ST. PAUL, Minn. — The worldwide diabetes epidemic is taking a huge toll in Minnesota. One-third of all adults in the state either have diabetes or are pre-diabetic, with blood glucose levels that are higher than normal.

Over the past 15 years, the number of Minnesotans with diabetes has grown so fast that state health officials describe the disease as a juggernaut threatening to overwhelm the state’s health care system.

In human terms, diabetes is measured in heart failure, amputations and loss of eyesight. Measured in dollars, the cost is enormous: $2.6 billion a year in Minnesota alone.

As bleak as the numbers are, there is some hope. Researchers at the Mayo Clinic and the University of Minnesota have set out to conquer diabetes within 10 years.

Diabetes strikes when the body stops producing insulin or becomes resistant to insulin. Without insulin in the digestive system, a person cannot convert food to energy. As a result, blood sugars rise to dangerous levels while the body essentially starves.

The discovery of replacement insulin in 1921 transformed the most severe form of diabetes from a fatal disease to a chronic condition. People who were on their death bed were suddenly revived after receiving an injection of insulin. The Canadians who discovered the new treatment received a Nobel Prize for their achievement.

But 91 years later, diabetes is still a devastating disease.

“It’s just awful to watch someone walk in, have a little ulcer on their foot that you say, ‘Hmm this doesn’t look good. We’re going to get you to see the surgeon right away,'” said Dr. Elizabeth Seaquist, a University of Minnesota diabetes specialist. “And in three days they lose their leg.

“These things happen with diabetes,” she said. “It’s a terrible disease.”

Limb amputations, blindness, kidney failure, heart disease and strokes are all caused by repeated exposure to excessive blood sugar levels. Modern treatments can help patients drive down their blood sugars to a normal range. But it’s still an enormous challenge to try to mimic the body’s natural response to food, day in and day out, over the course of a lifetime.