Epidemic of the Future: Diabetes?

Diabetes appears to be the New York Times malady of the moment. They’ve done a 4 part series on it called “Bad Blood.” The focus of the series is on type II diabetes, which was formerly known as adult-onset diabetes. It’s now found more and more commonly among younger people. Type II diabetes accounts for 95% of cases in the U.S.

Diabetes is called it a silent scourge because people can live with diabetes and not know it. The result is that many people learn they have the disease when it becomes serious, or when complications occur. The complications are frequently gruesome, however. Most leg and partial leg amputations occur as a result of diabetes.

The saddest aspect of diabetes is how little is done to manage it. Some people refuse to believe that they are ill, until it is too late to save them from such complications as amputation, heart disease, or kidney failure. In some cases, people refuse to take their pills or insulin, or to check their blood sugar on a regular basis. They also neglect the lifestyle changes that are necessary to properly control diabetes.

It’s important to remember that individual choices are only part of the picture. The New York Times series also explores the social and economic conditions that contribute to diabetes’s toll. For many who need the most help in their fight against diabetes, there are few resources. They often are located away from places where they can get exercise or find healthful foods. Many may not have insurance coverage. Sometimes the stress of life is enough to wear down resolve.

It doesn’t help that health decisions are often driven by concerns about profit rather than health. Junk food is cheaper than health food, but it’s also easier to make money from it. Insurance companies and hospitals also look at preventive care for people with diabetes as a drain on profits. Hospitals can charge more for procedures like kidney dialysis than amputations, and both are more likely to be covered by insurance than preventive services like endocrinologist or podiatrist visits.

Recently, the link between Type II diabetes and genetics was confirmed. A variant of one gene in particular can increase the risk of developing diabetes by up to 45% in people who carry 1 copy of the variant gene, and 141% in people who carry 2 copies. Over a third of Americans may carry this gene variant, and scientists estimate that 7% of Americans carry 2 copies. The variant appears to be responsible for 21% of diabetes cases—over 4 million people.

If a screening test could be developed for this genetic variant, it’s possible that many cases could be prevented using diet and exercise. In order for that to truly happen, people must be provided with some extra incentives to do so.

This post refers to:

Kleinfield, N.R. “Diabetes and Its Awful Toll Quietly Emerge as a Crisis.” Bad Blood, Part 1. New York Times. January 9, 2006.

Kleinfield, N.R. “Living at an Epicenter of Diabetes, Defiance and Despair.” Bad Blood, Part 2.New York Times. January 10, 2006.

Urbina, Ian. “In the Treatment of Diabetes, Success Often Does Not Pay.” Series: Bad Blood, Part 3. New York Times. January 11, 2006.

Santora, Mark. “East Meets West, Adding Pounds and Peril.” Bad Blood, Part 4. New York Times. January 12, 2006.

Fountain, Henry. “On Not Wanting to Know What Hurts You.” New York Times. January 15, 2006.

Wade, Nicholas. “Gene Increases Diabetes Risk, Scientists Find.” New York Times. January 16, 2006.

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