In my previous post, I looked at a RAND Corporation study of undiagnosed diabetes - something that continues to be a big problem. Now I want to zero in on one aspect of that study that really caught my eye. According to the sole author, James P. Smith, talk of a type 2 diabetes epidemic is over-exaggerated.

Hang on a minute. Aren't we always hearing about the so-called epidemic proportions of diabetes' spread in the US and globally? And aren't cities like New York taking steps to track the spread of diabetes, keeping tabs on its growth just as you'd do with a contagious epidemic outbreak of, say, tuberculosis? Well, yes. But Smith isn't buying it.

During the twenty-five-year period included in the study, Smith says diagnosis of men with diabetes more than doubled. However, it's a tricky thing to take diagnosis rates and translate them into prevalence rates. That is, more people being diagnosed with a disease may simply mean we're getting better at diagnosing the problem. We may think we're seeing astronomical growth rates in diabetes when in fact it's probably a combination of increased diabetes and more efficient diagnosis.

Which is not to say Smith is denying that the spread of type 2 diabetes is a serious issue: "Diabetes is one of the major health challenges faced across the United States," he says, "but these finding suggest that the prevalence of the disease is not growing as rapidly as often claimed."

James P. Smith is RAND's corporate chair of labor market and demographic studies. RAND is a nonprofit research organization.

According to a RAND Corporation study, fewer and fewer diabetics are going undiagnosed these days. Specifically, the gap has closed dramatically over the last twenty-five years. So much so that Hispanics and African Americans are now no more likely than whites to be undiagnosed. Good news, to be sure.

And the news is especially good for men. James P. Smith, who authored the study, says that twenty-five years ago about fifty percent of men with diabetes did not even know they had the disease. Jump forward to 1999-2002, however, and the number drops to about twenty percent.

Smith concludes that even though ethnic and gender disparities remain, we are certainly doing a lot better at getting people diagnosed and into treatment. Diabetes programs that target minorities can take a lot of the credit for this shift, Smith believes.

On the down side, the less-educated people among us are much more likely to go undiagnosed and, when diagnosed, are less likely to successfully incorporate lifestyle changes required to manage the disease. Also of concern, Smith says, is the fact that even though obese people are at a high risk for diabetes, they nevertheless are more likely to have undiagnosed diabetes than are slimmer people.