A growing problem Featured

8:00pm EDT October 26, 2007

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 efsun@cvty.com or (412) 553-7549.