Diabetes is an epidemic and needs to be treated like one, with a public-health approach, Lexington policy experts say in new book

Diabetes is often called an epidemic, but is not treated as such. Two Lexington health policy experts argue in a new book that this has to change, Tom Eblen reports for the Lexington Herald-Leader.

The Great Diabetes Epidemic: A Manifesto for Control and Prevention was written by Dr. Gilbert Friedell, former director of the Markey Cancer Center at the University of Kentucky and founder of the Friedell Committee, a statewide health care policy organization; and Isaac Joyner, a public-health policy analyst who has worked on a variety of issues in Kentucky, Texas and the Carolinas. It outlines specific steps that people, communities and the government should take in its approach to diabetes, saying the solution is a “major public health response.”

“If we continue to treat diabetes on a one-patient-at-a-time basis, we can’t deal with an epidemic,” Friedell told Eblen. “Unless you take a public health approach to an epidemic, it doesn’t work.”

Kentucky has seen a 158 percent increase in cases over the last 15 years, “outpacing every other state except Oklahoma,” according to the Centers for Disease Control and Prevention. Eblen reports that most cases are Type 2 diabetes, which is related to obesity.

“A flu epidemic of such magnitude would create public alarm and swift official response,” Eblen writes.

The authors say the first step in changing diabetes in America is widespread, routine screening. They cite Centers for Disease Control and Prevention estimates that more than one-fourth of the people who have diabetes don’t know it because they have not been tested.

In Kentucky, that means that 370,000 Kentuckians know they have diabetes, but 137,000 more might have it and not know it, Eblen reports. Officials estimate 233,000 Kentuckians have pre-diabetes, meaning they are at immediate risk of developing the disease.

“You have to find cases early, which means you have to screen people who seem well,” Friedell said. “The symptoms of diabetes come on maybe 10 years after the disease starts. But nobody knows they have the disease. We’re wasting 10 years that we could be doing something good for people.”

Current recommendations for diabetes screening is for people with high blood pressure, or anyone older than 45. The authors say everyone older than 20 should be screened. They say this has to be viewed as a societal problem, not an individual one, Eblen reports.

The authors call for increased government and community funding and efforts toward proven diabetes prevention programs and for insurance companies to revise the way they reimburse for diabetes saying, ” the longterm payoff would be huge” with these changes. Most importantly, they also call for increased public awareness and urgency.

“There has to be a sense of urgency, and there is no sense of urgency about diabetes,” Friedell told Eblen. “We need to do something to get the public involved, and the public has to feel that it’s important.”

Friedell and Joyner will speak about the book and sign copies at 5 p.m. Friday, Nov. 14, which is World Diabetes Day, at The Morris Book Shop, 882 East High Street. They also are scheduled to testify Nov. 18 in Washington to the Congressional Caucus on Diabetes.

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