Diabetes and Public Health in the United States

Abstract

Diabetes mellitus (DM) in the United States is a chronic disease epidemic. Further, the rate of increase in the prevalence of diabetes, year to year, is increasing, and the onset of diabetes is at ever younger ages, with prevalence of type 2 diabetes now increasing at greatest rates among people in their 30s. Should the epidemic of type 2 DM increase, even at its present rate, it is projected that there will be approximately 30 million persons with known DM in the United States by 2050. In essence, there will be more people with diabetes who have a longer duration of disease, with the devastating complications and associated morbidity, mortality, impaired quality of life, and costs; and this could increase substantially during the next two decades. The rise in prevalence observed in the United States is also happening throughout the world, and all countries can anticipate increasing challenges associated with DM.

3-Year Follow-up of Clinical and Behavioral Improvements Following a Multifaceted Diabetes Care Intervention

“…D iabetes is a serious, costly disease that continues to rapidly increase. 1 It represents a major public health challenge and is an emerging pandemic 2,3 as it places an undue burden on the person diagnosed, their families, communities, 4 and the health care system. 5 Large randomized controlled trials 6,7 established that achieving near-normal glucose control reduces the risk of diabetes complications, but the results also validate the complexity of diabetes care and management.…”

Translating the Chronic Care Model Into the Community

“…Diabetes represents a significant public health burden worldwide by decreasing quality of life and causing death and disability at great economic cost (2). Though quality diabetes care is essential to prevent long-term complications, care often falls below recommended standards regardless of health care setting or patient population, emphasizing the necessity for system change (3)(4)(5)(6).…”

The Diabetes Self-management Assessment Report Tool (D-SMART®)

“…Increasing patient participation is a critical element in successful chronic disease management, 24,25 and systems that support the development of both informed and activated patients have demonstrated positive outcomes. 24 Therefore, the researchers regard the fact that the D-SMART helped patients think about their diabetes and helped to improve their communication with their diabetes educator as the most important outcome identified in this study.…”

“…An effort is currently under way to test a Hispanic version of the D-SMART. 26 As the rates of diabetes continue to increase in epidemic proportions, 25,27,28 it becomes critical to explore innovative methods that support the delivery of DSME. If we are to meet the goals set for Healthy People 2010, to increase those reached with diabetes education from 40% (1998) to 60% (2010), 29 it is important to explore timesaving methods that help the diabetes educator meet the needs of more patients.…”