ABSTRACT
The prevalence of diabetes is increasing in epidemic proportions on a worldwide basis. In the United States alone, it has been estimated that there are approximately 16 million patients with diabetes, representing about 6% of the population. In addition, an estimated 5.4 million people are undiagnosed. On a more alarming note, it has been estimated that approximately 20 million people have impaired glucose tolerance, a clinical state felt to be representative of pre-diabetes. The projected increase in new cases of diabetes is also expected to increase the prevalence of complications associated with the disease, i.e., retinopathy, neuropathy, nephropathy, and cardiovascular disease. In addition to the morbidity and mortality resulting from these complications, the financial cost is staggering. It has been estimated that the total cost to care for diabetes and its related complications in the United States alone was over $98 billion for the year 1997. Thus, the current and evolving emphasis in diabetes management is to 1) evaluate strategies for the prevention of the disease and 2) implement clinical treatment regimens, as outlined in subsequent chapters, with the goal of reducing or delaying the progression of these devastating complications.
