As the prevalence of diabetes has doubled in North Carolina and the nation over the past decade, doctors are only now beginning to unravel the complex series of cellular events that cause some people to develop the chronic disease, while others remain healthy.

And while a cure is elusive as ever, new findings among area researchers are creating additional targets for drug therapies – raising hope for the estimated 550,000 people in North Carolina who have diabetes.

The disease, once considered fairly straightforward, results when the body does not produce or effectively use insulin, a hormone produced in the pancreas that helps cells absorb sugars for energy. People who are overweight or obese have a greater risk of developing diabetes, because too much food and too little physical activity can burn out the body's ability to manage insulin.

"It's almost like it's a social problem as much as a disease," said Dr. John Buse, director of the Diabetes Care Unit at the University of North Carolina at Chapel Hill.

"Our society has evolved quickly, and the genetic background that enabled people to withstand episodes of starvation now has turned against us."

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