Changes in diet and exercise habits of people in the United States and throughout the world, in addition to widely distributed genetic risks, have resulted in an epidemic increase in diabetes. An estimated 7.3% of Americans currently have diabetes (7.4% of Rhode Islanders). More than one in every seven individuals over the age of 60 is affected. An equal number of people have impaired glucose tolerance, which is a metabolic state that often progresses to diabetes. More than one in every five patients admitted to Rhode Island Hospital and other major hospitals in Rhode Island have diabetes. The number is increasing in adults and, alarmingly, at an especially rapid rate in children.
In addition to the immediate problems presented by high blood glucose levels, long-term complications that develop in patients with diabetes are responsible for much of the mortality and morbidity of this disease. Diabetes is now the fifth leading cause of death in the United States, contributing to more than 200,000 deaths per year. The diagnosis carries with it increased risks of coronary artery disease (2- to 5-fold), stroke (2- to 3-fold), blindness (20-fold), kidney failure (25-fold), and amputation (40-fold). The care of patients with diabetes requires endocrinologists, multiple other medical and surgical specialists, and trained and experienced support staff.
For effective management of diabetes, it is essential to coordinate the efforts of a multidisciplinary team in order to provide optimal approaches to blood glucose control, patient education, and interventions ranging from retinal laser therapy to vascular surgery or transplantation.
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