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Diabetes Wake-Up Call

By Nicole A. Vaughn, PhD 3/19/2014


It’s time for a wake-up call in America when it comes to diabetes.  It is a major cause of heart disease and stroke, as well as kidney failure, adult blindness and non-traumatic lower-limb amputations.

Approximately 79 million people in the U.S. have prediabetes, and the percent of adults who have progressed from prediabetes to diabetes has increased from less than 5 percent in 2006 to nearly 10 percent in 2012.   Not only is there a physical cost to having the disease, there is a high economic burden: diagnosed diabetes cases cost more than $245 billion in 2012 alone.2

Yet, it is a preventable illness—which means we can and should do something to slow its spread.

Tackling Disparities

The illness also affects some communities more than others. African Americans have the highest prevalence of the disease.2 In addition, individuals living in urban and underserved communities are at increased risk.

In light of these disparities, my colleagues at the Drexel University School of Public Health in Philadelphia have joined partners worldwide to study pre-diabetes and related issues such as cardiovascular disease and food labeling in urban communities both in the U.S. and on a global scale.

A Local View: Philadelphia

Diabetes is one of the top 10 causes of death in Philadelphia. To help address the alarming diabetes rates among African American communities in Philadelphia, a new research study called Getting People in Sync (GPS) is underway.

GPS is an evidence-based group pre-diabetes program in two churches in Philadelphia that builds on the video-on-demand series Project NOT ME, which includes the Mid-Atlantic Emmy® Award-winning episode, “Take Charge.”  Project NOT ME was designed by UnitedHealth Group and Comcast for people with pre-diabetes and is an online version of the diabetes prevention program The series follows six adults who are at high risk for developing type 2 diabetes as they work to changing their eating and exercise behaviors by watching a novel reality television series and finding support through web and mobile technology for weight loss.  The preliminary results have been encouraging as individuals participating in GPS have regularly attended the sessions and lost on average 7.45 lbs.  Participants have been excited to get back into clothes they have not worn in over a decade! 

Researchers at the Drexel University School of Public Health, including myself, are leading the work with the in-kind support of Dr. Deneen Vojta from UnitedHealth Group.  The United Health Foundation and Comcast are funding the project.

Also in Philadelphia, Dr. Amy Auchinclass, a social epidemiologist at Drexel University’s School of Public Health, is examining the restaurant community and how nutrients and labeling encourage individual behaviors.

  • - Her study on healthier food options at fast food restaurants in Philadelphia found that calories and nutrients often exceeded appropriate levels for a single meal and even exceeded recommended daily limits for sodium and saturated fat.
  • - On the positive note, a similar study found that customers of full-service restaurants use nutritional labeling on menus to make healthier food choices.  However, even consumers who used the labels purchased oversized meals that, on average, far exceeded what could be considered healthy.
  • - Other research on shows the importance of using environments in urban areas to provide opportunities for residents to stay healthy.  This includes helping older adults looking to age in place.


A Broader Perspective

In addition to these local initiatives, Dr. Longjian Liu, an Associate Professor of Epidemiology and Biostatics, along with international colleagues, is working globally to understand how cardiovascular disease and heart failure (which many times are co-morbid conditions among individuals with diabetes) impact lives. 

  • - Heart failure was found to be a new epidemic affecting nearly 5.8 million people in the U.S. and more than 23 million people worldwide. In 2008, heart failure accounted for more than $35 billion in health care costs in the U.S.4
  • - 550,000 individuals in the U.S. are diagnosed annually with heart failure for the first time, and one-in-five have a lifetime risk of developing the syndrome.
  • - In China, risk of heart disease has become a serious public health issue and is a particular concern in urban areas. ,


Take Action

While working with churches and with restaurants can be a model for addressing pre-diabetes in communities nationwide, individuals can take their own steps to prevent diabetes as well as the conditions that accompany it, like cardiovascular disease.

The American Diabetes Association Alert Day occurs on Tuesday, March 25, 2014.  It is a one-day “wake-up call” where individuals can see if they are at risk for developing type 2 diabetes by answering a few simple questions.

While it is a single-day event, Alert Day serves as a friendly reminder to take your own steps throughout the year to help prevent diabetes.


Nicole Vaughn, PhD

Auchincloss A, Leonberg B, Glanz K, Bellitz S, Ricchezza A, Jervis A. Nutritional Value of Meals at Full-service Restaurant Chains. Journal of Nutrition Education and Behavior. January 2014. Vol. 46, Issue 1, Pages 75-81

Auchincloss A., Mallya G., Leonberg B., Ricchezza A., Glanz K., Schwarz D. Customer Responses to Mandatory Menu Labeling at Full-Service Restaurants. American Journal of Preventive Medicine. Volume 45, Issue 6, December 2013. Pages 710-719

Liu L, Eisen HJ. Epidemiology of heart failure and scope of the problem. Cardiol Clin. 2014 Feb;32(1):1-8, vii.

Zhang Q, Zhang C, Song X, Lin H, Zhang D, Meng W, Zhang Y, Zhu Z, Tang F, Liu L, Yang X, Xue F. A longitudinal cohort based association study between uric acid level and metabolic syndrome in Chinese Han urban male population. BMC Public Health. 2012 Jun 8;12:419.

Zhu Z, Liu Y, Zhang C, Yuan Z, Zhang Q, Tang F, Lin H, Zhang Y, Liu L, Xue F. Identification of cardiovascular risk components in urban Chinese with metabolic syndrome and application to coronary heart disease prediction: a longitudinal study. PLoS One. 2013 Dec 17;8(12):e84204.


Blog Author


Nicole Vaughn, PhD

Dr. Vaughn is an Assistant Professor in the School of Public Health at Drexel University. She received her Masters and Doctorate in Medical Psychology from Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland. As a research health psychologist with a focus on health disparities reduction, Dr. Vaughn has extensive education, training, and experience in community-based research with ethnic minority groups. Her research interests include a focus on community-based approaches to eliminating health disparities, health care access and utilization among insured and uninsured minority groups, obesity and overweight, maternal and child health and the influence of culture on health behaviors particularly for chronic conditions. As a Ford Foundation fellow, her master’s thesis focused on examining health care behaviors for cancer and diabetes symptoms among young-adult males in the military and her doctoral work focused on examining data from a large federal database to determine the impact of health insurance status on health care use and quality self-care behaviors among insured African Americans and Hispanics with Type 2 Diabetes. Dr. Vaughn’s doctoral work received meritorious distinction at the annual Society for Behavioral Medicine meeting.

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Dr. Tuckson is an active member of the Institute of Medicine of the National Academy of Sciences and served as the Chairperson of its Quality Chasm Summit Committee and a member on their Committee on the Consequences of the Uninsured. Currently, he serves as Chair of the Secretary of Health and Human Services’ Advisory Committee on Genetics, Health and Society. Additionally, he recently served as a Commissioner, Certification Commission on Health Information Technology (CCHIT); and is currently a member of the Performance Measurement Workgroup, Ambulatory Care Quality Alliance (AQA); and the Quality Workgroup, American Health Information Community (AHIC).

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