Defenders against diabetes need a leader to emerge in Dallas
By: Health Insurance
Submitted: 2009-12-14 18:23:28 | Word Count: 671
Diabetes is marching through the Dallas area. One in 10 adults over age 30 already has it. One in three born this year will get it. For Hispanics and African-Americans, it's one in two.
But the city's fight against this chronic disease is taking place on several fronts, with each group of defenders uncertain about what's working and about what the other defenders are doing.
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"We're starting to have some meaningful conversations; we're starting to do some of the right things to move this forward," said Quin Neal, senior executive director of the North Texas branch of the American Diabetes Association.
That's well short of what it will take to head off an epidemic of disease and an explosion of health care costs that will affect everyone in the area.
The American Diabetes Association last week released a study predicting the number of Americans suffering from the disease would double in the next 25 years to 44 million, while the cost of treating the disease would triple to $336 billion a year.
"Not to say we're in a panic mode, but maybe we need to look at it that way," Neal said.
Diabetes is an example of why Dallas needs the kind of health care summit that took place Monday at the Dallas Regional Chamber. It's a communitywide problem that requires everyone's attention.
There is no vaccination for diabetes. But in nine out of 10 cases, it can be prevented – and sometimes reversed – by changing eating and exercise habits.
Easier said than done.
More than two-thirds of us are overweight or obese. For those with health insurance, such conditions should warrant a frank discussion with a doctor about a disease that causes blindness, lower limb amputations, hypertension, heart disease and more.
For those without insurance, the discussion needs to take place in churches, schools, community centers and food markets. If there's no one on hand to lead the diabetes dialogue, well, politicians are elected to lead.
Three-fourths of what we spend on health care goes toward treating chronic diseases like diabetes. Yet the way health care is delivered in Dallas, diabetes doesn't get the attention it deserves until patients with insurance come down with it or until patients without insurance show up in the emergency room with full-blown symptoms.
Cathy Schoen, a vice president with the New York-based Commonwealth Fund, noted this fall that many Texans are falling through the cracks. Only 38.5 percent of adult Texans with diabetes received recommended preventive care in 2006-07.
Employers alarmed by the rapid increase in the cost of employee health insurance have started keeping tabs on area physicians to see which ones are doing recommended diabetes-related testing. Some are also swapping notes on what works to get employees to lose weight and exercise.
BlueCross BlueShield of Texas, the state's largest health insurer, joined a pilot program this month that will give 1,650 physicians booklets on how to deal with obesity among children.
"What used to be called adult-onset diabetes is now showing up in 9-year-olds," said Dr. Eduardo Sanchez, chief medical officer of BlueCross BlueShield of Texas.
Schoen said the problem is skewing public spending.
"Already you are starting to see dialysis centers built rather than playgrounds. That's a real misuse of resources, if we could just keep people healthy," she said.
The problem is acute. The need to fight it is obvious. But so, too, is the need for coordination.
"It takes a community," said Marianne Fazen, executive director of the Dallas-Fort Worth Business Group on Health.
