SAN FRANCISCO (KTVU) - Stunning new numbers from the World Health Organization highlight the explosion of diabetes worldwide.
Tabulating both type 1 and type 2, the latter more preventable, the health agency announced diabetes cases have quadrupled, calling its spread an "unrelenting march.''
Diabetes has always been around, associated with age, obesity and lifestyle.
But now it's striking more people, and younger people, and in nations that never had a problem with it before.
Since 1980, cases have grown from 108 million to a current 422 million people living with diabetes. .
"Sugar gets a lot of the blame because it deserves a lot of the blame," UCSF Endocrinology Professor and researcher Suneil Koliwad told KTVU, " and there are aspects to the way we live our lives today that are fundamentally unhealthy."
At the Diabetes Care Center at UCSF, new patients meet in a classroom setting to learn how to manage their disease with nutrition and exercise.
Among the tools they leave with: measuring cups, to help with portion size and over-eating.
"As each country around the world adopts the so-called Western lifestyle, we see diabetes go up in those countries," observed Dr Koliwad, who also serves with the Bay Area Chapter of the American Diabetes Association.
Sugar is not only present in sweets and sodas, but in processed foods and alcohol as well.
Too much of it can overload the pancreas so it stops producing sufficient insulin, the hormone that balances blood sugar.
Then those blood levels fluctuate dangerously, unless controlled with oral medication or self-administered insulin.
"I do have regrets about what I used to eat before, " diabetes patient Vince Gidvani told KTVU, in the clinic waiting room.
Gidvani is in the restaurant business, surrounded by food, wine, temptation.
"It's always a work in progress," he admitted, "and every day you want to change your life. Every day you want to eat healthy. But everyone is in a different situation."
Millions of Americans, like Gidvani, live each day, testing their sugar levels, adjusting diet, and injecting insulin as needed.
The WHO notes that some nations where diabetes is skyrocketing, lack the medical resources or technology patients need.
In the U.S. diabetes is elevated in communities of color, and among lower socio-economic groups that may not have access to nutritious food.
"My sugar is high, but not dangerous," Collen Holliman told KTVU, as he made his way through the farmer's market in the Castro District Wednesday evening.
Holliman said, growing up in Alabama, on a diet of fried foods and baked goods, he has relatives with diabetes, and wants to fend it off.
"I'm eating more vegetables, just being more cautious about what I eat, limiting carbs and sugars," Holliman explained, "It’s not hard. Dying is more difficult."
Among the numbers from the WHO: 2.2 million deaths directly caused by diabetes in 2012, and 2.2 million more related to diabetes, because it is the primary cause of heart disease.
"It's just so cheap and easy to go to a fast food and get junk food," observed Chelsea Cowell, also shopping for vegetables at the farmers market.
Cowell is a personal trainer, with clients who have diabetes, and she sees their struggles as motivation to eat healthy and stay active.
"It's actually amazing to see how many people have the tools to fix it and don't care to change their lifestyle at all. That's what I've noticed a lot," she added.
Diabetes is often reversible with lifestyle changes.
WHO would like food makers to step up and curb fat and sugar in their products, and for governments to encourage urban planning that encourages walking and cycling, among many recommendations in their report.