November is National Diabetes Awareness Month, and a recent survey by Episcopal Health Foundation shows that nearly half of adults in Texas say they live in a household experiencing diabetes or prediabetes.

Many of those diagnosed with the illness say they've skipped or postponed health care due to cost.

The foundation's Chief Communications Officer Brian Sasser said leaders need to change the focus from diagnosis and treatment to preventative care.

"That shows you what a critical issue it is, especially when you look at the health impacts of those who battle diabetes," said Sasser. "Kidney disease, heart disease, strokes - serious chronic conditions, that not only take a toll on the health of people, but the costs of those treatments get higher and higher."

The survey found that 66% of Texans see diabetes as a "major problem" in the state.

While diabetes can be hereditary, Sasser said there are non-medical factors that can increase a person's risk of developing the disease and how it's managed.

"If I'm diagnosed with diabetes - and I live in a neighborhood that has affordable grocery stores, and easy places for me to walk, and there's parks nearby," said Sasser, "my reaction to being diagnosed with prediabetes is much different than if I live in a neighborhood that doesn't have sidewalks, I can't walk at night, there's nothing but convenience stores in the neighborhood."

People who are prediabetic have a higher-than-normal blood sugar level, and are at higher risk of developing type-two diabetes. The risk increases without regular physical activity and healthier eating.

More than 38 million Americans live with diabetes, including nearly 1 million Georgians.

The Georgia Department of Public Health estimates another 230,000 people in the state may have diabetes but don't know it.

During National Diabetes Month, Dr. Griffin Rodgers - director of the National Institute of Diabetes, Digestive, and Kidney Diseases at the National Institutes of Health - emphasized the importance of managing diabetes early to prevent serious health complications.

"Diabetes can damage blood vessels and nerves," said Rodgers, "so the patients that have it have a higher risk of developing conditions like a heart attack or a stroke, diseases of the kidneys and the eyes and the teeth, as well as the lower extremities."

Between 2014 and 2018, diabetes led to over 100,000 hospitalizations and 154,000 emergency-room visits in Georgia.

But Rodgers said diabetes is preventable and manageable. He added that regular wellness visits - where blood sugar, blood pressure, and cholesterol are checked - are key to staying healthy.

Rodgers said a healthy diet is a major part of managing or preventing diabetes.

He suggested eating plenty of fresh produce, whole grains, and lean proteins like fish - and cutting back on sugary drinks by choosing water instead.

Regular exercise and seven to eight hours of sleep each night are also important.

"On the physical activity side, 30 minutes a day, five days a week for most adults is what's
generally recommended," said Rodgers. "Just walking. And if you can't do the 30 minutes all at one time, breaking it into either two 15, or three 10-minute intervals is sufficient."

Early signals that diabetes could be a problem include frequent urination, constant thirst or hunger, fatigue, blurry vision, nausea, unexpected weight loss, or tingling in your hands and feet.

Rodgers said managing diabetes can be as simple as focusing on "the A-B-Cs of care" - checking your A1C, blood pressure and cholesterol levels, and quitting smoking.




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California could be in for some big cuts to health care for low-income families under a second Trump administration, according to health experts.

Policy specialists at the nonprofit KFF said they are bracing for Trump allies in Congress to make major reductions to Medicaid expansion under the Affordable Care Act, in order to pay for big tax cuts promised by the president-elect.

Larry Levitt, executive vice president of health policy at KFF, said it would force states to backfill or raise costs.

"For the ACA, simply letting enhanced financial aid expire after next year would result in big out-of-pocket premium increases, reduced enrollment and more people uninsured," Levitt projected.

Robert F. Kennedy Jr., President-elect Trump's choice for Health and Human Services Secretary, did not say much on the campaign trail about funding for Medicaid or the Affordable Care Act, so his positions are unclear. Kennedy has expressed skepticism about vaccines and has said the U.S. should stop putting fluoride in drinking water.

Jennifer Kates, senior vice president and director of the Global Health and HIV Policy Program for KFF, said the Centers for Disease Control and Prevention cannot require states to follow its recommendations on vaccines and fluoridation.

"That's up to states and local governments," Kates explained. "But CDC can recommend, and if those recommendations are not being made or being watered down or changed, that sends a message to states, to schools, to parents."

Health advocates are also raising concerns DACA recipients could lose access to health plans sold on the state marketplaces created under the Affordable Care Act. Changes to so-called "public charge" rules could make families with mixed immigration status hesitant to use Medicaid benefits.


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Some Kentuckians are more likely to be diagnosed with cancer and more likely to die from the disease than others.

Dr. Nathan Vanderford, associate professor of toxicology and cancer biology at the University of Kentucky College of Medicine, said Kentucky has a massive cancer problem. The Commonwealth ranks first in the nation for overall cancer incidence rates and second for overall cancer mortality rates, around 30,000 cases each year and 10,000 deaths. He added Appalachia is ground zero for cancer.

"What's worse is that the cancer problem is significantly greater in eastern Kentucky," Vanderford pointed out. "There are 54 counties in Eastern Kentucky that are in the Appalachian region and cancer rates there are significantly higher."

Lung cancer incidence rates are more than 100% higher in Eastern Kentucky versus the national average. Appalachian Kentucky residents are 8% more likely to die from a preventable or screenable cancer than their non-Appalachian counterparts.

Vanderford pointed out more than 150 Appalachian students have participated in the Appalachian Career Training in Oncology program, an education and intervention program aiming to address cancer disparities. Dozens of participants have gone on to medical school.

"We engage high school students and undergraduate students from any of the 54 Appalachian counties in cancer research, cancer education, clinical shadowing, all around the goal of motivating and preparing them to pursue cancer-related careers," Vanderford outlined.

Holly Burke, coordinator of the program, said participating students explore how cancer has affected their families and communities, particularly lung cancer.

"They talked about experiences with cancer and why they think the rates are so high," Burke observed. "And then they also gave solutions on what they think can be done to lower those rates."

The American Cancer Society recommends yearly screening for lung cancer for people aged 50-80 years old who smoke, or formerly smoked and have a 20-pack a year or greater history of smoking.