Nearly half of adults in California have either undiagnosed diabetes or elevated blood sugar levels that can lead to diabetes — an expensive, life-threatening chronic disease, according to a new study by researchers at the University of California, Los Angeles.
Researchers found that about one-third of Californians from 18 to 39 years old had elevated blood glucose characteristic of prediabetes, which can escalate to Type 2 diabetes, an endocrine disease in which the body doesn’t properly use insulin. Type 2 diabetes is typically seen in older adults.
The UCLA study, sponsored by the California Center for Public Health Advocacy, evaluated data on more than 6,400 people from a long-running federal health study known as the National Health and Nutrition Examination Survey and information on another 40,000 Californians from the state’s ongoing California Health Interview Survey.
Nine percent of all adults in California reported that they’d been diagnosed with diabetes. People of color, including Latinos and African-Americans, had higher rates of prediabetes than whites and Asians.
The UCLA study was funded by the California Health Care Foundation and The California Endowment (California Healthline is funded by the California Health Care Foundation).
The very concept of prediabetes as a medical condition is somewhat controversial: Medical experts are divided on how often it advances to actual diabetes, and some have raised fears of “medicalizing” large populations based on specific health indicators. Most people don’t know they have the condition.
But public health advocates are trying to draw increased attention to the condition to improve access to medical screening and encourage people to make lifestyle changes that can help prevent the disease from developing.
California spends less than any other state on diabetes prevention and relies on federal grants rather than state money for its programs, according to a 2015 state auditor’s report. A California Department of Public Health spokesman said the agency is continuing to work on those federal grants, and that it coordinates diabetes prevention activities through larger wellness programs aimed at preventing chronic disease.
But state Assembly Member Beth Gaines (R-El Dorado Hills) has introduced a bill that would require the agency to improve its reporting on the impact of diabetes on California and its efforts to prevent and control the disease.
Nationwide, about 86 million Americans are believed to have prediabetes, and another 29.1 million are estimated to have full-blown diabetes, according to the U.S. Centers for Disease Control and Prevention.
Diabetes can cause kidney failure, limb amputation, heart attack, stroke, blindness and premature death. Billions are spent each year on medications and lifestyle programs to control the chronic illness, including about $19 billion in California alone, according to the study’s lead author, Susan Babey, a senior research scientist at the UCLA Center for Health Policy Research.
Prediabetes “is a very important measure to use to gauge where we’re headed,” said Harold Goldstein, one of the study’s authors and executive director of the California Center for Public Health Advocacy. “From the public health perspective, the intervention that’s required here is not pharmaceuticals in any way.”
Instead, Goldstein and other advocates are promoting the use of “lifestyle modification” programs that help people eat healthier foods, lose weight and get more exercise. Our car-centric communities, sedentary jobs and diets of highly processed foods are almost “engineered” to promote diabetes, Goldstein said.
Studies have shown that programs like the CDC’s National Diabetes Prevention Program can help prevent the progression of prediabetes to actual diabetes, Goldstein said.
Xavier Morales, executive director of the Latino Coalition for a Healthy California, thinks it’s time to get more proactive about confronting the disease.
“It’s disheartening that these levels continue to exist in our community, not just in the Latino community but for Pacific Islanders, African Americans and Native Americans,” Morales said, noting that the advanced symptoms of diabetes — leg amputations, kidney disease, blindness — hit hardest in low-income communities of color.
“It’s beyond the time for studies. We’ve really got to have some action that gets at the roots of diabetes,” he said. “We need to have safe places for physical activity, clean water and more access to fresh fruits and vegetables. For us, diabetes is an issue of health justice.”