The theme of World Diabetes Day this year is Eyes on Diabetes. The idea is to “focus on promoting the importance of screening” and treatment to reduce the risk of serious complications. According to the Centers for Disease Control and Prevention, the rate of new diabetes cases in the United States has begun to fall, but the numbers are still very high.
Diabetes is a Public Health Crisis
More than 29 million adult Americans, or approximately 12 percent of the adult population, currently suffer from some form of diabetes. It is one of the most common chronic diseases around the world and the seventh leading cause of death in the United States. More than 76,000 people die of diabetes-related complications every year (although that figure might be an underestimation). The spread of type 2 diabetes throughout the US has imposed a substantial burden on society. More than 20 percent of all health care spending in the United States now goes to treating it. And because the number of people diagnosed with obesity-related type 2 diabetes keeps rising, the total cost of treating diabetes and pre-diabetes now reaches more than $300 billion every year, including approximately one in three Medicare dollars spent by the federal government. Diabetes is not an inevitable disease, but it is has become an intractable public health problem, in part because reducing the prevalence of the disease will mean changing people’s behavior and lifestyle. Those who are at the greatest risk of developing diabetes tend to be obese, sedentary, physically inactive, over the age of 45, and have a family history of the disease. Type 2 diabetes accounts for almost 95 percent of all cases; type 1 diabetes makes up for the remaining 5 percent.
Complications from Diabetes
Early detection and diagnosis is critical with diabetes. If left untreated, it could lead to a number of other dangerous conditions, since elevated levels of blood sugar can damage vital organs, such as the heart, kidneys, blood vessels, and nervous system. Cardiovascular disease is the most common cause of death associated with diabetes. The odds of a person with diabetes developing heart disease or a stroke over their lifetimes is almost twice as much compared to the rest of the population — and it will occur at a much earlier age. Diabetes is also the leading cause of kidney failure, adult-onset blindness, and lower-limb amputations (due to infections in the feet). Nerve damage is ubiquitous in diabetes sufferers, causing sensory loss and damage to the limbs. Women who develop gestational diabetes during pregnancy may experience higher levels of birth-related trauma and birth defects. According to the CDC, approximately 25 percent of US adults with diabetes don’t yet know they have it and could be at risk of serious complications. Life expectancy for people with diabetes is about 10 years shorter.
Managing and Treating Diabetes
According to the American Diabetes Association, people with type 2 diabetes, or those who are in danger of developing type 2 diabetes, can prevent or delay diabetes-related complications by losing seven percent of their body weight and exercising at least 30 minutes a day, five days a week. In order to control their weight, people should eat healthier foods such as fruits, vegetables, and whole grains that reduce blood sugar, while avoiding added sugars and junk food. If that is not enough to suppress blood sugar levels, doctors will usually prescribe medications to their patients. About 40 percent of diabetes sufferers need to take oral medication and another 40 percent require regular insulin injections. People with the less common type 1 diabetes are almost completely dependent on insulin injections for survival.
Around 86 million people, or more than a third of American adults, suffer from a condition known as pre-diabetes, in which blood sugar levels are elevated, but not enough to qualify as type 2 diabetes. Because their condition isn’t very advanced or they do not yet experience any symptoms, 90 percent of them do not realize they suffer from pre-diabetes. Yet without proper intervention, many of these cases will develop into type 2 diabetes in 10 years or less. According to the CDC, people with pre-diabetes who take part in a structured lifestyle change program can cut their risk of developing type 2 diabetes by as much as 58 percent.
The Future of Public Health Policy
Among the many obstacles that still stand in the way of providing better treatment to diabetes sufferers, screening is one of the most important. According to the World Health Organization, many people are not properly diagnosed until several years after the onset of the disease, when complications are already present. Fortunately, the odds of developing diabetes can be reduced with better public health policy: that means identifying and connecting with people at high risk of type 2 diabetes, improving public and professional awareness, and providing better access to proper treatment. The CDC recommends four different approaches: promote proven methods for reducing the risk of diabetes, such as CDC-recognized lifestyle change programs; monitor key risk factors and gauge the effectiveness of certain health initiatives in order to better guide public health policy; help people with diabetes manage their chronic conditions over a longer lifespan, as the average age of the US population continues to increase; and partner with outside organizations to create and expand effective health programs across American communities. Without significant changes to public policy, however, the strain on the health care system will only grow more acute. It’s estimated that by 2050 a third of US adults may eventually develop some form of the disease. That would place an enormous burden on the US health care system and also lead to a significant loss of economic productivity.