The Great Diabetes Epidemic: A Manifesto for Control and Prevention

Step back to 1994. Suppose an epidemic struck the United States, causing blindness, kidney failure, and leg amputations in steadily increasing numbers. Suppose that in less than a decade's time, the epidemic had victimized one out of every eight people.

That epidemic is real, and its name is diabetes, now the nation's sixth leading cause of death. It is the leading cause of new cases of blindness, of non-traumatic leg amputation, and of dialysis or renal transplantation. It is also among the leading causes of heart disease and stroke. Diabetes currently costs our nation over $275 billion per year. By 2050, when today's teenagers are in their fifties, those costs will skyrocket to half a trillion dollars per year. Diabetes is not "just a touch of sugar," as people like to say. It is a serious and costly and often fatal disease.

There is good news, however. We know how to stop diabetes. But it will take public and political will, as well as a commitment to take action at the community, state, and federal levels. In The Great Diabetes Epidemic: A Manifesto for Control and Prevention, authors Gilbert H. Friedell, MD, and J. Isaac Joyner, MPH, outline a game plan to make that change happen. We can all act now to save lives, save money and save our nation. This book will show you how.

Testimonials

"Dr. Friedell has turned his vast medical knowledge and expertise in the field of cancer toward solving the social, economic, and medical problems associated with diabetes. He and his co-author have a grasp of the real-world issues and important steps that must be taken to stem the ever-increasing epidemic of diabetes and its complications." — Stewart Perry, Past Chair of the Board, American Diabetes Association

"Friedell and Joyner have taken a hard look at the burgeoning diabetes problem. They have created a playbook, with steps to contain a disaster that already affects 400 million people worldwide. They write in terms of "control" rather than "cure" — a vital distinction in my opinion — and make a convincing case that the disaster does not need to happen if we apply well-established, common sense interventions using a public health model." — Stephen L. Pohl, MD, Endocrinologist, Diabetes Specialist

"As a family physician, I regard Type 2 Diabetes as Public Enemy Number One for my patient population. This common form of diabetes has the features of an epidemic so powerful that it may soon affect the majority of families in America. This book calls on us as a society to recognize that stopping this epidemic will require organized commitments at multiple levels." — Kevin A. Pearce, MD, Professor and Chair, Department of Family and Community Medicine, University of Kentucky College of Medicine

"This book is a passionate and authoritative wake-up call on the tsunami that diabetes will become for our country and health care system unless we take action. The authors call for the kind of urgency we expend on dangerous viruses and they offer a thoughtful, detailed plan of action." — William J. Doherty, PhD, Professor and Director of the Citizen Professional Center, University of Minnesota

About the Authors

Gilbert H. Friedell, MD, is director emeritus of the Markey Cancer Center, professor emeritus of pathology, and, since 2005, professor emeritus of behavioral science at the University of Kentucky in Lexington. He has been a member of the Advisory Committee of the University of Kentucky College of Social Work since 2005.

Dr. Friedell graduated from the University of Minnesota Medical School in 1949 and received his training in pathology in Boston. He has been involved for many years in the conduct of laboratory and clinical cancer research and in cancer control activities, with particular emphasis on problems concerning cervical, breast, and urinary bladder cancer. He taught at the medical schools of Harvard University, Boston University, and the University of Massachusetts before coming to Kentucky. While serving as the chief of pathology and then the medical director of a 600-bed community teaching hospital in Worcester, MA, he was the director of the National Cancer Institute (NCI) National Bladder Cancer Project from 1971 to 1983.

Arriving in Kentucky in 1983 as the first director of the Markey Cancer Center, Dr. Friedell was the founding director of the Kentucky Cancer Registry, the principal investigator of the NCI Mid-South Cancer Information Service, and co-director of a statewide cancer control outreach program, now the Kentucky Cancer Program. All were developed in association with the University of Louisville Brown Cancer Center, although based at the Markey Cancer Center. In 1990 he stepped down as director of the Markey Cancer Center to become the full-time director for Cancer Control. Dr. Friedell retired in 1998.

Throughout his career, he has put particular emphasis on reaching the medically underserved. Since coming to Kentucky, his primary focus has been on the control of cancer and other chronic diseases in the rural population of Eastern Kentucky and Central Appalachia. In 1994 he and his colleagues started Kentucky Homeplace at the UK Center for Rural Health, a lay health worker program funded by the General Assembly to facilitate access to healthcare services for the underserved. It is now active in 58 primarily rural counties across Kentucky.

Since 2008 he and his colleagues have been assisting people in three Appalachian Kentucky counties developing the Tri-County Diabetes Partnership, focused on communities taking responsibility for various aspects of diabetes control and prevention. Their efforts have illustrated the challenges to establishing effective population-based approaches to the diabetes epidemic and have led to the compilation of national and Kentucky data and The Great Diabetes Epidemic: A Manifesto for Control and Prevention.

Among the honors bestowed on Dr. Friedell are:

• National Humanitarian Award, American Cancer Society, 1998
• Individual Community Service Award, Susan G. Komen Foundation, 1998
• Special Recognition Award from the Appalachian Regional Commission, 2003, for "Untiring commitment, dedication and leadership in improving the health and well-being of the people of Appalachia"

Isaac Joyner received his master's of public health degree in community health planning from the University of Texas Health Science Center-Houston in 1987. He worked in the late 1980s at the American Social Health Association, in Research Triangle Park, NC, as technology manager for the National AIDS Hotline.

In the 1990s, Joyner worked in the office of South Carolina's governor as planning manager for the Continuum of Care for Emotionally Disturbed Children. His work involved expanding the system of care for children's mental health in South Carolina.

In 2002, Joyner became the bureau chief of planning and evaluation at the Houston (TX) Department of Health and Human Services. He focused on establishing an environmental public health data system and served as managing editor of the State of Health in Houston/Harris County, Texas. This report compiled health indicators for three dozen health and environmental health concerns. In his planning role, Joyner facilitated the development of the department's strategic plan and several multi-agency health plans.

In Kentucky, Joyner has supported the communication of epidemiologic data on H1N1 influenza for the Kentucky Department for Public Health. He also has facilitated and coordinated planning for the public health impact of the 2010 World Equestrian Games.