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August 2016

What We Don’t Talk About When We Talk About Preventing Type 2 Diabetes—Addressing Socioeconomic Disadvantage

Author Affiliations
  • 1Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, Minnesota
  • 2Mayo Graduate School, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2016;176(8):1053-1054. doi:10.1001/jamainternmed.2016.2952

About half of the adults in the United States have either diabetes (mostly type 2), or prediabetes.1 Societies across the globe have been generating people living with diabetes at a fast pace, a pace that shows signs of stabilizing in the United States.1 Yet, there is a sustained increase in the incidence of diabetes in people with lower socioeconomic status.1 That a rampant diabetes epidemic is preferentially impacting the disadvantaged shines light on the problematic way in which we have chosen to respond. This approach—to prevent diabetes 1 person at a time—has hampered our response as a society to the diabetes epidemic. The substantial investment of resources in a unidimensional strategy, despite limited evidence of benefit, threatens the viability of health care systems (ie, their ability to meet expanded needs of the population with constrained resources), and sets an ineffective precedent for the way that we address epidemics.