Is there a bigger health care challenge to our nation right now than diabetes? The numbers are staggering: Nearly 26 million Americans have diabetes, and a third don't even know it, according to the Centers for Disease Control and Prevention. Another 80 million Americans are at high risk of developing diabetes.
A study by UnitedHealth Group's Center for Health Reform & Modernization estimates that by 2020 more than 50 percent of all Americans will have diabetes or prediabetes.
To put it in perspective, the American Diabetes Association points out that someone is diagnosed with the disease every 17 seconds and that diabetes kills more people each year than breast cancer and AIDS combined.
And consider the financial cost: By the end of this decade, diabetes and prediabetes will account for about 10 percent of the nation's total health care spending, almost $500 billion annually — up from $194 billion in 2010, UnitedHealth Group reports.
Did I say staggering?
November is National Diabetes Month, and all kinds of events are planned on the local and national levels to bring attention to the burgeoning epidemic. Hospitals are working with their communities to sponsor screenings, informational sessions, fund-raising walks and healthy-living demonstrations.
Many hospitals are joining physicians, nurses and others to take the message into schools. That's important because the explosion of diabetes among kids is especially shocking. As recently as the mid-1990s, Type 2 diabetes was almost exclusively a disease of adults. Not anymore.
"Apparently fueled by the childhood obesity epidemic, cases in people younger than 20 have ramped up from virtually zero to tens of thousands in the United States in little more than a decade," according to an article in June in Kaiser Health News. What's frightening, KHN notes, is that "the children who have it are breaking new scientific ground: No one has any idea how they will fare over the course of a lifetime."
But make no mistake: The rise of diabetes is not limited to any single age or ethnic group. The percentage of non-Hispanic whites over 50 with the disease climbed from 11 percent in 1998 to 18 percent in 2008 and from 22 percent of non-Hispanic blacks in 1998 to 32 percent in 2008, according to the National Academy on an Aging Society.
There is some good news. Improving poor lifestyle habits can prevent Type 2 diabetes in high-risk individuals and can save money in the process. In research described at an American Diabetes Association conference in June, a group of high-risk individuals received one-on-one training in diet, exercise and behavioral modification, with the goal of losing 7 percent of body weight and getting at least 150 minutes of exercise a week. After three years, the study found that these lifestyle interventions reduced the rate of diabetes by 58 percent and would cut medical costs by $2,600 over 10 years. The results were reported in HealthDay.
For people who already have diabetes, emerging care delivery models offer hope of better controlling the disease. A report released in June by eHealth Initiative showed that coordinated care among a variety of providers using electronic health records resulted in a number of process improvements for patients with Type 2 diabetes and heart disease. For patients who participated in a medical home, the project demonstrated improvements in care planning, provider-patient communications, intra-office coordination, more advanced use of EHRs, enhanced patient coaching, improved referral process to specialists, expanded roles for nurses and more user-friendly information for patients.
Experts agree the No. 1 way to reduce the rate of diabetes is to reduce the rate of obesity. Let's hope that by focusing attention on those intertwined epidemics we can save millions of lives, improve the quality of millions of other lives and save billions of health care dollars. This is the month to start.
Bill Santamour is managing editor of Hospitals & Health Networks. Follow his tweets at www.twitter.com/hhnmag.