Wednesday, December 02, 2015

HEALTH - Diabetes Rates, San Diego County

"OFFICIALS CHEER DROP IN U.S. DIABETES RATES" by Paul Sisson, San Diego Union-Tribune 12/2/2015

NOTE:  This is from the online version of the paper, therefore no article link.

County pattern is also encouraging, disease experts say

Fewer cases of diabetes are being diagnosed in U.S. adults, according to promising federal statistics released Tuesday.

The number of diabetes cases had been climbing for decades, driven by the nation’s surging obesity rates.  In 2009, the number of new cases reached 1.7 million.  By last year, it dropped to 1.4 million.  “After so many years of seeing increases, it is surprising,” said Edward Gregg, a diabetes expert who has been tracking the numbers for the U.S. Centers for Disease Control and Prevention.  It is unclear whether the national decline extends to San Diego County.  While nationwide diabetes data for 2014 was made public Tuesday, the most recently available countywide statistics are from 2012.

Still, the local pattern is encouraging.  According to the CDC, the San Diego region saw a significant decline in diabetes incidence between 2011 and 2012, with the number of cases per 1,000 people dropping from 7.8 to 6.6.

Tuesday’s announcement gave Dr. Wilma Wooten, the county’s public health officer, hope that diabetes rates are continuing to drop as an assortment of local programs target weight loss through exercise, healthier eating and stress reduction.  “There have been millions in grants awarded to many community organizations, and it’s quite encouraging to see some indication that all of the effort maybe paying off,” Wooten said. Officially, the CDC does not know for sure what is causing the diabetes rate to decrease.  Public-health experts would like to think it is the result of a push to get people to be less sedentary and cut back on sugary foods and drinks.  “This is what’s supposed to happen when you put a lot of effort into prevention over the years,” said Gregg, who is scheduled to present the new data at a conference in Vancouver today.

The drop in national diabetes rates did not fall evenly across all demographic groups.

The biggest declines in new diabetes case rates were in men, white people, young and middle-aged adults, and in people with more than a high school education.  But there have not been substantial declines in other groups, including the elderly and minorities.

That made sense to Jane Campbell, director of the Center for Health Promotion at Paradise Valley Hospital in National City, which each year serves about 45,000 South County residents striving to avoid or overcome obesity and diabetes.

Although she said the center’s programs that target diabetes continue to draw more enrollees, Campbell also said she has noticed a significant change in recent years that suggests the region may have turned a corner in the diabetes battle.

“We’ve had more and more people who come in and say, ‘I’m not diabetic, but I want to prevent it’ or ‘I’m not diabetic, but I want to get my blood sugar checked,’” Campbell said.  “People are starting to realize that even if they don’t necessarily have the risk factors, they could still have diabetes.  I think maybe awareness is finally starting to filter its way into the population as a whole.”

While greater public recognition might seem like a warm and fuzzy concept devoid of concrete impact, Dr. Parag Agnihotri, medical director of the Sharp Rees-Stealy Medical Group in San Diego County, said getting people to think about diabetes before they become diabetic is a vital part of the larger fight.

“We have to take a step back and look at addressing people in the pre-diabetes stages if we really want to see the numbers drop.  To do this, we clearly need to raise awareness,” he said.

Rees-Stealy is five years into a program that seeks to help patients manage their diabetes through nutrition counseling, medication management and regular follow up.  The idea is to come up with a solution that lasts.

Agnihotri said a study of 100 patients participating in the program has shown that they lost 50 pounds on average— and have been able to keep the weight off for four years.  “We saw their fasting blood glucose levels drop, and we saw almost a 40 percent reduction in their medication regimen,” he said.

Ultimately, doctors, nurses, dietitians and public- health experts emphasize that the battle against diabetes is far from over.  There are still 1.4 million new adult cases of diabetes each year, and overall, there are about 22 million Americans living with diabetes.

Dr. Daniel Einhorn, medical director of the Scripps Whittier Diabetes Institute in San Diego, said he was encouraged by the latest numbers in the same way that he was encouraged by the gradual decline of smoking.

“If you remember, it happened in dribs and drabs, and gradually we have all agreed that we should get rid of second-hand smoke,” Einhorn said.

He noted that studies, including one out of UC San Diego, have indicated that like smoking, there is a social aspect to obesity.  So making headway against the overall obesity rate might create social pressure for more positive changes, especially those concerning visible habits like soda consumption.

“There is some evidence that obesity is a social disease.  If you have obese friends, you are more likely to gain weight.  I’m hoping that there will be some parallel to what we saw with exposure to second-hand cigarette smoke so that the most egregious obesity behaviors are done less.  Hopefully, that will portend more improvement for the diabetes rate in the future,” Einhorn said.

The Associated Press contributed to this report.

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