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article imageReport: Diabetes in Texas reaches epidemic levels

By Lynn Herrmann     Dec 1, 2010 in Health
Austin - A new report released by the Texas Health Institute finds that more than 8 million Texans will have diabetes by 2040, numbers projected to quadruple the current number of 2.2 million Texans now battling the condition.
Labelled a “modern-day epidemic,” the report notes diabetes rates among young adults have tripled in less than a decade, closely associated to the rising obesity rate which doubled during the same time period.
Texas has some of the highest incidence rates for diabetes in the nation. Much of this is due to the state’s changing demographics: an aging population and ethnic makeup. The older population and the Latino population are the fastest growing in the state and much of the high incidence rate is associated with these two factors.
The 43-page report, Responding to the Epidemic: Strategies for Improving Diabetes Care in Texas (pdf), is a wake-up call for the health care industry, stating the costs associated with treating diabetes
“and its complications represent a significant threat to the financial solvency of the Texas public and private health infrastructure.”
Diabetes is a condition that does not allow the body to properly use or produce insulin. Insulin, a naturally produced hormone, is responsible for the body to access starches, sugar and other foods for energy.
The three main forms of diabetes are Type 1, Type 2 and gestational diabetes. Type 1 diabetes is typically, but not always, diagnosed in children and young adults with an autoimmune disorder.
Type 2 diabetes is the most common form of diabetes and, until recently, was historically diagnosed in adults. It is now being diagnosed in children. Type 2 diabetes is responsible for 90-95 percent of all cases being diagnosed today.
Gestational diabetes occurs when women experience high blood sugar levels during pregnancy. In some cases, the pregnant woman may have never previously experienced diabetes. Although gestational diabetes is a transient condition and usually reverses itself upon childbirth, it should be monitored closely during pregnancy. Left untreated, the condition highly increases the risk of a complicated birthing process, with risks ranging from premature birth to a newborn with excessive weight. The condition also increases the risk of the mother developing diabetes again later in life.
The report notes the American Diabetes Association estimates 5.7 million Americans are unaware they have Type 2 diabetes. Additionally, another 57 million suffer a condition called pre-diabetes, a Type 2 diabetes precursor.
Although all forms of diabetes are treatable, there is no known cure at this time. Daily and “more frequent” treatments allow many people with diabetes to lead relatively healthy and normal lives. Self-management, in the form of daily insulin injections, medications, dietary adjustments, exercise and blood glucose monitoring, is crucial.
The report states early diagnosis and treatment are vital to reducing or preventing serious effects of the disease, such as stroke, heart attack, kidney failure, blindness, or loss of limbs.
Among the round-table discussions that led to the report, reducing obesity was found to be essential as a primary prevention. Among the emerging themes at these discussions was a need for improved health care for those already diagnosed with the condition. The report notes that:
“it is crucial to prioritize cost-effective ways of improving healthcare status of the more than 2 million Texas adults currently living with diabetes and the more than 1 million Texas adults living with pre-diabetes.”
Alarm has been raised over the current rate of obese children in Texas. The report shows that more than 20 percent of all children in the 10-17 age group are obese, with that rate rapidly rising due to increased consumption of fast foods and a lack of physical exercise.
In a press release associated with the report, Dr. Victor Gonzalez, chairman of the Texas Diabetes Council, said: “You put those two factors together, and it’s a disaster.”
Currently, Texas leads the nation in the rate of diabetes among the Hispanic population, with 680,351 people, or 11.1 percent of the state’s Hispanics currently affected with the condition. Among African-Americans in Texas ages 18 or older, 251,543 people, or 13 percent of the population, have diabetes. Although the rate is higher than the Hispanic rate, individual numbers are lower.
Overall annual costs of diabetes among all age groups in Texas exceeds $12.5 billion, according to the American Diabetes Association. This number includes $8.1 billion in excess medical expenses and $4.4 billion in reduced productivity, absenteeism, unemployment and other indirect costs. Additionally, one on ever 10 healthcare dollars is attributed to diabetes.
Among the many no-cost strategies suggested in the report are assessing the impact of the state’s current work on diabetes prevention and treatment, a recalibration of existing resources, and creating a budget blueprint that identifies costs, needs, and resources for addressing the diabetes epidemic.
Some of the cost-strategies recommended include implementation of a state-wide screening program and testing within a healthcare setting, expanded self-management training (this benefit is covered under Medicare and private insurance, but not with Medicaid in Texas) and closing the gap of benefits between Medicaid and CHIP for pregnant women,
More about Diabetes, Texas health institute, Texas diabetes council
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