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1 (July 15, 1998)

handle is hein.crs/crsuntaafvb0001 and id is 1 raw text is: 98-592 STM Updated July 15, 1998 Diabetes: Basic Information and Federal Funding Donna U. Vogt Analyst in Social Sciences Science, Technology, and Medicine Division Summary An estimated 8 to 10 million Americans know they have diabetes mellitus, a metabolic disorder in which the body either fails to produce, or fails to properly use, the hormone insulin. It is the seventh leading cause of death in the United States,' the leading cause of adult-onset blindness, and a significant contributor to several debilitating health complications, including heart disease, stroke, kidney disease (nephropathy), nerve disease (neuropathy), and amputations. The American Diabetes Association estimates that direct and indirect costs of diabetes mellitus in the United States exceed $98.2 billion each year.2 This report describes diabetes, current treatment and management, public health impact and cost, innovations in treatment, and federal spending on treatment and research. This report will be updated periodically.3 Background Diabetes mellitus, or simply diabetes, is a disease that affects the way the human body uses food as fuel. This fuel, glucose, is a sugar which comes from other sugars and starches; human body cells convert glucose into energy to live and grow. Some cells can absorb glucose only in the presence of insulin. Insulin, a hormone made by the pancreas, is carried by blood to body cells. Insulin is produced by beta cells which are present in cell clusters called islets of Langerhans scattered throughout the pancreas. When someone is diabetic, either the body does not produce insulin or the body does not respond normally to insulin. When glucose cannot enter the cells, it builds up in the bloodstream, and causes a condition called high blood sugar, or hyperglycemia. When 1 National Center for Health Statistics, Advance Report ofFinal Mortality Statistics, 1995, Monthly Vital Statistics Report, supplement 2, v. 45, no.11, 12 June 1998. Diabetes causes 2.6% of total deaths in the United States. 2 Department of Health and Human Services Budget Office, HHS and National Cost for Thirteen Diseases and Conditions, 20 February 1998. 3 This report replaces CRS Report 97-13 SPR, Diabetes: An Overview, by Christine Miller, 18 December 1996. Congressional Research Service + The Library of Congress CRS Report for Congress Received through the CRS Web

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