Diabetic Retinopathy

Most Californians May Have Diabetes or Prediabetes

Here’s a jolt. New data published by the UCLA Center for Health Policy Research suggest that 55% of people in California have either diabetes or prediabetes. The headlines generated by this study are sensational, but there’s no obvious reason to doubt the report’s accuracy.

In this report, we can glimpse a future filled with chronic disease. The California Center for Public Health Advocacy commissioned the study and Executive Director Harold Goldstein described its significance:

This is the clearest indication to date that the diabetes epidemic is out of control and getting worse. If there is any hope to keep health insurance costs from skyrocketing, health care providers from being overwhelmed and millions of Californians from suffering needlessly from amputations, blindness and kidney failure, the state of California must launch a major campaign to turn around the epidemic of type 2 diabetes.

Despite these staggering implications, responding will not be a simple matter. Diabetes prevention is pretty well understood, thanks to the landmark work of the Diabetes Prevention Program. Intensive behavioral therapy for obesity treatment and diabetes prevention is legally required to be freely available under every health plan in the U.S. But reality for patients and providers falls way short of matching this requirement.

A new study in the Journal of the American Board of Family Medicine (JABFM) finds a combined 45% prevalence of diabetes and prediabetes in a national sample and finds that the diagnosis of prediabetes is not even routinely recorded. Further, they find that three-fourths of patients with prediabetes are not provided with evidence-based care for it. Among the potential reasons for this failure, the authors note that “there is a concern among some clinicians that diagnosing prediabetes overmedicalizes a condition that is not a disease.”

Sound familiar? Obesity is a primary risk factor for prediabetes. Evidence-based obesity care and diabetes prevention go hand in hand. Both are seriously neglected in U.S. healthcare.

The longer we wait to provide needed care for these conditions, the more expensive and intractable they will become.

Click here for the UCLA study and here for the study from JABFM. Click here for more from the LA Times.

Diabetic ReDitinopathy, photograph © Community Eye Health / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


March 15, 2016

2 Responses to “Most Californians May Have Diabetes or Prediabetes”

  1. March 15, 2016 at 11:20 am, Allen Browne said:

    This is a “Duh” article.

    We need to add on to behavioral therapy for most of these people and now we have more tools than ever – but still very spotty payer support and spotty medical provider support despite the clinical and research evidence that they are necessary. Understanding the physiology makes this all make sense.

    And this is all true for the children, too.

    Much work to do.

    • March 15, 2016 at 12:26 pm, Ted said:

      Very true, Allen,