One in 10 Floridians has diabetes, a "disturbing" trend revealed in the nation's fat report last week. Though Florida ranks as the 29th-most-obese state in the country, the Sunshine State is No. 10 for diabetes. It's a distinction that comes with a hefty price tag.
Although obesity is the primary reason Type 2 diabetes develops, Florida's rate of diabetes outpaces its fat score because of two other factors: Its population is older and more culturally diverse than in most states.
Those forces have combined to nearly double the state's rate of diabetes in 15 years, taking it from 5.7 percent to 9.9 percent.
"While the number is disturbing, it isn't surprising," said Dr. Richard Pratley, medical director of the Florida Hospital Diabetes Institute.
The older you get, the more likely you are to develop diabetes, experts say.
Florida is the nation's fifth-oldest state, behind only Maine, Vermont, West Virginia and New Hampshire, according to the 2010 U.S. census. The nation's median age is 36.8, while Florida's is 40.
And the Sunshine State's racial mix also skews the obesity rate upward.
Compared with the rest of the nation, Florida has more blacks (16 percent compared with 12.6 percent) and more Hispanics (22.5 percent compared with 16.3 percent). Both groups have higher rates of diabetes than whites do: 77 percent higher among blacks and 66 percent higher among Hispanics, according to the American Diabetes Association.
Why blacks and Hispanics have more diabetes is only partly understood. Lower income and education levels are associated with higher rates of obesity and diabetes. However, when adjusted for socioeconomic factors, these ethnic groups still have more diabetes, indicating there may be a genetic predisposition or cultural drivers, Pratley said.
Minorities also often have unequal treatment and unequal access to care, said Cynthia Harris, a professor and director of the Institute of Public Health at Florida A&M University. However, many communities are making strides to change that.
At Florida Hospital, the Healthy 100 Kids program, which launched a year ago, works with many minority families to help them fend off excess weight and diabetes.Orlando resident Carmelita Gyebi and her son, Josh, met with a program dietitian Wednesday to review the boy's eating habits and get suggestions for more-healthful alternatives.
Referred by his doctor, who was worried about how much weight the 12-year-old was gaining, Josh hopes the program helps him lose weight and get stronger.
"I was on the edge of getting diabetes," he said.
His mom says the dietary changes are for the whole family.
"It's not just for him," said Carmelita Gyebi, who wants to help her two teenage daughters and husband eat better, too.
Such strides are particularly important in the diabetes belt, a swath of 644 counties in 15 mostly Southern states, including Florida, where many Americans are obese, sedentary, black — or all of the above. A quarter of Florida's counties fall into this belt.
Worst yet to come
More worrisome than the rankings, however, is that diabetes will continue to rise 10 to 20 years after the obesity epidemic peaks, Pratley said. "We're in for a long ride."
According to the "F as in Fat" report — released last week by the Trust for America's Health and the Robert Wood Johnson Foundation — 16 states, including Florida, weighed in fatter this year than last year, and not one state got thinner.
Even when obesity rates do start to slide, there won't be an immediate drop in diabetes rates. That's because the onset of diabetes lags behind the onset of obesity, said Dr. Jim Marks of the Robert Wood Johnson Foundation.
The worst will hit in 20 years, experts predict.
Of all the health problems associated with obesity, diabetes is the most expensive. Diabetes cost the country $174 billion in 2007, the most recent year for which data are available, said the diabetes association.
Of that, $116 billion was for medical costs and $58 billion was for lost productivity and premature death. Add in undiagnosed diabetes, pre-diabetes and gestational diabetes, and the costs climb to $218 billion.
In the United States, about one in every 10 health-care dollars goes toward treating diabetes. On average, a person diagnosed with diabetes will have medical costs 2.3 times higher than someone without the disease.
The fact that diabetes is striking younger Americans, and particularly children, will make matters worse, said Pratley, because the longer a person has the disease, the more it costs.
Once a person has diabetes, he or she will likely always have it. Apart from bariatric surgery, a drastic and costly intervention, doctors know of no other way to reverse the disease yet.
To control the inevitable rising costs, Pratley said, "we need to create a much more efficient way to treat the huge number of patients entering the system, and work on prevention starting with our youth.
"If you're in your 20s and your BMI is 40, the cat is out of the bag," he said. "The best hope we have is with our kids."
Josh Gyebi already is more aware of diabetes, and how to avoid it, than most youths.
"It's not good to get," he said, "so you really have to watch what you eat."
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