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Aging, Systemic Disease and Oral Health: Implications for Women Worldwide (Part I)

Course Number: 302


Diabetes is a disease occurring when the pancreas produces an inadequate amount of insulin or when insulin is improperly used by the cells, thus, leaving the body incapable of breaking down carbohydrates and starches into energy. Insulin, an important hormone, is used to regulate blood sugar. An increase in the amount of blood sugar is known as hyperglycemia, which is a common reaction from uncontrolled diabetes over a period of time. Many of the body’s systems such as the heart, eyes, kidneys, oral cavity, nerves, and blood vessels can become damaged due to uncontrolled diabetic conditions.

People with Type 1 diabetes do not produce insulin and represent about 5% of those diagnosed with the disease. It is essential that people with Type 1 diabetes receive insulin daily. A person with Type 1 diabetes produces very little, or no insulin. Without insulin, you cannot convert food into usable energy. Without insulin, a person with Type 1 diabetes cannot survive.37 About 90% of those with diabetes globally have Type 2 diabetes, which is largely due to excessive body weight and inactive or limited physical activity. Those with Type 2 produce insulin either at in insufficient amounts or the body uses what is produced improperly. Oftentimes, the disease is diagnosed years after symptoms have been identified and serious complications have already developed. According to the WHO, almost half of the deaths associated with high glucose usually occur before age 70 and diabetes is projected to be the 7th leading cause of death in 2030.38 Nearly 10 percent of pregnancies in the U.S. are affected by gestational diabetes mellitus (GDM) every year. It has been well documented that women found to have GDM are at high risk for development of type 2 diabetes mellitus in subsequent years.39

The Centers for Disease Control and Prevention have reported diabetes as the seventh leading cause of death among American women and the fourth leading cause of death among Hispanic and African-American women.40 Women with diabetes can experience two-to-four times higher risk of heart issues than women without a diabetic diagnosis. If blood glucose levels can be controlled, the risk of a CVD event can be reduced by 42% and the risk of a stroke, heart attack or death from CVD can be reduced by 57%.41 Many do not even know they have diabetes. In fact, of the 29.1 million American adults who have the disease, it is estimated that 1 out of 4 are unaware of their diagnosis.42

Globally in 2015, diabetes had affected around 415 million with estimated projections to reach 642 million by 2040. (Table 1, Figure 6).43 According to the IDF, 5.0 million died in 2015 from diabetes and 1 in 11 adults were diagnosed. The IDF estimates 1 in 10 adults will be diagnosed with diabetes in 2040 along with 1 in 2 adults undiagnosed. In countries with high-income, the IDF reports 91% of adults having type 2 diabetes. During 2015, 199.5 million women were diagnosed with diabetes and projections are 313.3 million by 2040. Progress has been noted from implementing screening programs and risk scores are now being tested globally in more than 32 countries.43

Table 1. Top 5 Countries/Territories with Diabetes among Adults–2015.*

China109.6 million
India69.2 million
United States29.3 million
Brazil14.3 million
Russian Federation12.1 million

*International Diabetes Federation43

Image: Top 5 countries with largest numbers of diabetics-2010*

Figure 6. Top 5 Countries with Largest Numbers of Diabetics–2015.*

*International Diabetes Federation43

Significant economic burdens are placed on families, individuals, countries, and healthcare systems due to diabetes and its numerous complications. Countries in the Western world report those with Type 2 diabetes frequently experience kidney disease, which has exorbitant costs associated with dialysis.43