Diabetes in the Appalachia Region
As many as 1 in 3 U.S. adults could have diabetes by 2050 if current trends continue, according to a new analysis from the Centers for Disease Control and Prevention. One in 10 U.S. adults has diabetes now. The prevalence is expected to rise sharply over the next 40 years due to an aging population more likely to develop type 2 diabetes, increases in minority groups that are at high risk for type 2 diabetes and people with diabetes living longer, according to CDC projections published in the journal Population Health Metrics. Projected increases in U.S. diabetes prevalence also reflect the growth in the disease internationally. Predictions that the number of new diabetes cases each year will increase from 8 per 1,000 people in 2008, to 15 per 1,000 in 2050 have been made. Following the obesity trends (CDC-Obesity) from the 1980s until the present demonstrates the national spread of the obesity problem and highlights what has occurred in the Appalachian region. The Appalachian regional Commission and others have supported some work to combat the diabetes epidemic in Appalachia, but much more needs to be done.
A study conducted by the CDCs Department of Diabetes Translation researchers (Barker, et al., 2011) identifies a geographically contiguous region of the U.S. called the "diabetes belt" consists of 644 counties in 15 mostly southern states. This belt includes many counties that are part of the Appalachian region where the prevalence of diagnosed diabetes is especially high. People who live in the diabetes belt are more likely to develop type 2 diabetes than people who live in other parts of the United States. Those living in this region lead a sedentary lifestyle and tend to be more obese than those in the rest of the U.S. Thirty percent of the excess risk was associated with modifiable risk factors such as sedentary lifestyle and obesity, and 37 percent with non-modifiable factors. The authors concluded that culturally (See here) appropriate interventions aimed at decreasing obesity and sedentary lifestyle in counties within the diabetes belt should be considered. A culturally sensitive toolkit to address diabetes in Appalachia has been created.
Evidence points to the needs to alter the ways diabetes is managed and addressed in the Appalachian region. Those living in rural areas of Appalachia can have additional challenges when it comes to diabetes and its management. A 2009 study identified that diabetes prevalence is growing in Appalachia and the numbers of persons with diabetes is increasing. However, healthcare facilities in the region rarely employ specialized health professional providers and the expertise concerning diabetes in some clinicians may be limited. Additionally, health care facilities often have few health care professionals with diabetes expertise employed. Ideas about healthy weight many not reflect the current standards or guidelines.
A number of studies have examined the Appalachian region and a growing body of literature exists for understanding the needs of those in the region. Some findings also point to the lack of knowledge of many diabetes educators about ways to work effectively with families. Evidence also points to special risks linked with food insecurity in Appalachian communities. We also know that managing daily routines linked with diabetes can be especially difficult for families. The burden of depression can also be great for those living in Appalachia.
Resources
Appalachian Rural health Institute (ARHI): Diabetes/Endocrine Center
The Appalachian Rural Health Institute (ARHI) is an interdisciplinary health service and research institute at Ohio University created in recognition of Ohio University's unique position to address critical rural health issues. The ARHI Diabetes/Endocrine Center was established in 2003 and recognized by Ohio University in 2004. It was designed to meet the complex health care challenges linked with diabetes and provides a place for clinicians, basic and clinical researchers, and educators from multiple academic units to collaborate in efforts to address diverse problems.
Kentucky Diabetes Network, Inc.
KDN, Inc.is a statewide partnership of Kentucky organizations, associations, and individuals who have a professional or personal connection with diabetes.
Kentucky Diabetes Prevention and Control Program
This is a population-based, public health initiative consisting of a network of state, regional and local health professionals whose mission is to reduce new cases of diabetes as well as the sickness, disability and death associated with diabetes and its complications.
Mississippi State Department of Health
In 2010, Mississippi ranked 2nd highest in the U.S. for overall diabetes prevalence, with over 270,000 adult Mississippians having type 2 diabetes (over 12% of the adult population). Diabetes contributed to the deaths of 926 Mississippians in 2010, and many more live with the complications of Type 2 diabetes, including lower extremity amputations, end stage renal disease, blindness, loss of protective sensation, heart disease and premature death.
Ohio Department of Health: Diabetes Prevention and Control
This website can help you connect you with the state agency in Ohio.
Central Ohio Diabetes Association
The Central Ohio Diabetes Association helps Central Ohioans living with diabetes detect their condition, prevent onset and complications, and learn to live well with the challenge of diabetes.
Virginia Diabetes Council
The Virginia Diabetes Council (VDC) is a 501(c) 3 non-profit organization that provides a forum for communication, collaboration and action among diabetes stakeholders in the Commonwealth of Virginia.
Virginia Diabetes Prevention and Control
The Virginia Diabetes Prevention and Control Project (DPCP) focuses on improving A1C, blood pressure, and lipid control among persons with diabetes and to decrease tobacco use among persons with diabetes or pre-diabetes. The program accomplishes these goals through training, health communications, partnerships, and policy, environmental and system (PSE) changes.
Virginia Diabetes Plan 2008 - 2017
This plan is organized around eight strategic initiatives: capacity building, surveillance and evaluation, prevention, education and empowerment, access to care, quality of care, research, and advocacy.
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