The numbers are staggering.

Diabetes affects 246 million people globally. Nearly 21 million children and adults in the U.S. have diabetes, including 6.2 million people who don’t know they have the disease. If current trends continue, one out of three Americans, and one in two minorities, born in 2000 will develop diabetes in their lifetime. Since 1987, the death rate due to diabetes has increased by 45 percent, while the death rates due to heart disease, stroke and cancer have declined, according to the American Diabetes Association.

November is American Diabetes Month, providing opportunities to communicate the seriousness of the disease and the importance of proper diabetes control. Wednesday, Nov. 14, 2007 marked the first United Nations-observed World Diabetes Day. Among the activities were the formation of a human blue circle on the United Nations grounds and the lighting of monuments and buildings worldwide in blue. The blue circle is the global symbol for diabetes and the landmark lightings symbolize beacons of hope for those living with diabetes, according to the International Diabetes Federation.

“The issue for all of us is to not let this be a culmination but a beginning,” said Dr. Larry Deeb, clinical professor of pediatrics at the University of Florida and immediate past president, medicine & science, for the American Diabetes Association, based in Alexandria, Va. He has been involved with getting the United Nations to approve World Diabetes Day since 2005.

“Emotionally our job was to let people know diabetes is a big deal,” he said. “I think we accomplished that. The next phase of all this is to begin to figure out better what to do.”

Among the goals is to develop better treatments, prevent complications and ensure adequate research funding, Deeb said.

“The word used over and over was ‘unite,’” Deeb said. “Unite for diabetes. Unite as a world.”

Diabetes is a disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy needed for daily life, according to the ADA.

Type 1 diabetes results from the body’s failure to produce insulin. Type 2 diabetes results from insulin resistance combined with relative insulin deficiency.

Environmental factors such as lifestyle, inactivity and diet play more of a role than anything else for type 2 diabetes, said Lawrence Harkless, DPM, professor of podiatric medicine and surgery and founding dean of WesternU’s College of Podiatric Medicine.

More children are becoming obese due to the Westernization of the world. Children need to be educated about living a healthy lifestyle and they should not be tempted by soda and other unhealthy food at school.

“You need to give them healthy food,” Harkless said. “Don’t give them a choice. You’ve got to show them the way.”

Harkless served on the Texas Diabetes Council for 12 years, and served as chairman from 2001 to 2007. He will receive the 2008 Distinguished Achievement Award in Diabetic Limb Salvage from the Georgetown Diabetic Limb Salvage Conference in September 2008.

Harkless asks each patient 12 questions to better understand them. Getting to know their character and attitude is important, he said. People with diabetes often come in with fear and depression from the start.

“Psychological aspects are important to understand who they are and why they’re behaving the way they’re behaving,” Harkless said.

The likelihood of getting the message of healthier living across is greater with a team effort. A primary care physician might have only 15 minutes with a patient, but a dietician, endocrinologist and other health professionals could add to that message.

“Everybody on the team should be knowledgeable and ask questions – the ‘who, what, when, how come,’” Harkless said. “Get to know the patient – who they are, where they are going and where they came from.”

Diabetes affects many different systems in the body because it affects blood flow, said Elizabeth Hoppe, OD, MPH, DrPH, professor of optometry and founding dean of WesternU’s College of Optometry. When the eyes aren’t getting enough nutrition from the blood supply, small, fragile blood vessels may grow. But these new blood vessels break and bleed easily, causing scarring, she said. Diabetes is the leading cause of new blindness, Hoppe said.

In the early stages, a person might notice a vision or prescription change. Fluctuating blood sugar levels could blur their vision. A patient should also be aware of personal risk factors, such as body mass index and family history. Regular checkups and early detection are important.

“Treatment can prevent vision loss and blindness,” Hoppe said.

Diabetes is often overlooked, but it completely changes people’s lives, said Laura Morales, special events coordinator for the Juvenile Diabetes Research Foundation International (JDRF), Inland Empire Chapter in Colton, Calif.

Morales’ 4-year-old daughter was diagnosed with type 1 diabetes at 13-months old. Type 1 diabetes is a difficult disease for anybody to handle, but even more so for a child, she said. They’re pricking her fingers 10 to 15 times a day to check blood sugar and injecting insulin three to five times per day.

“For a child that’s very hard,” Morales said. “How could anybody get used to that? Their diet changes. Their whole life changes.”

Any parent of a diabetic child likely doesn’t sleep more than three or four hours a night, checking blood sugar, Morales said.

The mission of JDRF is to find a cure for diabetes and its complications through the support of research. The foundation has awarded more than $1.16 billion to diabetes research since its founding in 1970.

“There are so many ways to help out by educating people and getting the word out,” Morales said.

E-mail Dr. Elizabeth Hoppe at

E-mail Dr. Lawrence Harkless at

For more information about the American Diabetes Association visit the Web site

For more information about the Juvenile Diabetes Research Foundation International visit the Web site

For more information about the International Diabetes Federation visit the Web site

For more information about World Diabetes Day visit the Web site