Rep. Hubert Collins
May 6, 2013
It’s no secret that Kentucky is not the healthiest state in the Union. We have high rates of smoking, stroke, most cancers, and diabetes.
With 10.1 percent of Kentucky adults carrying a diabetes diagnosis, the Commonwealth ranked sixth nationally and was tied only with Oklahoma for the percentage of adults with the disease in 2010, according to the Centers for Disease Control and Prevention Diabetes Report Card for 2012. For Kentucky, 10.1 percent of the state’s adult population is roughly 370,000 adults—and that’s adults only. Children and young adults also account for a percentage of diabetes cases, either from Type 1 (“juvenile diabetes”) or Type 2 (“adult onset”) diabetes, although studies indicate the childhood obesity epidemic has increased the number of children with adult-onset diabetes in recent years.
The reasons for the increase in Type 2 diabetes in Kentucky are manifold: High rates of obesity, low rates of physical activity, high blood pressure, and high cholesterol all increase the risk for developing diabetes, and at least a third of Kentuckians fit in each of these categories, according to data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey cosponsored by the CDC and the state of Kentucky.
The rate of Kentuckians with “prediabetes” (meaning blood sugar levels are above normal but not high enough to be diagnosed as diabetes) is another factor, since physicians say most persons with prediabetes will develop full blown diabetes if they do not change their habits. The Kentucky Diabetes Prevention and Control Program’s 2011 fact sheet states that 7 percent of Kentucky adults tested for diabetes between 2007 and 2010—or about 233,000 people—were diagnosed with prediabetes.
Not only is diabetes increasingly common in Kentucky, it is also deadly and debilitating: Nineteen percent of all hospitalizations (or around 114,900) in Kentucky were diabetes-related in 2009, according to the state Diabetes Prevention and Control Program. Most of those hospitalizations were for heart disease, which uncontrolled diabetes can cause. Diabetes can also damage the eyes, kidneys, nerves, skin, and gums, and is a leading cause of limb amputation in the Commonwealth. Over 1,200 Kentuckians lost a leg in 2009 because of uncontrolled diabetes, the state Diabetes Prevention and Control Program reports.
Diabetes is also very costly. State Legislatures magazine reported in April that the cost of health care for diabetics average 200 percent more than for those who don’t have the disease. One in every five federal health care dollars goes toward diabetes treatment, the magazine reports. And the cost of diabetes to Kentucky is over $2 billion (over 10 percent of our state’s biennial budget) when you factor in both medical cost and lost productivity.
One way to control the cost of an expensive disease like diabetes, besides prevention, is through adequate health insurance coverage. Good coverage can lower costs for individuals and government. Most every state recognizes the importance of diabetes prevention and treatment and offers a level of coverage for those diagnosed with the disease. At least 46 states—including Kentucky—and the District of Columbia require some level of health insurance policy coverage for treatment of diabetes. Coverage in some states is more generous than in others (Mississippi, Missouri, and Washington State, for example, only require insurers to offer coverage, not necessarily coverage in all active policies) while four states have no mandated coverage or insurance requirement for diabetes (Alabama, Ohio, North Dakota, Idaho).
So how does Kentucky “measure up” against other states in diabetes care? Really well, actually. We met, nearly met, or exceeded the U.S. three-year average reported by the CDC in 2009 for reported rates of diabetes-care practices among adults with diabetes (including, but not limited to, physician visits, professional foot exams, and daily self blood glucose monitoring). The only area where Kentucky fell considerably short was in the preventative care practice of self management education. The average rate reported for diabetics who had ever had self management education in 2009 was 56 percent nationally, and 49 percent for Kentucky.
If you have diabetes, or someone you care about does, you are urged to have self management education. Kentucky requires coverage for outpatient self management training and medical nutritional therapy. You can learn more by contacting your physician or health care provider, or by contacting the Kentucky Diabetes Prevention and Control Program at (502) 564-7996. You can also learn more on the program’s web site found at http://chfs.ky.gov/dph/info/dpqi/cd/diabetes.htm.
Diabetes is a mean, ugly, expensive disease. Let’s do what we can to control it, not only for ourselves but for our children and future generations. Have a good week.