Diabetes: What is our breaking point?

July 27, 2020 / By Private: Katie Christensen

Diabetes is an epidemic and it’s getting worse.

“The prevalence of diabetes (type 2 diabetes and type 1 diabetes) will increase by 54% to more than 54.9 million Americans between 2015 and 2030; annual deaths attributed to diabetes will climb by 38% to 385,800; and total annual medical and societal costs related to diabetes will increase 53% to more than $622 billion by 2030.”

A strong contributor to diabetes onset is the prevalence of obesity in children. Of all high income countries, the United States has the highest rates of overweight and obesity, with fully a third of the population obese—a rate projected to rise to around 50 percent by 2030.

Perhaps it is on my mind because, as a health professional, I am struck by the inconsistencies of our health care response. On the one hand, we are willing to participate in and largely embrace stay in place orders so as not to risk asymptomatic transmission of a deadly virus which currently has no cure. Now I realize that diabetes is not contagious, so it is not an apples-to-apples comparison to COVID-19, but many more Americans will be inflicted with, and ultimately die, from diabetes . 

It is not an either/or proposition, but we should treat this as a war. It requires tough choices to save our children and a recognition of inconvenient truths about some of our unhealthy lifestyle choices.

1. The Role of Social Determinants

Hot dogs and soft drinks can be a fun, inexpensive way to fill a child’s belly but consistently turning to these foods for nourishment can lead to diabetes. This problem of cheap over healthy gets at the core of social determinants of health, such as health literacy, financial stability, food scarcity and potentially even transportation to be able to access more food options. One can help mitigate these factors by understanding the risks and making the connection to individual purchasing behavior. Mitigation, however, also depends on having the financial means to make different choices and the ability to reasonably make those different purchasing decisions as a function of local market availability and means of transportation.

2. Government Intervention and Individual Choice

Even with full knowledge of the health care system, individuals often do not act rationally. Food choices can be based on fear, stress or poor health literacy, and behavior can often be a function of our historic experience and our own biases. If our shelves were filled with cookies as a child, they may continue to be filled with cookies as an adult.

To be clear, I am not advocating for the elimination of sugar, but just as we regulated smoking to ensure that our children were not improperly exposed, and smoking is deterred through taxation, it is appropriate in my opinion to introduce measures to both incentivize healthier food choices (why are fruits so expensive?) and discourage unhealthy food choices.

3. The Role of Marketing and Lobbying Efforts

As a society, we need to change the way we view our unhealthy eating habits. Do we ultimately view that bag of potato chips as a harmless snack or as a calorie dense food that, when eaten to excess, can cause major health problems? The way I view the bag of potato chips is representative of my own health literacy, but is also affected by how the bag of potato chips is marketed.

4. We are disproportionately impacted, yet we all bear the cost.

Health care costs are skyrocketing for many reasons, but one underlying theme is that more and more Americans are developing chronic conditions which require more medications, more visits to the Emergency Room and more hospitalizations. This drives up all of our insurance premiums.

What lesson can we take away from the coronavirus pandemic? We are all dependent on each other, we ARE a community and it takes a community effort to fight a disease. Let’s go to war against diabetes. Together we can beat this for ourselves and for our children.

Katie Christensen is a healthcare consulting manager within the Population and Payment Solutions group of 3M Health Information Systems.