Public support for addressing diabetes is imperative when you consider the tremendous amount of money it costs to manage the disease. One of every five health care dollars spent in the U.S. is for someone with the disease. Medicare, the federal insurance program for seniors, pays 60 percent of the nation's annual $83 billion diabetes-related hospital bill; Medicaid, the federal-state insurance program for low-income citizens, pays another 10 percent.
"Right now we're having a diabetes epidemic," said American Diabetes Association president for health and education Geralyn Spollett, an associate nursing professor at Yale University's Diabetes Center. "People don't realize the urgency of the problem we have with people at high risk." Spollett said the challenge is to realistically frame diabetes so it's not scary to the point of making people feel powerless. On the other hand, she added, "If you give a message that everything is fine, the seriousness of the disease doesn't come through."
THE THIN LINE
Susan Dentzer, editor-in-chief of Health Affairs, calls in the journal's diabetes-focused January 2012 edition for "an all-out assault on the condition -- and, since obesity and diabetes walk hand-in-hand, a long-term commitment to radically reshaping the obesogenic environment we live in."
The fat-creating environment makes it exceedingly difficult for people at risk for diabetes -- because of poor diet, obesity, and lack of exercise -- to resist the forces that work against their own good health. The environment typically features structural factors such as impractical transit systems, and towns and cities dependent on the car; desk jobs and non-physical recreation such as TV watching, video-gaming, and web-surfing; and a savvy food industry that has hooked the public on a great deal of unhealthy food items.
Most perniciously of all, the diabetes-inducing environment -- let's be frank: America in general -- fosters a casual attitude toward obesity and ignorance of its impact on individuals, families, and the nation.
Despite its extraordinary consequences, a 2009 University of Chicago study found that most Americans are not seriously concerned with obesity. Although more than half of us are overweight, the study authors said that less than 25 percent of the 909 adults they surveyed saw their own weight as a serious or very serious problem.
It's hard to pinpoint any one reason for the obesity epidemic, said Dr. Jeffrey P. Koplan, director of the Emory Global Health Institute at Emory University in Atlanta. "Our daily lives and environment have changed significantly over 50 years," he said, "creating an environment that is more favorable to taking in excess calories and getting less exercise. Portion size, snacking, how and when we eat, who we eat with, how food gets prepared -- there's a bundle of issues there, virtually all of which promote eating when we don't need to, eating the wrong things, and eating too much."