When Stewart Perry offers insight and advice on the disease he has battled for years, he hopes people listen. Perry, former chairman of the board of the American Diabetes Association and former Bluegrass board president, knows the problem first-hand. He suffers from Type 2 diabetes.
There’s a sense of alarm in Perry’s voice when he talks about what diabetes, which keeps the body from regulating the amount of sugar in the blood, is doing to Kentuckians and to our state as a whole.
“Diabetes in Kentucky is a $4.8 billion problem. [Those are] direct and indirect costs that include lost production,” said Perry. “Kentucky is second only to Oklahoma in the percentage increase in the prevalence of diabetes.
“Kentucky edged out states like Mississippi and Alabama, places that had historically been high diabetes-concentrated states,” added Perry, who is a long-time Lexington insurance agent.
Health experts say diabetes has an impact on businesses, state government and our tax dollars. Hospitalizations for diabetes in Kentucky resulted in charges of $183 million in 2011. Emergency room visits for the disease totaled $23 million.
Kentucky is attempting to address the problem. In 2011, Gov. Steve Beshear signed into law Senate Bill 63, which required the state to create a diabetes action plan and to update it every two years. The first plan was released last January.
Officially, the law obligates the Department for Medicaid Services, the Department for Public Health, the Office of Health Policy within the Cabinet for Health and Family Services and the Department for Employee Insurance within the Personnel Cabinet to report their diabetes-related efforts.
“We believe Kentucky is one of the first states to pass legislation like that, and now other states are using Kentucky’s law as a model to improve their rates with diabetes,” said Dr. Stephanie Mayfield, commissioner for the Kentucky Department of Health, in a recent interview.
The statistics cited in the report are sobering. About 370,000 Kentuckians have diabetes; that’s 10 percent of all adults, a rate that has tripled since 1995. Another 137,000 have diabetes, but it hasn’t been diagnosed, meaning up to half a million Kentuckians have the disease, according to the report. Another 233,000 Kentuckians have pre-diabetes and will develop the full-blown version unless they get proper medical care to halt its progression.
In addition, 10 percent of those with diabetes are uninsured, and 37 percent have incomes under $15,000 per year, the report states. Ten percent of people in the Kentucky Employees Health Plan have the disease.
“We know people with chronic diseases like diabetes have a higher cost per person when you look at medical data,” said Mayfield.
One encouraging item in the report is that diabetes is controllable.
The report encourages partnerships with health programs to improve the health of Kentuckians. The YMCA of Central Kentucky has a Diabetes Prevention Program that teaches people new behaviors in order to change their lifestyles to help improve their health. The plan is centered on better diet and more exercise.
Humana’s Vitality Wellness initiative is available to state employees as part of the Kentucky Employee Health Plan and Disease Management program.
“If you keep them from getting diabetes, they avoid costs associated with having a chronic disease,” said Perry, who also expressed dismay over another diabetes-related statistic: More pregnant women are developing the disease. Many times it goes undiagnosed and puts both the mother and unborn child at great risk.
Mayfield said many of Kentucky’s diabetics are also smokers — not surprising in a state with one of the highest adult smoking rates in the United States. Smoking further complicates diabetes.
“This is supposed to be a detailed action plan with cafeteria-style opportunities that the General Assembly can look at and decide what to do, what to fund, what to pass legislation on,” Perry said. “There are things that can be done without any state dollars attached.”
Mayfield urges uninsured Kentuckians to sign up for health-care coverage under the Affordable Care Act through kynect, the state exchange that provides individuals, families and small businesses with one-stop shopping to locate health insurance. Mayfield also said having regular check-ups as well as treatment for any number of diseases, including diabetes, will lower the health and economic impact on the entire state.
“We hope to make a real significant dent in chronic disease management, exacerbation of acute diseases and most of all, health prevention,” Mayfield said.