Vivian Fonseca, MD

Disclosures

June 17, 2015

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We did a study across the country in several million people who had their A1c levels measured at Quest [Diagnostics], and we looked at data from previous years to see whether they had diabetes or did not have diabetes in the past.[1]

Anyone with an A1c above 6.5 for the first time was counted as having "newly diagnosed diabetes." Using that data, we roughly estimated how many people there are in the country with new diabetes; we have been seeing a steady increase over the past few years.

When we broke the data down further, we found that some states had a surge in newly diagnosed diabetes, and those were the states that had expanded Medicaid because of the Affordable Care Act. In comparison, states that did not expand Medicaid had no increase in diabetes diagnoses.

What this essentially means is that people are being screened for diabetes because they now have access to healthcare in some states but not in others. There are many implications for this kind of data.

When people are diagnosed with diabetes, they are essentially seeking care to prevent the long-term complications of diabetes, which we know are fairly serious, such as kidney failure requiring dialysis or a transplant, amputations, blindness, etc.

We know that there are many people out there who have diabetes and don't know it. One of the reasons why they don't know it is that they don't seek medical care because they don't have insurance, and it is too expensive for them to seek such care.

We think screening is a good thing. It helps identify diabetes early and allows preventive treatment to take place in a very timely manner. It also identifies, possibly, people who are at risk of getting diabetes and who may take preventive steps.

We have an epidemic in this country. Preventing diabetes and, once it is diagnosed, preventing its complications, are really a priority for healthcare.

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