Jane E.B. Reusch, MD, ADA President, Medicine & Science, has an assignment for every ADA member: Tell the story of diabetes and change the outcome of the disease.
“The ADA vision is a life free from diabetes and all its burdens,” Dr. Reusch said during her Presidential Address Sunday. “We need to hear the story of diabetes and we need to tell the story of diabetes. The facts alone are a call to action.”
The facts are that diabetes is a 24/7/365 job for all diabetes patients and their family members, Dr. Reusch said.
Diabetes patients are lucky to spend four hours a year with their medical provider, which Dr. Reusch translated to 0.046 percent of the year. The other 99.954 percent of the time, managing diabetes is up to the patient and family, she said.
“The total burden of diabetes is on the person and their family,” said Dr. Reusch, Professor of Medicine, Biochemistry, and Bioengineering and Associate Director of the Center for Women’s Health Research at the University of Colorado School of Medicine Anschutz Medical Campus. “[They] handle all of the decisions when it comes to diabetes control. [Their] decisions make the difference between having a good day and having a tough day.”
Dr. Reusch has her own diabetes story. Her father, Roy, lived with type 2 diabetes for 27 years. When he was diagnosed in 1975 at age 53, there were only two classes of drugs available, sulfonylureas and insulin. When he was 73, he had a stroke, and at 79 his left leg was amputated. At 80, he had a second stroke and died.
“He couldn’t walk his daughter down the aisle to be married because of diabetes, although he was able to dance with me in his wheelchair,” Dr. Reusch said. “In the United States alone, there are 30.3 million stories of diabetes. And the numbers are going up faster than we ever imagined.”
In 2000, experts projected there would be 450 million people worldwide with diabetes by 2030. Best estimates now call for 693 million people with diabetes by 2035.
“Diabetes is out of control,” Dr. Reusch said. “We cannot accept that trajectory. We have to change that curve.”
The power of diabetes is staggering. It causes a stroke every two minutes, an ischemic cardiac event every 80 seconds, kidney failure every 10 minutes, lower limb amputation every 5 minutes, and a death every 6.5 minutes, Dr. Reusch said. Compare that with the current opioid epidemic, which claims a life every 52 minutes yet receives far more attention than diabetes.
Diabetes cost $377 billion in the U.S. in 2017, one of every $4 spent on health care. And too few legislators know those numbers, she said.
“Spending elevates diabetes to a nonpartisan, nonpolitical, nonnegotiable issue,” Dr. Reusch said. “With these numbers, every legislator is interested. Access to care and affordability of insulin are not just theoretical issues to people with diabetes.”
Dr. Reusch said there are too many cases like Shane Patrick Boyle, who died in June 2017 because he couldn’t afford insulin. At age 26, he came off his parents’ health coverage and discovered how expensive insulin is. Despite his best efforts, including a GoFundMe campaign, Doyle ran out of money, ran out of insulin, and died.
“Insulin affordability threatens lives and takes lives,” Dr. Reusch said. “It’s crucial that the ADA, as part of its mission, keeps insulin affordability in the spotlight.”
Public awareness is also key to reducing the toll of diabetes. Too many people with type 2 diabetes have no idea they have a problem. That’s why the ADA launched the “Take the Diabetes Risk Test,” which has a goal of testing 20 million Americans for diabetes.
Why test? Because diabetes diagnosed at age 40 means years of life lost. And diagnosis is coming earlier and earlier, sometimes as early as adolescence.
“Early intervention can change the mortality curve, but you can’t intervene without awareness,” Dr. Reusch said. “By increasing public awareness of diabetes, we have an opportunity to change the curve. Know the story of diabetes and tell the story to anyone who will listen.”