Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin (insulin is a hormone that regulates blood sugar) or when the body cannot effectively use the insulin it produces(WHO,2012). Type 2 Diabetes was previously called non-insulin- dependent diabetes mellitus (NIDDM) or adult- onset diabetes(CDC,2011).

 347 million people worldwide have diabetes  Type 2 accounts for around 90% of all diabetes worldwide  Total prevalance of diabetes in the U.S. includes 25.8 million children and adults or 8.3% of the population.  Diabetes is predicted to become the seventh leading cause of death in the world by the year 2030  Total deaths from diabetes are projected to rise by more than 50% in the next 10 years (WHO,2012)

 The American Diabetes Association estimates:  18.8 million people have physician diagnosed diabetes  7.0 million people have undiagnosed diabetes  79 million people have pre-diabetes.  1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in  25.6 million or 11.3% of all people age 20 and older have diabetes. Age 65 years or older,  10.9 million or 26.9% of all people age 65 and older have diabetes.  13.0 million, or 11.8% of all men age 20 years or older have diabetes and 12.6 million, or 10.8% of all women aged 20 years or older have diabetes.

 People diagnosed with diabetes, aged 20 years or older include the following prevalence by race/ethnicity:  7.1% of non-Hispanic whites  8.4% of Asian Americans  12.6% of non-Hispanic blacks  11.8% of Hispanics Among Hispanics 7.6% for Cubans 13.3% for Mexican Americans 13.8% for Puerto Ricans (ADA,2011)

 Diabetes is a leading cause of blindness, amputation and kidney failure(WHO,2012).  Diabetes has become one of the major causes of premature illness in most countries (WHO,2012).  Death  In 2007, ADA stated that diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. Unfortunatley, diabetes contributed to a total of 231,404 deaths.

 You are 45 years of age and older  Have a parent, brother, or sister with diabetes  Come from a family background that is African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander  You are inactive  You are overweight  Have had diabetes while pregnant (gestational diabetes)  Have been told your glucose levels are higher than normal(pre-diabetes)  Your blood pressure is 140/90 or higher, have been told you have high blood pressure  Your cholesterol levels are not normal  You have been told you have polycystic ovary syndrome  Have Acanthosis nigricans  Have a history of Cardiovascular Disease (NIH,2011)

 Obesity is one of the major risk factors that contributes to Type 2 Diabetes (CDC).  Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active (NDIC). Muscle, fat, and liver cells stop responding to insulin which then causes the pancreas to produce more insulin (NDIC). When insulin production decreases, insulin rises which then can lead to pre-diabetes or diabetes (NDIC).

 People with metabolic syndrome have an increased risk of developing Type 2 Diabetes and Cardiovascular Disease (NDIC,2011)  Metabolic syndrome or insulin resistance syndrome, refers to a group of conditions common in people with insulin resistance including:  Higher than normal blood glucose levels  Increased waist size due to excess abdominal fat,  High blood pressure,  Abnormal levels of cholesterol and triglycerides in the blood(NDIC,2011)

 Lack of access to medical care  Cultural attitudes and behaviors  Education  Adults with less than a high school education had a risk of diabetes-related mortality that was twice that of those with a college degree  Income  Those living in poverty had a risk of diabetes- related mortality that was 2.4 times that of those with an income 400% FPL (Saydah & Lochner,2010)

 Diet patterns  Many people do not have access to supermarkets or produce stands which make it difficult for people to eat healthy  Physical activity patterns (Schneider, 2011)

 Losing just 5-7 percent of your body weight or about 15 pounds for many people, can help prevent or delay the chances of getting type 2 diabetes  Pre-diabetes can be reversed with weight loss (NIH,2011)

 Eating a healthy diet, regular physical activity, and blood glucose testing significantly reduces the risk of developing Type 2 Diabetes (CDC, 2012).

 Division of Diabetes Translation plan is to “define the diabetes burden— public health surveillance, conduct applied translational research, implement the National Diabetes Education Program (NDEP) and coordinate media strategies and provide public information.”  The National Diabetes Prevention Program “supports establishing a network of community-based, group lifestyle intervention programs for overweight or obese people at high risk of developing type 2 diabetes.” As of early 2011, it was anticipated that 33 U.S. sites will offer group lifestyle interventions in 2011, with plans to expand to other communities (CDC, 2012).  The NDIC funds many studies that examine better ways to prevent and treat type 2 diabetes, including: look AHEAD (Action for Health in Diabetes)—this study looks at people who already have type 2 diabetes. It has shown that a lifestyle intervention that helps participants lose weight reduces the need for medications to control diabetes, and improves mobility and quality of life (NDIC,2011).  Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, the first large-scale study to compare treatments for young people with type 2 diabetes  Restoring Insulin Secretion (RISE) study is looking at ways to preserve beta cell function in people early in the course of type 2 diabetes  ACCORD, DPP/DPPOS, and DCCT/EDIC studies continue to follow participants so we can learn more about the long-term outcomes of people with and at risk of diabetes (NIH, 2012).

 American Diabetes Association. (2011, January). Diabetes statistics: Diabetes basics. Retrieved from  Center for Disease Control and Prevention (2013, February). Groups especially affected. Diabetes Public Health Resource. Retrieved from  Center for Disease Control and Prevention. (2008). National diabetes fact sheet: general information and national estimates on diabetes in the U.S, U.S. Department of Health and Human Services. Atlanta, GA. Retrieved from  Center for Disease Control and Prevention. (2012, April). Overweight and obesity: Causes and consequences. Retrieved from  Center for Disease Control and Prevention. (2012, December). Diabetes public health resource: About cdc's division of diabetes translation. Retrieved from  Center for Disease Control and Prevention. (2012, September). Diabetes public health resource: Basics about diabetes. Retrieved from  National Diabetes Information Clearinghouse. (2011, September). Causes of diabetes. Retrieved from  National Institutes of Health. (2011, November). Diabetes-chronic diseases. U.S National Library of Medicine. Retrieved from  National Institutes of Health. (2012, Fall). Tailoring diabetes treatment to the patient. NHIH: Medline Plus Magazine., 7(3), 14. Retrieved from  Saydah, S., & Lochner, K. (2010, May/June). Socioeconomic status and risk of diabetes-related mortality in the u.s. (Rep.). Retrieved from CDC website:  Schneider, M.J. (2011). Introduction to Public Health. (3rd E.d.). Sudbury, Massachusetts: Jones and Bartlett Publishers.  World Health Organization. (2012, November). 10 facts about diabetes. Retrieved from  World Health Organization. (2012, September). Diabetes. Retrieved from