Nurse’s Notes: The state of diabetes in America – The Missoulian

A recent study reported that diabetes is the third leading cause of death in the United States, up from seventh in 2010.

This study also reported that life expectancy has slowed down or even decreased, mainly due to the rise of diabetes and obesity in our country. Per recent Centers for Disease Control statistics, 21.95 million people in the United States, or 9.3 percent of the population, in 2014 had diabetes. In those 65 years old and older, more than 25 percent have diabetes, and that percentage is expected to double by 2050 if current trends continue.

If glucose levels are high over long periods of time, heart disease, blindness, kidney disease, nerve damage and other complications can result. But prevention of these complications is possible. The American Diabetes Association recommends that most non-pregnant adults with diabetes maintain a hemoglobin A1c (a 3-month blood sugar average) less than 7 percent, with daily blood sugars less than 130 mg/dl after fasting and less than 180 mg/dl two hours after eating.

Diabetes costs $245 billion a year; $69 billion of those costs are indirect, such as lost productivity and increased absenteeism from work. Patients with diabetes have medical costs twice as much as those without diabetes. The risk of death in adults with diabetes is 50 percent higher than for adults without diabetes. Prediabetes (often a precursor to type 2 diabetes) currently has a prevalence of 86 million, or 30 percent of the population, and nine out of 10 of those folks are unaware they have it. In the Medicare population, more than half have prediabetes, based on estimates from the Centers for Disease Control.

Recent statistics estimate that 90 percent of the cases of type 2 diabetes can be prevented through lifestyle change, specifically Diabetes Prevention Programs. Structured DPPs are effective interventions lasting one year and taught by a lifestyle coach. Participants in the DPP learn about healthy eating, ways to incorporate exercise, how to manage stress and set up their environment and life for success.

The goal of the DPP is to have participants lose 7 percent of their body weight over the course of a year through nutrition interventions and exercising at least 150 minutes per week. The results from the DPP suggest over a 50 percent reduction in acquiring type 2 diabetes for those at risk. In 2018, Medicare will pay for the DPP as long as the program goes through the CDC accreditation process.

The potential is there to slow the rate of type 2 diabetes in our country. If you or someone you love is concerned about having prediabetes, ask your doctor to do a simple blood test such as a hemoglobin A1C or take the CDC risk test found at cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf.

We can turn the tide of diabetes in our country by screening all people with risk factors for diabetes and getting them into a DPP. Such opportunities exist in Missoula and Western Montana. As Robert Ratner, M.D., chief scientific officer for the American Diabetes Association once said, We must prevent diabetes or our health system will be consumed by it. Now is the time!

Jennifer Troupe, MS, RD, is the manager of Providence Endocrinology, Diabetes and Nutrition Center

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Nurse's Notes: The state of diabetes in America - The Missoulian