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From the Division of Endocrinology, Diabetes, and Hypertension, SUNY Downstate Medical Center, Kings County Hospital Center, and VA New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, New York.
The incidence of diabetes mellitus, particularly type 2 diabetes, is increasing dramatically in the United States and in other Westernized, industrialized societies because of increasing obesity, sedentary lifestyle, and population aging. There are currently 20 million persons with diabetes in the United States, of whom more than 5 million remain undiagnosed. The diabetic population consumes a disproportionate share of health care resources because of both microvascular and macrovascular complications. Diabetes is a major cause of new-onset blindness, end-stage renal disease, and nontraumatic amputation in the United States. Cardiovascular disease accounts for up to 80% of premature excess mortality in diabetic patients. Strategies to lessen the disease burden in these patients include hygienic measures (diet and exercise) as well as rigorous treatment of hypertension, dyslipidemia, and hyperglycemia.
Key Words: Type 2 diabetes cardiovascular disease health care obesity morbidity mortality
Address for reprints: Nathaniel Winer, MD, Division of Endocrinology, Diabetes, and Hypertension, Box 1205, SUNY Downstate Medical Center, Kings County Hospital Center, and VA New York Harbor Healthcare System, Brooklyn Campus, 450 Clarkson Avenue, Brooklyn, NY 11203-2098.
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