What is Diabetes?

Diabetes soda can image

Diabetes is a chronic disease marked by higher-than-normal levels of glucose (sugar) in the blood.  It is caused by the body’s inability to produce or use insulin, a hormone that acts to move glucose out of the blood and into cells to be used as energy. There are two types of diabetes:
Type 1 diabetes, also known as juvenile diabetes, is an autoimmune disease in which the body does not produce the hormone insulin. There is no known way to prevent type 1 diabetes, which represents 5% of diabetes cases.
Type 2 diabetes is the most common form, representing about 95% of all diabetes cases.   It usually begins with insulin resistance, where the body does not use insulin properly.  At first, the pancreas makes extra insulin to make up for it.  But over time, the pancreas loses its ability to produce enough insulin to keep blood sugar at normal levels.  Type 2 diabetes is preventable.
Prediabetes, also referred to as impaired glucose tolerance or impaired fasting glucose, is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes have a much higher risk of developing type 2 diabetes, as well as an increased risk for cardiovascular disease. Without intervention efforts, up to 30 percent of people with prediabetes will develop type 2 diabetes within five years5, and up to 70 percent will develop diabetes within their lifetime6.
A 2016 study by UCLA found 13 million adults (46 percent of all adults in California) to have prediabetes or undiagnosed diabetes.   An additional 2.5 million adults have diagnosed diabetes. Altogether, 15.5 million adults (55 percent of all California adults) have prediabetes or diabetes.7

Sugar Sweetened Beverages and Type 2 Diabetes

Liquid sugar is a unique driver of today’s skyrocketing type 2 diabetes and obesity epidemics. Diabetes rates have almost tripled over the past three decades,8just as sugary beverage consumption has doubled.9  At the same time, the rates of obesity (a major risk factor for diabetes) more than doubled for adults, tripled for adolescents and quadrupled for 6-11 year old children.10,11
A growing body of research shows that sugary beverages – because they provide all of their calories from sugar in liquid form – are uniquely harmful. We absorb liquid sugar in as little as 30 minutes, much faster than a candy bar, leading to a spike in blood sugar that the body is not well-equipped to handle, particularly in repetition. These spikes in blood sugar can overwhelm the body and lead to the transformation of sugar into fat in the liver, which contributes directly to the development of type 2 diabetes.12,13
Studies have found:
• Drinking one or two sugary drinks a day increases the risk of developing type 2 diabetes by 26 percent.14
• After six months, daily consumption of sugary drinks increases fat deposits in the liver by 150 percent, leading directly to both type 2 diabetes and heart disease.15
• Sugary drink consumption is especially high in undiagnosed diabetic populations.  In 2003-2006, 45% of diabetic adults in the U.S. consumed a sugary drink on any given day.  Undiagnosed diabetics consumed significantly more (60% versus 38% of people with diagnosed but uncontrolled diabetes).16

Diabetes Complications and Costs

Without careful management, diabetes can lead to complications such as:  Blindness, amputations, kidney failure, liver disease, heart attacks, strokes, cancer, and death.17,18  In 2006, an estimated 60 percent of people with diabetes in the United States had one or more of these complications.19  In 2007, diabetes contributed to 231,404 deaths in the United States.20
Diabetes cost the United States an estimated $245 billion in 2012, with $176 billion in direct medical costs and $69 billion in indirect costs such as lost productivity, disability and premature death.  Average medical expenditures for people with diabetes are 2.3 times higher than for those without diabetes.21
According to a recent UCLA study which examined hospitalizations costs in California, a third of all hospitalizations in 2011 involved patients with a diabetes diagnosis.  Hospital charges in California totaled $35 billion – of that, an estimated $17.3 billion was spent on patients with diabetes.  On average, hospital stays for diabetic patients cost $2,200 more than those for patients without diabetes, and a majority of these hospitalizations were paid for by public insurance.22

Preventing Type 2 Diabetes – Kick the Can!

