mini review
Paul
Keckley*
Principal/Owner of the Keckley Group, A
Healthcare Advisory Firm, USA
*Corresponding
author: Paul Keckley, President of the Keckley Group, A
Healthcare Advisory Firm, USA. Tel: +16153510265; Email:
pkeckley@paulkeckley.com
The incidence of Type
2 diabetes has increased to 9.4% of the adult population, increasing by 1.5
million from 2016 to 2017. The Center for Disease Control and Prevention
estimates that 23.1 million U.S. adults have been diagnosed with Type 2
diabetes, 7.3 million are diabetic but undiagnosed and 84.1 million have
pre-diabetes and are at risk. Costs for treatment of those who are diagnosed
increased to $322 billion in 2015, up 31% from $245 billion in 2013 and are
expected to double in the next five years [1].
Public health
officials attribute the increased incidence of Type 2 diabetes to many factors:
heightened incidence of obesity and hypertension, decreased physical activity
and changes in eating habits among them. Many with prediabetes are unaware they’re
at risk; and among these, many are unwilling or unable to make lifestyle
changes that might slow its progression to diagnosed Type 2 diabetes and its
associated costs.
Reduction of the prevalence of Type 2 diabetes and its costs requires changes in eating habits and lifestyle changes to slow its severity for those already diagnosed and reduce its progression among persons with pre-diabetes. For those diagnosed and in treatment, medication and changes in eating habits have been the primary focus; for those with prediabetics, improvement in food choices and lifestyle changes have been encouraged, but public confusion about healthy diets and inability/unwillingness to make lifestyle changes have been problematic.
Policymakers and public health officials should take two immediate steps to address the problem: (1) The U.S. Dietary Guidelines should be updated to include food options (nutrition therapies) to address the heterogeneity of the prediabetic and Type 2 populations and provide evidence-based directives for consumers and their caregivers. (2) A public education campaign should be developed to educate consumers about the Dietary Guidelines and nutrition therapies to nullify nutritional advice that is misleading, contradictory and confusing.
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