Intriguing New Study Shows Increasing Diagnoses of Diabetes – And Why That May be a Good Thing

Twitter Summary: Intriguing results from #ACA expansion show increased #diabetes diagnosis – & why that may be a good thing

When people ask me what my vision is of the future at The diaTribe Foundation, I imagine a world where people who are living with diabetes have the daily burden of management lifted from their shoulders. I look to a future where everyone impacted by diabetes is empowered with knowledge, support, and the right tools to deal with the disease. And ultimately, we hope to promote the possibilities for prevention – where fewer people (or none!) are diagnosed with this disease. That’s why it may surprise you that a new study showing the rapid increasing cases of newly diagnosed diabetes in some states doesn’t alarm me, and in fact, is likely a promising development for patients and policymakers across the country.

What do I mean, you ask? A new observational study from Quest Diagnostics (a medical testing company) found that states that expanded Medicaid as part of the Affordable Care Act (ACA) saw a 23% rise in new diabetes cases vs. a 0.4% increase in states that had not expanded Medicaid over the same period. The Medicaid expansion presented a natural experiment, as 26 states chose to expand the program under the ACA, while 24 chose not to. Although at first glance this increased rate of newly diagnosed diabetes seems troublesome, it may demonstrate that expanded access to health care allows for earlier diagnoses of diabetes – and potentially, earlier treatment and better outcomes. Geez, do we need this!

This study is a small look into the giant need that still exists in the gap between health and access.  What does it mean? Well, it has two critical implications when it comes to how we think about diabetes. First, early identification is key to preventing long-term complications, which bring significant health care costs. Recent data shows that 8.1 million people with diabetes in the US remain undiagnosed and are not receiving the treatment and care they need to manage blood sugars, prevent complications, and protect their health. Furthermore, there are 86 million Americans with prediabetes (more than one in three US adults) who are at risk of developing type 2 diabetes within 10 years.

Second, people who need the most help may not have the necessary access to care. Many of the states that chose not to expand Medicaid are primarily in the South and Midwest, regions with high obesity rates and sizable populations at risk for type 2 diabetes. This is hugely worrying in light of the study results, and means, to me, that there MUST be more of an emphasis on earlier detection and management of type 2 diabetes, regardless of the politics.

To put the mildly, the Affordable Care Act has generated a great deal of debate among experts and the public alike, and we are still learning about some unexpected implications for diabetes from the new health law. Although the study used Quest’s company data and represented a smaller sample compared to more accurate federal data, the dramatic conclusions are still indicative of a larger story, and hopefully one where we have a glimpse into a world with better prevention, better management, and an improved life for anyone and everyone diagnosed with diabetes. What are your best ideas? 

very best,

Kelly L. Close