Comment: Diabetes needs more focus from society, individuals

By Chad Lewis / For The Herald

Diabetes is a big deal, much more so than covid-19 in terms of the numbers affected, disabled, and dead. About 10 percent off the U.S. population has the disease. According to studies, four times that number are prediabetic, with many eventually developing the full-blown condition.

Diabetes is the seventh leading cause of death in the U.S. But the ranking would be much higher if its contribution to other causes of death could be counted. For example, people with diabetes are up to five times more likely to have a heart attack, the No. 1 killer. Diabetes is also the leading cause of blindness, impotence, kidney disease and neuropathy which can lead to amputations. Riding on a blood sugar roller coaster every second of every day and night without a break adds to personal misery.

The economic costs are staggering. In 2017, diabetes cost the U.S. economy $327 billion; $237 billion in direct medical costs and another $90 billion in indirect costs, such as those associated with missed workdays or reduced productivity. That’s a quarter of all health care costs. At $16,750 per year — the average health care cost of each person with diabetes — that’s more than double that of those who don’t have the condition. The financial burden will only grow as cases rise.

Surprisingly, this epidemiological disaster hasn’t triggered front-page treatment. With covid-19, the U.S. upended its economy to slow or stop its progress. Millions of people masked up and practiced social distancing. Diabetes has had and continues to have a significantly more significant health impact. So, why not the same urgency?

Boatloads of dollars do go into diabetes-related medical care, but that’s primarily for treatment. What about public policy directed at prevention and cure? Given the current and looming problem, you’d expect the equivalent of the Manhattan Project that built the atomic bomb, the NASA funding that put us on the moon, or the attention and resources paid to covid-19. But it’s not happening. For example, according to the same data set, the National Institutes of Health’s funding is almost three times more for HIV/AIDS research than for diabetes, despite over 30 times more deaths attributed to diabetes. (But the difference is vastly more significant because these numbers don’t reflect the contribution of diabetes to deaths caused by cardiovascular disease.)

Part of the problem is that diabetes devastation happens gradually at individual and societal levels. It’s a slow-moving train wreck rather than a dramatically fast one like covid-19. As with today’s inattention to global warming, it’s easily put aside until another day. The problem has crept up at all levels. And the creeping continues.

So what to do? At the societal level, we can urge our government representatives to support diabetes research funding and regulatory relief from the exorbitant cost of diabetic drugs and devices, which are many times more expensive in the U.S. than in Canada and Mexico. Government action to address a shortage of endocrinologists is another good idea.

At the individual level, it starts with being proactive about getting a diagnosis. According to studies, about a quarter of those with diabetes don’t know they have it. Then, there are the previously mentioned millions who are prediabetic and may not realize it. Simple blood tests and consultations with a care provider can provide a diagnosis and put a person on the road to better health.

Some concluding thoughts. Diabetes is permanent, even if remission is possible with some forms of the disease. So, it’s best to head it off. Eat a healthy diet but never “go on one.” Realize that exercising for health can be treated as a regular chore, like mowing the lawn or doing the dishes that doesn’t require much time. According to federal guidelines, only 75 minutes of vigorous or 2 ½ hours of moderate exercise spread over the week suffices. And it doesn’t have to happen in a gym.

A person with diabetes or prediabetes can live a long and healthy life. But to reiterate, it starts with a diagnosis. I urge you to speak with your doctor.

Chad Lewis is a retired educator. He has lived with diabetes for 54 years and is the author of “Doing Diabetes Differently: Empower a Healthier You” (River Grove Books, 2022). You can learn more about Lewis and his book at doingdiabetesdifferently.com.