WASHINGTON — Startling statistics recently released by a Centers for Disease Control and Prevention project that 1 in 3 U.S. adults could have diabetes by 2050. What is already a serious condition, affecting 1 in 10 Americans, could become an epidemic over the next 40 years.
“The message we really want people to understand is that this is an urgent public health problem, we can’t possibly sustain 1 in 3 people having diabetes, it would just be a catastrophe, and so it’s incredibly important that we have people very seriously come together around the issue of diabetes prevention,” said Ann Albright, director of the CDC’s Division of Diabetes Translation.
Diabetes was the seventh leading cause of death in 2007 and can lead to complications such as blindness, kidney failure and amputations. According to the CDC, diabetics can face twice the medical costs of those without the disease.
But those who are at risk may be able to significantly reduce their chances of developing Type 2 diabetes by making some modest lifestyle changes, Albright said. The CDC launched the National Diabetes Prevention Program in April, based on research from the Diabetes Prevention Program clinical trial, led by the National Institutes of Health.
Research showed that lifestyle changes including a loss of 5-7 percent of body weight and an exercise plan of at least 150 minutes per week could help reduce the onset of Type 2 diabetes in pre-diabetic patients by 58 percent. By rolling out the National Diabetes Prevention Program throughout the country and targeting those with pre-diabetes or at very high risk, Albright said the CDC and its partners hope to significantly reduce or delay new cases of the disease.
The CDC has oversight of the national program and partnered with the YMCA to deliver it to communities across the country. Jonathan Lever, Vice President for Health Strategies and Innovation at the Y said there are currently 18 sites around the country holding classes, 10 more planned to open in early 2011, and even further openings expected later next year.
“Because YMCA’s are community-based, accessible and places that people love to go, we’re a natural place to help people engage in behavior change around healthy living,” Lever said.
According to Albright and Lever, there is funding guaranteed for 28 of the sites between aid provided by the CDC and reimbursement and grants provided by a special division of insurer, UnitedHealthcare. Albright said within the next year the CDC will approve standards of recognition for the program so that the Y sites can apply for formal recognition, which she hopes will help bring more insurers on board to provide coverage. Long-term funding by the CDC “is not a function we can serve as an agency,” she said.
Over a 16-week course, participants who have been diagnosed with pre-diabetes or fit certain high-risk conditions learn how to identify unhealthy habits and barriers and implement better nutrition and exercise habits into their lifestyle. Albright said it’s not a one-size-fits-all plan. “People are not given a specific diet, they are given principles and that is why this is an effective intervention,” she said.
Other important elements of the course are food journals and weekly weigh-ins to help participants monitor their progress and stay accountable.
“My problem is I eat too much fat, and I never knew this until I started journaling,” said Nena Joyce, 47, a program participant in Jacksonville, Fla. Joyce said she struggled to take proper care of her health, but now she has dropped six pounds and a dress size. “Thanks to this class I am eating better and I exercise more than I ever have in my whole entire life.”
She also said the support of her coach and fellow class members has played a big role in her success. Class coach and program coordinator for the Jacksonville Y, Jenna Braddock, said she loves to see people from all walks of life coming together to support each other in her class. “They are bound by a common thread – they have this problem that they are all working to fix.”
Following the 16 weeks, participants will have monthly follow-up meetings through the rest of the year to help support and guide their progress.
While the CDC is rolling out the program in partnership with the Y right now, Albright said once standards of recognition are approved, other sites that want to host the program are welcome to apply for recognition as well.
In Washington D.C., the MedStar Diabetes Institute at Washington Hospital Center is already being proactive. Program manager Gretchen Youssef, was on the work group to develop the CDC standards of recognition and she has helped bring the national prevention program to D.C. recreation centers. “Last year the D.C. Department of Health supported the efforts and actually provided us with grant money to set it up in the community,” she said.
She said her program follows the same format as the national one and she plans to apply for CDC recognition.
Reasons for the predicted surge of the disease include an aging population, an increase in minority groups which are at higher risk and the fact that people with diabetes are living longer, Albright said.
Risk factors for diabetes include older age, family history, obesity, a sedentary lifestyle, gestational diabetes and race or ethnicity. Many populations such as African-Americans, Hispanics, American Indians/Native Americans and those of Asian descent are at higher risk.
Susan Kirkman, M.D., Senior Vice President of Medical Affairs and Community Information at the American Diabetes Association, cites changes in occupations from outdoor to more indoor and inactive jobs and diet changes like larger portion sizes and more calorie-filled foods as contributing factors in Americans’ vulnerability to the disease.
Albright adds that societal and environmental factors like poverty, poor access to healthcare and food deserts also play a role. “Our hope is that people who participate will actually become activated, engaged citizens in their communities, working toward creating a healthy environment,” she said.
Experts say prevention and awareness are the key elements in the arsenal to fight diabetes. Kirkman said “the vast majority of people with pre-diabetes don’t know they have it and a quarter of people with Type 2 diabetes don’t know they have it.” She recommends people get screened if they are overweight and fall into one of the other risk categories.
Class coach Braddock says while the prevention program can be challenging, in the long run it’s worth it.
“Anything you can do on this side of diabetes is worth every minute of your life, every challenge,” she said. “I’ve had so many people that have come up to me while we’re screening and say ‘I’m diabetic now, and I wish I had something like this 10 years ago. Please tell people they need to do this program.’ “