Rethinking diabetes in the United States
William H Herman1,2, Dean Schillinger3
1Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, United States.
Frontiers in Endocrinology
|July 3, 2023
Summary
The National Clinical Care Commission (NCCC) found that the U.S. diabetes epidemic requires addressing societal and environmental factors, not just biomedical ones. Effective prevention and control of type 2 diabetes necessitate population-level interventions targeting social determinants of health.
Area of Science:
- Public Health
- Health Policy
- Epidemiology
Background:
- The U.S. faces an accelerating diabetes epidemic despite available treatments, marked by stalled clinical practice integration and persistent health inequities.
- Federal policies and programs have not effectively leveraged to prevent and control diabetes and its complications.
Purpose of the Study:
- To present the findings and recommendations of the National Clinical Care Commission (NCCC) regarding diabetes prevention and control in the U.S.
- To emphasize the need to address social and environmental determinants of health in combating type 2 diabetes.
Main Methods:
- Development of a guiding framework incorporating Socioecological and Chronic Care Models.
- Information gathering from federal agencies, public meetings, public comments, key informant interviews, and literature reviews.
- Analysis of social and environmental factors influencing type 2 diabetes risk.
Main Results:
- The NCCC report (January 2022) called for a paradigm shift, recognizing diabetes as a complex societal and biomedical problem.
- Progress is hindered by a failure to address the social and environmental determinants of health impacting diabetes.
- Recommendations focus on aligning public policies and programs with these determinants.
Conclusions:
- Preventing and controlling type 2 diabetes requires a comprehensive approach that acknowledges its societal dimensions.
- Public policies must actively address social and environmental factors to mitigate diabetes risk and improve health outcomes.
- Population-level interventions targeting social and environmental determinants are crucial for effective diabetes management in the U.S.
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