Diabetes Virtually Doubled

Diabetes virtually doubled over the last two decades, along with prediabetes. This news comes from a study just published in the Annals of Internal Medicine. The increase in both are attributed to rising rates of obesity over the same period of time.

There’s good news for our sick care system in this study — even if it’s not so good for our health and our budgets. Over these two decades, less diabetes goes undiagnosed and it’s better controlled than ever before. We have a glittering array of new technologies and drugs to thank for those improvements, along with improved systems for diagnosing and caring for people with diabetes. We’re giving better sick care. And it comes with a big price tag.

But at the same time, we’ve been stubbornly resistant to dealing with the root cause of these trends — obesity — as a health issue. For most of those two decades the sick care system erected barriers to people who sought treatment for obesity and the skilled clinicians who could deliver it.

Until 2004, the federal Centers for Medicare and Medicaid Services declared that obesity was not a disease and thus they would not cover any treatments for it. They still deny coverage for any drugs to treat obesity. Coverage for life-saving obesity surgery has often been hidden in a maze of bewildering restrictions. Many people are forced to pay out of pocket, travel out of country, or simply give up. Clinicians who bill for obesity treatment find insurance claims denied because of exclusions for obesity treatment.

This illustrates why the Trust for America’s Health says that we have more of a sick care system than a healthcare system. We deal with chronic diseases by treating them intensively when the health burden becomes undeniable. And we ignore conditions like obesity that create this problem. Or worse, we simply blame patients for their condition.

Perhaps we are changing direction. More health plans are covering obesity treatment. Intensive behavioral therapy for obesity is mandated with no co-pay under the Affordable Care Act. And the Treat and Reduce Obesity Act aims to plug some of the holes in Medicare for treating obesity.

“When you’re in a hole, stop digging.” — Denis Healey

Click here to read more about the study in Annals, here to read the study itself, here to read more about moving from sick care to healthcare, and here to read more about the Treat and Reduce Obesity Act.

Cedar Waxwing with Double Berry, photograph © Henry McLin/ flickr

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