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The Podium

Putting an end to the diabetes crisis

As president and CEO of Joslin Diabetes Center, I see every day the consequences of our nation’s unchecked pandemic of diabetes. Left untreated and uncontrolled, diabetes can lead to severe complications affecting the heart, blood vessels, eyes and kidneys. In the United States, despite our high quality of health care, someone dies of a diabetes-related illness every seven minutes.

Yet, too little is being done to halt the rise of this disease. The Centers for Disease Control predicts that by 2050 over 30 percent of the US population will be living with diabetes. The widespread human suffering from diabetes and its complications will be unprecedented, as will the impact on the nation’s economy and healthcare system.

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A few weeks ago, the American Diabetes Association released figures showing that the annual cost of the diabetes pandemic has reached $245 billion (an increase of 41 percent in the past six years). The data from the ADA also shows that the current cost of diabetes in Massachusetts is $6.07 billion. As more people develop diabetes, that cost can only increase — unless we begin to take action to prevent diabetes.

A growing body of research indicates that type 2 diabetes can in fact be prevented, even in people who are at high risk for the disease. But in spite of that, our health care delivery system places too little value on diabetes prevention to make a significant impact.

In 2011, Joslin convened a national diabetes prevention summit in Washington, D.C. The summit brought together researchers, clinicians, advocates, and policymakers to discuss how to effectively translate the best and most current evidence on diabetes prevention into practice. Many participants have now published their findings and recommendations in a supplement to the April issue of the American Journal of Preventive Medicine.

From the summit and the supplement, a consensus has emerged that the following are needed in order to increase prevention efforts:

• Expanded screening to identify individuals with pre-diabetes;

• Expanded employer, health plan, and government consciousness and support for diabetes prevention;

• Enhanced access to clinical programs for diabetes prevention;

• Greater patient awareness and education regarding diabetes prevention; and

• Continued research into diabetes prevention interventions.

For our part, we have fully reinvigorated prevention and wellness as a key priority for Joslin, and we have ensured that it is a major and essential component of our strategic plan. Our commitment to prevention is designed to leverage our core competencies as well as our earlier efforts in the Diabetes Prevention Program and the Look AHEAD (Action for Health in Diabetes) study. We intend to engage and collaborate with like-minded organizations, government agencies, insurers, and others who have been advancing solutions in the prevention and wellness arena.

We will work with as many pioneering enterprises, thought leaders, payers, and others as possible, because a concerted team effort will be essential to our success. By utilizing objective measurements and metrics, coupled with outcomes research, Big Data analytics, and cost/comparative-effectiveness assessment tools, we can demonstrate that the programs and resources spent in prevention and wellness are impactful and economically sound.

We invite all those with a commitment to putting an end to this crisis to join with us, as we pursue our goal of nothing less than a future without diabetes.

John L. Brooks III is president and CEO of Joslin Diabetes Center.
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