Forget COVID, diabetes is a national emergency

SUMMARY: Treating Americans with diabetes now costs more than the U.S. Navy’s annual budget. And the world’s richest nation is losing this battle — even before COVID.  85 percent of people with diabetes are overweight. While not all diabetes cases are linked to weight gain, overeating and eating too much is still the main cause of type 2 diabetes.

Reuters this morning had a story on diabetes that scared me a lot. Here is a summary:

The U.S. Centers for Disease Control and Prevention (CDC) cites research showing that 40% or more of the people who died with COVID-19 also had diabetes.

…Since then, despite billions of dollars spent on new treatments, the prognosis for diabetes has been getting worse as the number of patients with the disease has increased, especially among working-age and even younger people.

…Dr. Giuseppina Imperatore, who oversees disease surveillance and other areas in the CDC’s Division of Diabetes Translation, said that the recent trends on diabetic complications and deaths are “definitely concerning” and that the agency is still trying to fully understand what’s driving the poor outcomes, particularly among younger adults.

…Advances in medication and technology to help patients better manage their condition often fail to reach those whose access to care is hampered by their race, income, or type of insurance, according to diabetes and public health experts.

…At Children’s National Hospital in Washington, D.C., diagnoses of type 2 diabetes among patients 8 to 20 years old nearly tripled in the first year of the pandemic.

…A TELLING SPIKE: Dr. Brynn Marks, a pediatric endocrinologist at Children’s National Hospital in Washington, D.C., said the jump in diagnoses of type 2 diabetes among young people at her hospital during the pandemic partly reflects the impact of social distancing.

…In younger people, type 2 diabetes is often more severe than in cases that develop later in life, said Dr. Deborah Wexler, clinical director of the diabetes center at Massachusetts General Hospital and an associate professor at Harvard Medical School.

…But a Johns Hopkins University study published in the New England Journal of Medicine in June that tracked more than 6,000 type 2 patients from 1999 through 2018 found that the drugs weren’t getting to many patients who needed them, especially younger patients and those without insurance.

…The newer drugs can reduce the risk of heart disease and promote weight loss, but “they are costly and many of the patients that really need them … are not covered,” said Dr. Nestoras Mathioudakis, co-medical director of the Baltimore Metropolitan Diabetes Regional Partnership at Johns Hopkins.

…Dr. Mary Applegate, medical director of Ohio’s Medicaid program, acknowledged that many diabetes patients don’t receive the care and support they need to manage their disease, leading to poor outcomes and higher medical costs.

Poor health habits cause not all obesity. Genetics plays a big role as well as psychological factors. The real challenge, however, is motivating people to eat right and get some damn exercise. Pandemic aside, there are plenty of ways you can burn calories without going to a gym.

Insurers need to work with medical professionals to ensure obese patients are counseled on eating right and getting some exercise. A smartwatch can, for example, calculate your exercise for the day so patients can monitor calories burned.

We can’t continue to ignore this pandemic. Enough is enough. People who are obese because of the lack of exercise and eating habits need to pay more for healthcare.