Diabetes month

November is National Diabetes Month, and if ever a disease deserved more attention from the public and policy-makers, it is this sneaky killer that affects 16 million Americans.

It’s the primary cause of new cases of blindness; it leads to kidney disease, amputations, high blood pressure, heart attack, stroke, impotence and birth defects. Nearly 600,000 Americans will be diagnosed with diabetes this year; more than 300,000 will die from the disease or its complications.

Worse still, one-third of those with diabetes don’t know they have it and, if left undiagnosed and untreated, won’t know until their health complications turn catastrophic. A disease that often can be prevented or effectively treated if caught early — usually with modest lifestyle modifications — becomes a nightmare of intrusive, financially ruinous medical procedures. The Maine Diabetes Control Project estimates that some 22,000 residents of this state have undiagnosed diabetes.

The public’s role, first, is to recognize the warning signs — excessive thirst, extreme hunger, unexplained weight loss, fatigue, irritability, frequent urination, blurry vision, tingling hands or feet, drowsiness, recurring skin, gum or bladder infections.

Second, the public must realize that the primary risk factors of Type 2 diabetes, by far the most prevalent form of the disease, are eating too much and exercizing too little. True, some ethic groups — Indians, Hispanics, Asians and Blacks — are genetically predisposed to diabetes, but experts say being overweight and inactive are the leading causes more than 80 percent of the time and predict the incidence of the disease will increase as our society grows more and more sedentary.

That diabetes can be avoided altogether or controlled through diet and exercize is where policy makers come in. The upward spiral in diabetes could well be the most blatant and tragic example of what happens when lawmakers, the insurance industry and the medical profession emphasize a pound of cure over an ounce of prevention.

A basic education course in diet and exercize, at under $400, is not covered by most insurance policies, but dialysis at $40,000 a year is. The little 50-cent strips diabetics use several times a day to monitor blood glucose levels and control their disease through diet are not reimbursed, but amputation and kidney transplants are.

Maine, while recognized nationally as a leader in diabetes education, treatment and research, has some serious statutory shortcomings. A Mainer can get a finger-prick blood screening for cholesterol at any shopping mall health fair, but not for diabetes. A few years ago, the Legislature mandated expanded insurance coverage for some truncated diabetes education and medications for a small group of individuals, but among those left uncovered are the elderly under Medicare and the poor under Medicaid. Critics who wonder whether the lack of high-level attention given to diabetes is related to the social and economic standing of the disease’s victims may not be right, but they are right to wonder.

Diabetes affects 5 percent of the American population, yet consumes 15 percent of the nation’s health-care dollar. That is unacceptable. The disease is preventable, it is treatable, if the public and public officials have the will to do so.