Texas Times Weekly: December 8, 2006

Texas Times Weekly: December 8, 2006

Type 2 Diabetes: Screening Can Save Lives
By U.S. Sen. John Cornyn

During the last few decades, Type 2 diabetes has become a major health epidemic both throughout Texas and across the country. Unlike some chronic diseases, Type 2 can be prevented, delayed, or managed through sound lifestyle choices. We should all know more about this process.

Type 2 diabetes occurs when sugar builds up in the bloodstream, instead of being transferred into cells in the body where it can be used as fuel. When this buildup occurs, cells are starved for energy. Over time, high blood glucose levels can harm the eyes, kidneys, nerves and heart.

Before people are afflicted with Type 2 diabetes, they often develop "pre-diabetes," blood sugar levels that are higher than normal, but not yet high enough to be diagnosed as full Type 2. An estimated 54 million people—one in six Americans—have pre-diabetes, and this puts them at risk for long-term damage.

The disease tends to hit several U.S. demographic groups especially hard, including Hispanics, African Americans and senior citizens. The growth of Type 2 diabetes is a serious public health concern, and has huge financial consequences for U.S. taxpayers through federal programs—especially Medicare and Medicaid.

Type 2 can often be prevented by maintaining healthy eating habits, a healthy weight, and a regular exercise schedule. If not completely prevented with these measures, the disease can often be controlled successfully with an early diagnosis.

Left untreated, Type 2 can have debilitating effects, including severe cardiovascular disease, blindness, kidney disease or failure, amputation of affected body parts, and nervous system damage. In severe cases, this disease can be fatal.

Medicare beneficiaries with diabetes account for 32 percent—nearly one in every three dollars—of Medicare spending. According to a recent study in Diabetes Care, of the estimated 35 million Medicare beneficiaries age 65 or older, 21 million—over 60 percent—are afflicted with either diabetes or pre-diabetes.

According to the American Diabetes Association, some people with Type 2 diabetes experience symptoms, but others may have the disease for up to a decade without obvious symptoms. Also, some Type 2 symptoms resemble other diseases or conditions, making it harder to predict an accurate diagnosis without additional information.

Of the seven million Medicare beneficiaries with Type 2, nearly half of them are not yet diagnosed. Virtually all of the 14 million Medicare beneficiaries with pre-diabetes are undiagnosed.

In 2004, nearly 18 percent of Texans aged 65 and older had diabetes. According to the Texas Diabetes Council, diabetes is the sixth leading cause of death in our state, and is likely underreported as a cause of death, as well.

Many of the consequences of this disease could be prevented or successfully managed by early diagnosis, modest treatment, and better diet and exercise decisions. A landmark National Institutes of Health clinical trial—the Diabetes Prevention Program (DPP)— showed that even modest changes in exercise and diet can prevent Type 2 in 58 percent of people at high risk for the disease.

The federal government has been attempting to encourage early intervention, but has experienced only modest results. A major reason: We haven't done a good job of alerting people about the problem, and the resources available to those who may be at risk due to medical factors.

One way to improve our chances of fighting this disease is through increased diagnosis, and Medicare beneficiaries at risk for Type 2 are eligible for annual diabetes screening. So last week, I wrote U.S. Health and Human Services Secretary Michael Leavitt to encourage increased promotion of this screening benefit, and colleagues from both sides of the aisle joined me in this effort. Under Medicare, those found to have pre-diabetes may be re-screened at six month intervals thereafter. These tests are a vital first step in preventing Type 2 and heading off its most serious consequences.

Participants over 60 years of age are the greatest potential beneficiaries. Simple steps can prevent onset of Type 2 in 70 percent of high-risk seniors.

If everyone who is eligible would take these screening tests, we would save, or improve the quality of, many lives. We would also be able to conserve resources for the hard-pressed Medicare program, which is increasingly strained as the Baby Boom population begins to retire.

Complications from Type 2 can be delayed indefinitely by taking relatively simple steps to improve your health. If you suspect that you, or a loved one, may be at risk for Type 2 or pre-diabetes, take the initial screening test: The course of the disease may be dramatically improved.

http://cornyn.senate.gov/index.asp?f=page&pid=298&lid=1