Monday, February 8, 2016

Prediabetes Campaign: Individual Solution to a Societal Problem

The American Diabetes Association, AMA, and CDC have decided that 86 million Americans are prediabetic and they've launched a campaign to "do something about it." Before you let that huge number of people freak you out, remember that the term "prediabetic" is only used in the U.S. and was coined by the ADA.

Some diabetes experts, including Dr. Victor Montori of the Mayo Clinic (interviewed on MinnPost), think the new campaign recently launched by the Ad Council is misdirected. He outlines two problems with the idea of a big public health campaign about prediabetes:

First, if the problem affects one in three Americans, is it possible that diabetes is not the result of poor individual decision-making or poor individual habit choices, but rather the society that we are building? That society — the environment that we create — is a combination of advertisement, food policies, worksite policies, transportation policies, education policies. If these things are what is causing diabetes, why would we want to intervene one person at a time while keeping them in the environment that is pushing them in the direction of diabetes? How likely is it that we are going to have a sustained benefit from identifying individuals and treating them individually? So that’s one problem I have.

[Second] Patients already complain about their doctors not having time to meet with them and about hurried consultations. So we’re now going to be sending 86 million or more Americans to that overtaxed and overwhelmed health care system to seek individual care and counseling for pre-diabetes. It seems to me that people with diabetes are going to have to compete for access to care — the kind of care that is really important, like preventing complications. And if they don’t have such access, we’re going to have a net negative impact in that now we’re going to have more people living with the complications of diabetes.
Read the whole interview here.

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