In September, a Pennsylvania state commission created by Gov. Ed Rendell met
for the first time to find ways to improve the health management of chronic diseases. The commission is starting with diabetes, which is quickly becoming an epidemic in the United States.
Smart Business spoke to Eugene Sun,
M.D., MBA, vice president of medical
affairs for HealthAmerica, about diabetes
and its implication to health care costs.
Why should we be interested in chronic diseases like diabetes?
When Gov. Rendell announced the creation of a chronic care commission earlier
this year, he said that about 78 percent of
health care costs can be traced to about 20
percent of patients with chronic diseases.
The total annual economic cost of diabetes
alone was estimated to be $132 billion in
2002, or one out of every 10 health care dollars spent in the United States.
More importantly, diabetes is a very dangerous disease. It can result in blindness,
circulatory problems, kidney disease and
many other serious health problems.
Diabetes officially contributed to 224,092
deaths in 2002 — but the unofficial toll is
probably much higher.
The reason to focus on chronic diseases,
however, is that they can often be prevented, and they don’t have to be hard to treat
or costly if they are managed well. They are
a problem that can be fixed.
How serious is the diabetes problem today?
Diabetes is one of the fastest-growing
health problems in America. It’s estimated
that 20.8 million Americans — 7 percent of
the population — have diabetes. An additional 54 million are at high risk for developing diabetes within the next 10 years.
Furthermore, type 2 diabetes, which we
used to call ‘adult-onset diabetes,’ is
increasingly being found in children.
Twenty years ago, only about 2 percent of
new cases of type 2 diabetes occurred in people under age 20. Now, more than 30
percent of new cases are found in young
people.
Why is the number of diabetes diagnoses
growing?
Medical experts have not yet pinpointed
the cause of type 2 diabetes. However, we
know that, while genetic makeup may pre-dispose a person to diabetes, the chances
of developing it are dramatically increased
by being overweight. In fact, a person’s risk
of diabetes more than doubles with every
20 percent increase over his or her ideal
body weight.
Being sedentary makes the risk worse, as
does smoking. Other risk factors include
high cholesterol and high blood pressure.
What can be done to reduce the chances of
getting diabetes?
The good news is that type 2 diabetes is
highly preventable. A 5 to 10 percent reduction in body weight, coupled with 30 minutes of moderate exercise a day, can
reduce your chances for developing the
disease by 58 percent. Here’s what the federal government’s Diabetes Prevention
Program recommends:
Step one: Adopt a low-fat, low-calorie
diet. This is the same diet that doctors recommend for overall good health, but it also
helps prevent diabetes. That means lots of
fruits and vegetables, a minimum of fried
and fatty foods, plenty of whole-grain products, low-fat dairy items and few sweets.
Step two: Engage in 30 minutes of physical activity daily. Brisk walking or any
other moderate-intensity exercise will do.
The goal is to lose about 7 percent of your
body weight. That’s only 14 pounds for a
200-pound person.
Step three: Maintain the diet and exercise needed to keep the weight off.
What can someone with diabetes do to better
manage his or her health?
Although there is no cure for diabetes, if
you take care of yourself, you can enjoy a
healthy, active life. Work closely with your
doctor and follow these tips:
- Check your blood sugar level often.
- Follow your diet carefully.
- Exercise three or four times a week.
- Keep your blood pressure and cholesterol under control.
- Don’t smoke.
- Take good care of your gums, eyes, feet and skin.
EUGENE SUN, M.D., MBA, is vice president of medical affairs
for HealthAmerica. Reach him at [email protected] or (412) 553-7549.
