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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Many Diabetics Not Diagnosed UW Screening Program Finds Thousand At Risk Of The Illness

Associated Press

A lot of King County residents apparently have diabetes without realizing they are victims of the disease, according to a University of Washington screening program.

The National Institutes of Health (NIH) estimates that about half of the 16 million people with diabetes nationwide are undiagnosed.

The UW is one of 25 U.S. medical centers participating in a six-year Diabetes Prevention Program, one of the largest diabetes-screening and research projects ever, funded with a $150 million NIH grant.

UW researchers have held about 50 diabetes-screening clinics around the county since last summer. By the end of May, 4,632 people had taken the finger-stick blood test to determine their glucose level.

Results for about 1,000 showed they might not metabolize glucose very well, and about half - 495 - took a second follow-up test. The glucose tolerance test showed that 108 (22 percent) already have diabetes and 184 (37 percent) are at high risk for the disease.

“The numbers we’re seeing were totally unexpected,” said Dr. Steven Kahn, UW associate professor of medicine.

“This shows that diabetes is very, very common, and it’s getting more common, and people don’t know they have it,” he said.

At issue is Type II diabetes, which usually strikes after age 40, most commonly in overweight people. Type I diabetes begins in childhood and affects just 5 percent of diabetic people. Both can be devastating. The condition can lead to heart disease, stroke, blindness, nerve damage and kidney failure and death.

With diabetes, the pancreas doesn’t make enough insulin to adequately metabolize glucose, the blood sugar that is the product of digestion. It stays in the blood instead of moving into cells to be used for energy and growth.

“It’s like a lot of sludge in the blood,” said program manager Brenda Montgomery. “Glucose molecules are big and they can damage sensitive, minute structures like nerve endings.”

Diabetes is normally treated by careful monitoring of diet and, for some, regular injections of synthetic insulin.

About half of the people whose finger-stick test showed a potential for the disease didn’t take the more advanced test. Kahn and Montgomery offer two possible reasons for that: Some people may mistrust research programs. And some may have decided they weren’t really at risk because they thought they had no symptoms.

Some symptoms of early diabetes can be blamed on other things. Increased urination, for example, is common in middle age. And frequent fatigue is not uncommon for busy people.

Diagnosis usually lags four to six years after onset of the disease, Montgomery said. That’s enough time to allow damage to the kidneys, heart or eyes.

About 35 percent of those found to have full-blown diabetes in the King County tests are members of minority groups, as are 29 percent of those who were at high risk.

Minorities, especially Asian-Americans, are genetically predisposed to the disease, Kahn said. And the American lifestyle increases two risk factors: high-fat diets and inadequate exercise.

“Put the genes and the environment together, and that brings it out,” Kahn said.

While fewer than 8 percent of Tokyo residents have diabetes, as many as 25 percent of Japanese Americans in King County have the disease.