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.

I was just rereading a USA Today article on diabetes. I think it's worth a look because it examines one of the big issues related to the so-called diabetes epidemic in the US: the fact that many people diagnosed with Type 2 diabetes fail to deal with the disease adequately - if at all. First, many are slow to make necessary lifestyle changes - or don't make them at all. Second, many do not follow the treatment plans laid out by their doctors. The result, says journalist Anita Manning, is that diabetes continues to spread and cause terrible suffering, while diabetes experts "are beginning to sound like a broken record" as they repeat their urgent, yet often-ignored, health warnings.

So what's the deal? Well, there are lots of reasons Type 2 diabetics are not heeding the advice. First and foremost, the treatments and lifestyle changes mean an enormous life-shift for most people diagnosed with Type 2. So they know what they need to do, but don't follow through. Then there's the fact that a lot of us are too busy with everyday life to get to the doctor for help with symptoms of prediabetes. Commonly, they don't even realize that the health problems they are experiencing are prediabetes symptoms. Another factor is medical care: let's face it, most doctors out there are too busy to follow-up with their patients and make sure treatment plans are being adhered to. Sad but true. Recent studies have also shown that too many physicians exhibit "clinical inertia" when it comes to diabetes - they are too slow to ratchet up treatment levels when a patient's health declines. Finally, there's the issue of money. Doctor's visits, drugs and medical gadgetry all cost money and the tab is frequently too high to be affordable. Thanks to costly co-pays, this is often true even for those with medical insurance. It's all enough to make you sick.

American Indians and health professionals congregated in Oklahoma City last week to attend a four-day conference on diabetes prevention. As you may know, American Indians suffer from Type 2 diabetes at astronomical rates, and this is a cause of great concern for tribal leaders and for government and medical experts on the nation's health.

I was unable to find a website on the conference detailing exactly what happened and what was said. Oklahoma news station KTEN did create a brief report on the event, however, saying that speakers at the conference emphasized the urgent need for lifestyle changes in the form of weight loss, healthy eating and incorporating daily exercise into peoples' lives. The conference was sponsored by the Indian Health Service (a division of the US Department of Health and Human Services) and the Oklahoma Native American EXPORT Center.

UPDATE August 31: Okay, I tried to add a comment, but was unable for some weird computer-related reason. But it's my understanding that while genetics does play a role in who does and who doesn't get certain diseases, Type 2 diabetes is still largely determined by lifestyle. Until they figure out the role of genetics a little better, it's best to focus on lifestyle because at least that's something you can do something about! By the way, I see a new article has just come out in The New York Times on the subject of genetics and aging. Follow this link to read all about it.

Connie Bennett, star blogger of Sugar Shock Blog has posted a little piece on the website the Common Voice, originally posted on her own site. Bennett directs readers to a Contact Music profile of move producer Harvey Weinstein and says diabetics should all look to him for inspiration on diabetes self-management.

So, what's the big whoop about Weinstein? Well, Weinstein (who directed films like "Chicago" and "The English Patient") was diagnosed with Type 2 diabetes in 2004. Instead of relying (entirely) on a battery of drugs to help him deal, Weinstein decided to make some really big lifestyle changes. You know, those healthy-type changes that doctors and guilt-inducing health articles are always pushing. Weinstein has lost more than eighty pounds through good diet and exercise. Bottom line: no more gorging on sugary foods, I guess. Of course, this is Bennett's interpretation of Weinstein's story. I have not found the full version in Weinstein's own words. But he certainly looks slimmer and trimmer!