By Sarah Grant, MPH, CHES
Chronic Disease Educator and Lifestyle Coach,
Gwinnett, Newton, and Rockdale County Health Departments
The Definition
Blood sugar, or glucose, comes mainly from the food we eat and is a source of energy for the body (Medline Plus). Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood. Diabetes can be caused by too little insulin, resistance to insulin, or both. Blood sugar levels get too high and stay elevated for a long time. When diabetes is left untreated, individuals are at increased risk of damage to organs such as the heart, eyes, kidneys, and feet. There are three main types of diabetes: Type 1 diabetes, Type 2 diabetes, and gestational diabetes. Type 2 diabetes is the most common, affecting approximately 90% of people with diabetes.
The Theme
November is National Diabetes Month, and November 14th is World Diabetes Day. World Diabetes Day is an awareness day established by the International Diabetes Federation and the World Health Organization. The theme for this year is “Access to Diabetes Care”. Now, given that this is a global initiative, we in the United States might be tempted to think that the access issues refer to less developed countries. However, in many parts of this country, the State of Georgia, and Newton County, access to medical care, medications, and education is not guaranteed.
In Georgia, 13.4% of residents were uninsured as of 2019 (US Census Bureau). Uninsured people who are living with diabetes are often less able to afford cutting-edge medications that may be more effective in managing diabetes but are also more expensive than those found on discount lists at retail pharmacies. Even those with insurance, sometimes they or their provider have to advocate to have certain medications covered by insurance. Others struggle with achieving ideal blood sugar levels or find it challenging to prick their finger multiple times throughout the day to check their blood sugar. Devices like continuous glucose monitoring machines are lifesavers but are not yet considered a medical necessity by most insurance companies.
In Newton County, where the median household income is the lowest of the three counties serviced by GNR County Health Departments (US Census Bureau), paying for these devices out of pocket is not always an option. In addition, medical specialists like endocrinologists (who specialize in diabetes and other endocrine conditions), diabetes education programs, and other services are typically more concentrated in the heart of Atlanta than in rural counties like Newton County. Given the ongoing shortage of endocrinologists, the earliest appointment can be six months away, extending the time that some patients have to wait to get help. As mentioned above, the longer an individual’s blood sugar is above ideal range, the more likely they are to experience complications.
The Stats
Approximately 1 in 10 Georgia adults has diabetes. As of 2018, over 9% of Hispanics in GA have diabetes. That number is 12% for Whites and over 15% for Blacks. In Newton County, diabetes is the 8th leading cause of death overall; among residents aged 65-74, it is the 4th leading cause of death (OASIS 2020). Disparities also exist based on educational level achieved, as well as income level.
The Action
Gwinnett, Newton, and Rockdale County Health Departments want to encourage readers to know your risk, know the symptoms, get screened, and make lifestyle changes to reduce risk. The challenge with diabetes and hypertension is that people often do not experience or recognize symptoms until the condition is severe; thus, routine screening is important. Individuals can get blood sugar, blood pressure, and cholesterol screening for only $5 at one of our local health centers! There is also a quick quiz available to help determine your risk: https://www.cdc.gov/prediabetes/takethetest/. We encourage our community members to reduce their risk of Type 2 diabetes or manage their diabetes by eating nutritious, balanced meals, working up to 150 minutes of moderate physical activity each week, and if needed, losing excess weight. Our Community Health page (https://www.gnrhealth.com/services/community-health/) has links to resources about physical activity and nutrition. There, you will also find information about diabetes education and prevention, as well as blood pressure management programs offered internally or by our community partners.
We want readers to know that we are committed to advocating for our Newton County residents and improving access to diabetes care for all who need it! We are grateful for the work of local community agencies such as Willing Helpers Medical Clinic and the Newton County Family Connection for bringing access to those who need it in Newton County. If someone wants to know how to get assistance with paying for medications, Newton CAN (https://www.newtoncan.org/medication-help) is a great resource to see what prescription assistance programs are available.
References
https://medlineplus.gov/ency/article/001214.htm
https://worlddiabetesday.org/about/theme/
https://www.census.gov/quickfacts/newtoncountygeorgia
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