DIABETES: STATES BATTLE A RISING TIDE 

Diabetes is on the rise in the United States. From 1994 to 2004, the prevalence of diagnosed diabetes increased throughout the United States, including a rise of 50 percent or more among 23 of the 49 states that had data for those years. Currently, 20.8 million Americans (7 percent of U.S. residents) have the illness. About 6.2 million Americans are unaware that they do.

A healthy diet and moderate levels of physical activity can help stave off type 2 diabetes and its complications—which may include blindness, damage to the kidneys and nerve disease, which can lead to amputations. (The most common form of the disease, type 2 diabetes occurs when the body does not produce enough insulin or the cells ignore the insulin.)

African American, Hispanic, American Indian and Alaska Native adults are twice as likely as white adults to have diabetes. Researchers believe some people in these groups inherited a “thrifty gene” that enabled their ancestors to store food energy when food was plentiful, so they could survive when food was scarce. But now that “feast or famine” situations are rare in the United States, this once helpful gene may put these groups at higher risk for type 2 diabetes.

A Variety of Methods

States are taking a variety of approaches to the diabetes scourge. As of 2006, 46 states and the District of Columbia required insurance coverage for diabetes services or supplies. States that don’t require coverage are Alabama, Idaho, North Dakota and Ohio.

In addition to insurance coverage, legislators have considered a variety of policies for tackling diabetes. From 2003 through 2006, legislators considered bills that address the following:

• Child screening and diabetes management and care at school. California and Illinois enacted legislation that requires noninvasive screening of school children for diabetes risk. Nebraska, Utah, Vermont and West Virginia passed bills encouraging schools to adopt guidelines for the care or self-care and medical management of students with diabetes and to train school person­nel for this purpose.
• Tax exemptions for diabetes equipment or supplies. In 2004, Oklahoma adopted a tax exemption for diabetes monitoring equipment or supplies.
• Diabetes funding. Funding mechanisms for diabetes programs, research and education enacted during the past several years include revenues from special license plates, tax refund check-offs, grant programs, outright appropriations and public-private partnerships.
• Raising awareness. Efforts to raise awareness include legislative declarations of specific months or weeks for diabetes recognition, asking citizens to commit to blood glucose tests, and a “million-pound meltdown” resolution. (Diabetes is often linked to obesity.) States have established diabetes commissions or studies, passed resolutions urging Congress to fund diabetes research and lift restrictions on stem cell research, and required inclusion of diabetes as a causal factor on death certificates. Oklahoma established a university-based diabetes center with $12 million in state funding.