What if I told you that it was a disease? Naturally, you would think Ebola or another infectious agent – but, it isn’t. It’s something that has been around for a long time and the prevalence is increasing. What is it? Type II Diabetes.
Type II or adult-onset diabetes is a condition where the pancreas can either no longer manufacture insulin to keep blood glucose modulated – or – the body becomes resistant to insulin’s effect. For reference, Type I or juvenile, diabetes is caused by a defect where the pancreas is unable to make insulin.
I think we are all familiar with the complications of diabetes:
- Kidney failure
- Cardiovascular disease and Stroke
- High LDL levels
- Nerve disease
- Liver disease
- Gum disease
- Hearing loss
- Erectile dysfunction
- And, the most severe complication – death
As a matter of fact, diabetes was the seventh leading cause of death in the United States.
But, why is this a matter of national security? In order to understand that – we need to understand the components of the perfect storm.
First, and stay with me here, diabetes rates are on the rise – and this is not just a United States phenomenon. The prevalence is increasing in numerous countries (the UK, and Japan both show increases). It is such a pandemic that The World Health Organization has asked the United Nations members to work on resolving the issue now! Even President Obama mentioned it in his 2014 State of the Union address.
If we look at the latest data from the Center of Disease Control – there are 29.1 million people (or 9.3%). of the US population with diabetes (21 million are diagnosed, while 8.1 million are undiagnosed). While this is a mixture of Type I and Type II – this is a large percentage of the population, and the majority are Type II.
Furthermore, it doesn’t take into account people with a condition called ‘prediabetes’. This is a state where some, but not all, of the conditions for diabetes are met. And, while it is not necessarily a precursor to full-blown Type II diabetes, the effects of diabetes may have begun. Based on CDC data, 37% of US adults over the age of 20 have prediabetes! What does this mean – there is an estimated 86 million Americans over the age of 20 who may develop the disease.
So, all told – ~ 46% of the US population either has the disease, or – could develop the disease.
Second, there is an economic cost to all of this. If we just look at estimated cost, based on current data, the US population incurs a total cost of $245 billion. This is made up of direct medical costs of $176 billion and indirect costs (such as disability and productivity loss) of $69 billion. This equals 1.5 % of our 2012 GDP.
So, if you look at the ‘worse case’ scenario (with 46% of the US population either diabetic or prediabetic), that cost could increase to about $969 billion dollars in just a few years. This is 6% of our 2012 GDP. And. this assumes that there is no further increase in the rates of diabetes or prediabetes.
That assumption may prove false.
The expectation is that the number of diagnosed cases of diabetes will rise to 29 million by 2050 (an increase of 138%). So, if we assume a similar increase in prediabetic rates and undiagnosed cases – we could be looking at 91 million cases of diabetes by 2050. If we assume a similar makeup of the US demographic (which may, or may not, hold true) the percentage of people in the US with diabetes or prediabetes could reach a whopping 64 %. Based on today’s dollars, the costs incurred would be phenomenal – $1.34 trillion dollars (or ~ 8% of 2012 GDP). That is a huge amount to pay for one disease.
Third, we now have the Affordable Care Act and the US taxpayer will foot the bill for much of this. I am not against people having health care – but, I don’t think that Congress or the taxpayer know what they signed up for. With the advent of this legislation, the US taxpayer will be paying for our poor lifestyle and health choices. I don’t believe this variable was considered prior to approval of the final bill.
This, my dear reader, is why we have a national security issue on our hands as the economic consequences are dire.
Diabetes research is busy in finding ways to use stem cells and other technologies such as chip technology that will cure the disease. And, I applaud them. We have a significant problem on our hands.
But, I question why we don’discuss prevention in the first place. We discuss exercise, and keeping our weight in check, and this is common sense – but, I believe that something more is required that will change the course of medicine, our diets and improve the health of the population even more than just preventing diabetes. That change is the introduction of Functional Medicine to our healthcare system and changes to reimbursement of lifestyle medicine.
More on this topic later. And, I am excited to be part of it.