The Growing State of Diabetes in America on World Diabetes Day 2018

Diabetes is a family issue, and its prevalence is growing in America. November 14, 2018, is World Diabetes Day, and the International Diabetes Federation reminds us that this condition impacts the whole household — not just the person diagnosed with diabetes.

Why the family? Because diabetes is one disease that is largely preventable: through eating right, being physically active, and making healthy choices every day. The family is the primary ecosystem for daily living, and this environment can foster an individual’s healthy choices…or not.

The IDF reminds us that family members can and should be aware of the signs and symptoms of diabetes that can help detect the condition sooner rather than later.

Diabetes is also a family issue because the condition can significantly impact household finance. Nearly one-half of U.S. patients have skipped insulin doses or monitoring due to costs, an Upwell Health survey found. The rising cost of insulin has garnered a lot of media coverage: this JAMA article pointed out that insulin prices skyrocketed over ten years. Here’s a sobering example of the ultimate cost of self-rationing insulin due to cost: the death of a young man who did exactly that, featured in this STAT story about the role of financial health contributing to this patient’s ultimate mortality. The Endocrine Society has made recommendations for legislation that would ensure greater transparency over insulin pricing.

The rising costs of caring for diabetes haven’t yet significantly changed personal behavior relative to the key risks for Type 2 diabetes amenable to change: food intake and exercise.

The prevalence of diabetes in the U.S. increased in 18 states over ten years, and didn’t decrease in any, the map illustrates. The state of diabetes in America is gauged in the latest Gallup-Sharecare Wellbeing Index, which found that five of these states had at least two percentage point increases: West Virginia, Louisiana, Hawaii, Rhode Island, and South Carolina. West Virginia had a 17.9% prevalence rate, South Carolina 15.1%, Mississippi 14.8%, and Kentucky and Louisiana 14.4%. States with the lowest rates of diabetes include Alaska, Colorado, Montana, New Hampshire, Utah, and Vermont, all under 9% prevalence rate.

Obesity rates rose in 34 of the 50 states over the past decade, shown in the second map from the Gallup-Sharecare study. Obesity underpins these rates of diabetes: obesity can quadruple the odds of a person being diagnosed with Type 2 diabetes. Last year, Gallup-Sharecare said that, “Obese adults between the ages of 25 and 64 are at least four times more likely to have been diagnosed with diabetes than those who are normal weight.”

Gallup noted, in its companion report on the rise of diabetes in America, that communities, businesses and schools can play important roles in helping to reduce the risk factors of Type 2 diabetes. Since inactivity is a major risk factor, towns can plan and implement bike paths and safe places for walking in “active transportation” modes. Parks and green spaces also encourage movement, and have “strong inverse relationships” to both diabetes and obesity.

Business cross-industry is a key stakeholder in bending the diabetes prevalence curve. Grocery stores that offer healthy cooking classes and store tours that teach how to read food labels can help in the effort to drive healthy communities. The restaurant industry is also heeding the better-for-you wellness consumer trend: Panera recently announced its Food Interrupted campaign seeking to, “change food systems from the inside out.” Thus far, Panera has developed videos on sugar, eggs, and meat quality and provenance for food system sustainability and human health outcomes.

Businesses as employers, too, can better equip on-site cafeterias with healthier food options, and nudge people toward more active lifestyles through artful health benefit design.

 

Health Populi’s Hot Points:  Remember that, “Food has become the main driver of human health costs,” the Food Tank editor writes this week commemorating World Diabetes Day 2018.

One of the largest U.S. exports is America’s food-eating ethos. “If we start with global dietary patterns, we know they are shifting towards the U.S. model of high meat and high calorie consumption, coupled with low fruit and vegetable consumption,” Dr. Michael Hamm, Founding Director of the Michigan State University Center for Regional Food Systems told Food Tank.

As the U.S. continues to wrestle with the high costs of healthcare, preventing and managing Type 2 diabetes has a high DIY component: people who feel empowered and activated in health can do better to manage the condition once-diagnosed, or be mindful to prevent the onset of T2D if diagnosed with pre-diabetes.

Hearkening back to the IDF’s 2018 theme of the role of the family, it’s important to realize that families who eat together are healthier, as this TIME magazine article spelled out based on research evidence. A team of Rutgers researchers did a meta-analysis of 68 studies, connecting dots between family meals and weight gain. They learned that,

• Children who has more meals together with their families tended to eat more fruits, vegetables, fiber, calcium-rich foods, and vitamins, and ate less junk food
• Teens who ate with families were less likely to have signs of depression and feel families were more supportive compared with teens who dined less at home
• Children in families who frequently shared meals had lower BMIs than young people who did not.

Tune into the Food Tank Inaugural San Diego Summit on Wednesday 14 November to hear about the true cost of food, connecting to sustainability and holistic health – from farm to fork to disposal to the circular economy. your work towards a more sustainable food system for all? Please share your thoughts, concerns, or questions in the comments. You can attend the live stream here on FoodTank.com and Food Tank’s Facebook Live page.

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