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Marin's Diabetes Number Rising, But Still Low By Comparison


GREENBRAE, CA — The latest report of the California Department of Public Health on the diabetes epidemic shows that Marin County has the lowest prevalence of diabetes in the state at 2.7% (an estimated 5,000 residents have been diagnosed). That’s “cautious” good news, according to Dr. Linda Gaudiani, a diabetes specialist and medical director of the Braden Diabetes Center at Marin General Hospital. 

“But if you think diabetes is not a problem here, you’re wrong,” she says, “The incidence is rising significantly in Marin, just as it is across the nation.”

She points out, however, that there is encouraging news for diabetes patients. According to an April, 2014 article in the New England Journal of Medicine that looked at hospital discharge data for 11,000 diabetes patients between 1990 and 2010, rates of diabetes-related complications have been significantly reduced in the past 20 years, sparing millions of patients the ravages they once faced from the disease. Especially striking was the decrease in heart attacks, which declined by nearly 68%. Strokes and amputations declined by about half. “We think the key is prevention, early diagnosis, improved control of high blood pressure, cholesterol and associated factors and smoking cessation,” says Dr. Gaudiani, “We’re doing that better than ever now.”

“We live in one of the best places in the world to have diabetes, if there is such a thing,” she says. “Marin General Hospital has recently spearheaded a diverse service center specifically oriented to improve the care of patients with diabetes both in the community and within the hospital.  Marin residents with diabetes also have access to unprecedented educational tools at the hospital’s Braden Diabetes Center (BDC) to help them understand diabetes, support healthy choices, and learn how to self-manage blood sugar.  They also have the opportunity to participate in clinical research studies using the state-of-the-art oral agents and the newer and generic insulins through Marin Endocrine Care and Research.  It adds up to cutting edge care.”

Dr. Gaudiani also points to collaboration between Marin General Hospitaland UCSF. “Having the UCSF Prenatal Diagnostic Center next door to the Braden Diabetes Center allows mothers with gestational diabetes to receive expert care and education right here in our community. In the future, we are also hoping to develop a pediatric program together,” she says. 

Prevention is a huge challenge both in Marin and the U.S., according to Dr. Gaudiani. “In the U.S., the CDC estimates that 86 million are pre-diabetic, a term for early impaired glucose metabolism that puts individuals at higher risk of developing diabetes later. In Marin that translates to hundreds of people. Despite the relatively low prevalence of diabetes in Marin, it is accelerating rapidly. “Marin attracts a diverse group of people drawn to a healthier environment and lifestyle,” she says. “The county’s growing ethnic diversity includes many who are at genetic risk for diabetes. People are living longer, too, which is an additional risk factor. So it’s imperative that we also accelerate prevention efforts. “When you have rising rates of diabetes even in an affluent, health-conscious county like Marin, it’s troubling, because many cases of Type II could be avoided.”

Another concern is undiagnosed active diabetes “Fortunately, the level of undiagnosed diabetes has declined by about a third in the last 15 years,” says Dr. Gaudiani. “Still, about 11% of diabetes goes undiagnosed currently. Without a diagnosis, individuals aren’t getting the early treatment and support necessary to avoid complications that can be devastating. In fact, the first time many patients learn they have diabetes is when they’re being seen for one of its complications.”

To take charge of their health, Dr. Gaudiani says individuals need to find out where they stand. Risk factors for developing diabetes include having a relative with diabetes, obesity and sedentary lifestyle, gestational diabetes (diabetes during pregnancy), age and ethnic background. Symptoms such as excessive thirst and increased urination, weight fluctuations, blurred vision, and fatigue could be indicators that an individual has active diabetes. “But the disease doesn’t always present with these typical symptoms,” Dr. Gaudiani cautioned. “It sometimes can be silent for many years while causing complications to nerve, heart, kidney and eye tissues. Everyone over 40 should be screened.”

Fortunately, most people can take actions to avoid developing the disease, and those who are diagnosed with Type II diabetes can reduce complications, and in some cases, even reverse the course of the disease. 

“It’s almost never too late to achieve improvement,” says Dr. Gaudiani. “In many cases it’s not complicated. The top four things that will help you prevent diabetes will also improve your overall health and enjoyment. Eat better—more fruits and vegetables, less processed, fatty and high sugar foods. Exercise 30 minutes a day—it will lower your blood sugar, rev your metabolism and may help reduce your body fat. Lose weight—just a few pounds can lower your diabetes risk by half. Scientific data suggests that losing only 5% of your body weight has positive effects on your blood pressure and cholesterol. This is a prescription to minimize diabetes and maximize quality of life.”

“The really compelling fact about diabetes is that now, more than ever, its impact can be dramatically reduced,” says Dr. Gaudiani. Here in Marin we have access to all the care needed to accomplish that. Get screened and get going to reduce your risk.”

 

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