Diabetes an Urgent Issue for the States

When Illinois Rep. Michael Tryon had a physical exam in 2004, his cholesterol level was good, he had a normally functioning thyroid and his long-term blood sugar level—also called an A1c—was normal. After his first year of service in the legislature, things had changed.

In June 2005, Tryon’s cholesterol had risen from 159 to 279. He had low thyroid levels, high triglycerides and his A1c also had increased.

“I didn’t realize you didn’t break for lunch, you didn’t break for dinner, you didn’t get bathroom breaks and you ate at odd hours,” he said at Friday’s Health Policy Academy on diabetes. “… Low and behold, at the end of the first legislative session, I was diagnosed with type 2 diabetes.”

Tryon is not alone. In Illinois, 9.5 percent of the population has diabetes. In the United States, almost 26 million people are diabetic, which amounts to more than 8 percent of the population.

“If things don’t change, 53 million Americans are going to have diabetes in 2025,” said Dr. William Rowley, a senior fellow at the Institute for Alternative Futures. “… In 2025, it’s possible we’re going to spend over half a trillion dollars in this country on diabetes alone. … Even in Washington, that’s a big number.”

Dr. John Anderson, president-elect of Medicine and Science of the American Diabetes Association and a practitioner of internal medicine in Nashville, said education is key.

“We’ve got to let politicians and the public at large know this is a very serious disease,” he said. “… We need to get away from just treating patients when they get in here. We need to be very proactive at preventing this disease before it occurs.”

Some states are taking on the challenge of spreading the word about the risks, both physical and fiscal, posed by diabetes. Tryon is a founding member of the Illinois Diabetes Caucus, a 49-member group whose goal is to support and promote sound diabetes policy development. Although the state is making headway in introducing and passing several diabetes-related pieces of legislation—including a Students with Diabetes Care Act last year—it still has far to go.

“The only state I know of that pays for diabetes education in its Medicaid program is New York,” Tryon said. “That’s obviously a big cost, but that has to be solved somehow. People who have diabetes and are on Medicaid need education.”

In North Carolina last year, Joint Resolution 647 created the Joint Legislative Task Force on Diabetes Prevention and Awareness. Its purpose is to study all issues related to diabetes, from prevention to treatment. And in Kentucky, Senate Bill 63 required the departments of Medicaid and Public Health, as well as the Personnel Cabinet, to work together to reduce diabetes and improve treatment.

“It’s an anti-silo bill,” said Stewart Perry, a consultant with Novo Nordisk who has been active in Kentucky’s efforts around diabetes. “That’s the way we approached it in Kentucky. It’s a way to make people talk about this serious problem and do something about it.

“… We address the symptoms in diabetes more than we address this issue and that’s not what we can continue to do. We can’t sit back and say we have no money. We can’t sit back and say we can’t do this.”