The Atlantic hosts in-depth diabetes conversation

NEW YORK — On the eve of World Diabetes Day, The Atlantic convened a town-hall styled event called "The Diabetes Divide" to discuss the disease and share what city organizers, health groups and diabetes advocates are doing to educate people on diabetes' scope and strategies for addressing the epidemic that the International Diabetes Federation recently reported affects more than 415 million people —  half of whom haven't been diagnosed.

 

(A replay of the two-hour event can be found here, the presentation starts at about the 32:00 mark). 

 

“We have to improve detection and prevention if we're ever going to make a dent in these numbers,” Todd Hobbs, chief medical officer for Novo Nordisk North America, said at the forum. “At Novo Nordisk, we certainly want to reverse these trends. We have a bold vision — we want to defeat diabetes in our lifetime," he said. "We are dedicated to innovation in diabetes and other chronic conditions.”

 

In the U.S., 29 million Americans have diabetes, and 86 million more are pre-diabetic. And diabetes remains the No. 7 leading cause of death in this country.

“Despite these staggering numbers, the general public is still unaware of how prevalent and serious the epidemic of diabetes is,” Emily Akhtarzandi, AtlanticLIVE’s managing director, said. “Diabetes is a disease that disproportionately strikes minorities and disadvantaged communities. And trends show that diabetes is growing at alarming rates in urban areas.”

 

What are the issues?

 

"It's tough to eat right, do right, exercise right in the complicated society we live in," said Dan Glickman, executive director of the Aspen Institute Congressional Program and former U.S. Department of Agriculture secretary. He acknowledged that today’s American culture does not support healthy choices, rather making heavily-advertised, inexpensive processed foods that serve a convenience need readily available for dual-income familes or single parents who are crunched for time. “Under the best of circumstances, people have a couple strikes against them before they even start this,” Glickman said.

 

According to Hobbs, another inhibitor is the out-of-pocket costs associated with the underinsured.

 

“As patients weight these costs against their treatment, we know that they may choose to skip or reduce doses of medication,” Hobbs noted. “Or they make fewer visits to the doctor.”

 

People with diabetes who do not have insurance have 79% fewer phyisician office visits and are prescribed 68% less medications. They also had 55% more emergency rooom visits, Hobbs said.

 

“We are treating the disease as acute care, rather than preventative,” Diabetes Collective CEO Christel Aprigliano said. "We're not being proactive."

 

But Glickman suggested that the tide against diabetes may be turning, and it's starting at the ground level with consumers.

 

“Consumers today with handheld devices and with the modern media are much more empowered than they used to be,” he said. “People want to know what's in their food, where is it grown, how safe it is, how healthy it is. And it's not just at high-income levels, it's moving down the income chain. Empowering consumers is a big part of the solution of this problem.”

 

The empowerment Glickman discussed goes all the way to city halls across the country, as many municipal health officials are working toward addressing diabetes prevention as well. In Houston, the city has a program called “Cigna Sunday Streets,” where the streets are closed to vehicular traffic and opened to "active transportation."

 

“This is a very big deal for a city like Houston because we love our cars,” Houston's assistant Health and Human Services director Faith Foreman said. “But we actually shut the city down for four hours ... in very high-traffic areas.”

 

Alongside government efforts such community organizations as the YMCA have taken up the battle against diabetes. The YMCA’s Diabetes Prevention Program features a trained lifestyle coach who will introduce topics in a supportive, small group environment and encourage participants as they explore how healthy eating, physical activity and behavior changes can benefit their health.

 

The 12-month group-based program consists of 16 one-hour, weekly sessions, followed by monthly sessions led by a trained lifestyle coach who facilitates a small group of people with similar goals. The group discusses healthy eating, increasing physical activity, reducing stress and problem solving.

 

“What's really exciting about this is the partnerships with public health, Lori Rose Benson, VP Healthy Lifestyles, YMCA of Greater New York said.