Cure, Care, and Commitment: What Can We Look Forward To?
- Robert Rizza, MD1,
- David Eddy, MD, PHD2 and
- Richard Kahn, PHD3
- 1Division of Endocrinology, Diabetes, Metabolism & Nutrition, Mayo Clinic, Rochester, Minnesota
- 2Archimedes, Inc., San Francisco, California
- 3American Diabetes Association, Alexandria, Virginia
- Corresponding author: Robert A. Rizza, MD, Mayo Clinic, 200 1st St. SW, Room 5-194 Joseph, Rochester, MN 55905. E-mail: rizza.robert{at}mayo.edu
- CVD, cardiovascular disease
- ESRD, end-stage renal disease
- FPG, fasting plasma glucose
- MI, myocardial infarction
- NHANES, National Health and Nutrition Examination Survey
The prevalence of diabetes continues to increase at an alarming rate, with more than 9% of all adults and 20% of adults ≥60 years of age diagnosed with the disease (1). When those with impaired fasting glucose are added, about a third of the adult U.S. population has abnormal glucose metabolism. Equally alarming is that the cost of diabetes in 2007 was $175 billion, which includes $116 billion in excess medical expenditures and $58 billion in reduced national productivity (2). Thus, diabetes is a major, costly, and growing cause of morbidity and mortality in America. What should we be doing about this serious situation?
There are three obvious answers. First, we must redouble our efforts to find a cure for diabetes. This will take more research dollars invested into novel and imaginative ideas that explore the underlying cause of diabetes. Second, we must do whatever we can to reduce the likelihood that someone will develop diabetes. Although 100% effective prevention is not immediately in reach, there are many recent developments that hold great promise. Third, we must treat aggressively those who have or will develop diabetes to prevent the complications of diabetes from occurring. Despite the availability of a wide variety of glucose-lowering drugs and other relevant medications, supplies, devices, and well-established treatment guidelines (3,4), the majority of those affected by diabetes are not meeting the goals of therapy (5).
If diabetes can be cured or prevented or if the quality of care delivered to people with diabetes uniformly achieves recommended goals, undoubtedly there would be a major reduction in morbidity, mortality, and costs. If the impact of a cure for diabetes could be quantified, perhaps policy makers would be convinced that investing in diabetes research is not only the right thing to do, but the smart …
