Governer Ed Rendell is worried. An estimated eight percent of Pennsylvanians have diabetes. Nearly 800,000 people. We all know money talks, and what has caught the attention of state politicians is the tremendous cost to manage chronic diseases.

Governor Rendell recently shared that about 78 percent of the state's health care costs are linked to 20 percent of chronic diseased patients. The Governor has announced The Pennsylvania Diabetes Action Plan to improve how Pennsylvanians with chronic disease benefit from future health care.

In an effort to prepare Pennsylvania to educate the public about diabetes and diabetes prevention, and improve management of the disease to reduce complications, the Plan focuses on four key areas: surveillance, standards of care, health policy, and evaluation.

Truly a collaborative of care, more than 200 stakeholders, agencies, organizations and individuals contributed to the Pennsylvania Diabetes Action Plan. The plan was funded by the Centers for Disease Control and Prevention (CDC) and a state appropriation.

In 2005, potentially avoidable hospitalizations for diabetics in Pennsylvania cost nearly $730 million. Now that is a number even the Governor cannot ignore.

If at first you don't succeed - go straight to the patient's home. After a lackluster attempt to sell doctor's on prescribing Phizer's inhalable insulin, Exubera, the company has decided to begin running television and print campaigns to advertise directly to patients.

The ads will start appearing the second half of 2007. However the main contention from Congress and medical groups is that mass marketing to patients encourages excessive use of costly therapies. Exubera gained a reputation for being an over priced and not-so-discreet way to administer insulin. Doctors say the inhaler is unwieldy. Depending on a patient's health care plan, they can pay about $600 a year more for Exubera than injectable forms of insulin. Clinical trials have found the product can reduce lung function for some patients. Pfizer says the condition is reversible and is conducting a five-year study among users to monitor it.

Why the push, Pfizer? You seem hell-bent on making this one stick. The president of Pfizer's worldwide pharmaceutical operations says the television ads will target newly diagnosed diabetics who may not want to inject themselves daily. Patients who develop diabetes later in life may put off using insulin because of needle phobia. Fair tradeoff: I see your fear of needles and raise you $600 a year, a license to toke (in public), and maybe a little bruising on your alveoli. Puff, puff...give it a shot.