-term solution for permanent weight loss” for people who just want to lose weight, Narang said.

Perhaps the biggest hurdle in tackling obesity is the idea that it is a moral failure.

“We need to view obesity as a chronic disease that deserves long-term treatment, like other diseases such as diabetes, high blood pressure, and high cholesterol,” Narang says. “This is a neurohormonal process that is actually treatable.”

“Currently, there is a stigma that weight is someone else’s fault, and that needs to change.”