Type 2 diabetes and its complications are preventable through lifestyle change that involves reducing sugary drink consumption, healthy food and beverage consumption, weight loss, and exercise.  For those already diagnosed with Type 2 diabetes, preventing diabetes complications also requires close monitoring of blood sugar, blood pressure, and blood lipid levels, and possibly medication and insulin treatments.23
With sodas and sugary drinks being such a huge contributor to the type 2 diabetes epidemic, one of the simplest and most effective ways to turn around the diabetes epidemic is by “kicking the can.”  Get involved and start spreading the word about sugary beverages and type 2 diabetes - it's time for us to stop drinking ourselves sick!

For more information on Diabetes and Sugary Drinks, check out the following resources:  

1. American Diabetes Association. 2014 National Diabetes Fact Sheet, 2014.  http://www.diabetes.org/diabetes-basics/statistics.  Accessed June 23, 2014.  
2. Naryan KM, Boyle J, et. Al.   Lifetime Risk for Diabetes Mellitus in the United States.  AMA. 2003;290(14):1884-1890. 
3. Narayan KM. CDC issues diabetes warning for children. ADA Meetings. New Orleans, La; June 14, 2003.
4. May AL, Kuklina EV, Yoon PW.  Prevalence of cardiovascular disease risk factors among US adolescents, 1999-2008. Pediatrics.  2012; 129(6):1035-1041.
5.Centers for Disease Control and Prevention. Prediabetes. http://www.cdc.gov/diabetes/basics/prediabetes.html. Published October 21, 2014. Accessed January 27, 2016.
6. Tabák AG, Herder C, Rathmann W, Brunner EJ, and Kivimäki M. Prediabetes: A High-Risk State for Diabetes Development. 2012. The Lancet 379 (9833): 2279–90. 
7. Babey S, Wolstein J, Diamant A, Goldstein H. Health Policy Brief: Prediabetes in California: Nearly Half of California Adults on Path to Diabetes. UCLA Office of Health Policy Research. 2016
8. Centers for Disease Control.  Long-Term Trends in Diagnosed Diabetes, 2011. http://cdc.gov/diabetes/statistics/slides/long_term_trends.pdf.  Accessed June 23, 2014. 
9. Nielsen SJ, Popkin BM. Changes in beverage intake between 1977 and 2001. Am J Prev Med. 2004;27:205-10.
10. Ogden CL,Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007;132:2087-2102.   
11. Guo SS, Wu W, Cumlea WC, Roche AF. Predicting overweight and obesity in adulthood from body mass index values in  adolescence. Am J Clin Nutr. 2002;76:653-8.
12. JP, Shapira N, Debeuf P, et al. Effects of soft drink and table beer consumption on insulin response in normal teenagers and carbohydrate drink in youngsters. Eur J Cancer Prev.  1999; 8:289–95.
13. Mayes, PA. Intermediary metabolism of fructose. American Journal of Clinical Nutrition. 1993; 58:5, 754S-765S
14. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477-2483.
15. Maersk M, Belza A, Stodkilde-Jorgensen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95(2):283-289.
16. Bleich SN and Wang YC.  Consumption of Sugar-Sweetened Beverages Among Adults with Type 2 Diabetes.  Diabetes Care.  2011;34:551-5.
17. Centers for Disease Control and Prevention.  National Diabetes Statistics Report, 2014. http://www.cdc.gov/diabetes/pubs/statsreport14.htm.  Accessed June 23, 2014.
18. Giovannucci E, Harlan D, Archer M, et.al.  Diabetes and Cancer – A Consensus Report. Diabetes Care. 2010; 33(7): 1674-1685 
19. American Association of Clinical Endocrinologists. State of Diabetes Complications in America 2007.
20. American Diabetes Association.  2014 National Diabetes Fact Sheet. 2014.  http://www.diabetes.org/diabetes-basics/statistics.   Accessed June 23, 2014.  
21. Centers for Disease Control.  National Diabetes Statistics Report, 2014.  http://www.cdc.gov/diabeteS/pubs/statsreport14/national-diabetes-report-... .  Accessed June 23, 2014.  
22.  UCLA Center for Health Policy Research.  Health Policy Brief – Diabetes tied to a third of California hospital stays, driving health care costs higher, 2014.
23.  Centers for Disease Control.  National Diabetes Statistics Report, 2014.  http://www.cdc.gov/diabeteS/pubs/statsreport14/national-diabetes-report-....  Accessed June 23, 2014.