There are 20.8 million children and adults in the United States, or seven percent of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease. William Sivitz, MD, director of Diabetes Clinical Research and Programs, at University of Iowa Hospitals and Clinics, talks more about diabetes:

What is diabetes?

Diabetes is defined simply as elevated blood sugar. There are two major forms and in one form, the pancreas, that makes insulin, is damaged by autoimmunity and the damage is permanent and that person, unfortunately, will never make insulin. The second form, which is more common and often occurs in adults, but we’re seeing more of it in children, is highly related to being overweight or being inactive. And in that form, the problem is that insulin just doesn’t work very well, and people can’t make enough extra insulin to overcome that.

If left untreated, what will or could diabetes do to the body?

Well unfortunately, bad things. It’s well known to damage the eyes; the kidneys; the nervous system; and blood vessels that supply the heart, the brain, and the feet.

Why are so many people living with diabetes, unaware that they have the disease?

That’s because it can present in a mild form where the blood sugar is clearly elevated but not high enough that the person will experience symptoms. In some cases, the disease presents aggressively and rapidly and people experience symptoms of high blood sugar: thirst, urination, and fatigue. But in some cases it just can go on and even lead to the damage that I mentioned above without symptoms for some years.

Should everyone be tested for diabetes annually?

According to the American Diabetes Association, many people do need to be tested, but not everyone. People over age 45 should be tested and people that have certain risk factors, such as being overweight or inactive, African-Americans, Latinos, and Native Americans seem to have a higher predilection and they should be tested. Women that have had large babies and persons with high blood pressure, hypercholesterolemia, high blood cholesterol, and blood vessel disease should be tested.

Are there family genetics that predispose people to diabetes?

Yes there are and unfortunately we don’t fully understand these yet. But for example, the form of diabetes where the pancreas stops making insulin, type I diabetes, that’s present if you have an identical twin that has that disorder, you have about a 40 percent chance of getting it at some point. On the other hand, if you have a twin that has type II diabetes, the kind that’s associated with overweight and inactivity, and if you are the same weight and have the same activity, your chances are 90-plus percent of also having type II diabetes. So it’s clearly genetic.

How is diabetes treated?

We try for a simple means, first. In many cases, not type I but in type II diabetes, we can often make tremendous progress just through diet and exercise. When that isn’t enough, we add medication. It either makes insulin work better or stimulates the pancreas to make more insulin. If that isn’t enough, we’ll generally recommend insulin.

Can diabetes be cured, or is it a life-long disease?

Well, we’re working on a cure. As of now it’s a lifelong condition. It can be controlled; people are working on a means of transplanting pancreatic islets or using stem cells to generate new islets. But we don’t have a cure yet.

Is the University of Iowa involved in any new or ongoing research with regard to diabetes?

Yes, more than I can say here. We have some long-term studies that we’re doing of type I diabetes, learning about the epidemiology, what the risk factors are. We have studies looking at the affect of controlling the blood sugar on complications and we have basic science studies that look at the way insulin acts. We even have a study that we’re doing to see if we can develop a non-invasive means of measuring the blood sugar using infrared light.

What is the future of diabetes? Will there ever be a genetic or non-surgical cure?

I think I’m optimistic, I think we’re making tremendous progress. I think that possibly we’ll have the cure, if not, we’ll have better means to control it. Already we’ve made a lot of progress in that we know that controlling the diabetes does prevent the complications that I mentioned above.

If someone wanted to learn more about participating in a diabetes research study at the University, where can they learn more about them?

Call the Diabetes Clinical Research Program at 877-807-9590.

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William Sivitz, MD

Diabetes Clinical Research and Programs