Education is the key to stemming the rising tide of adult diabetes.
Type 2 diabetes is a growing crisis in South Carolina. With rates climbing higher in recent years, the Palmetto State ranks fifth from the top in percentage of adult diabetes diagnoses. The burden falls hardest on those who face barriers to education, accessible care and access to healthier lifestyle options. Add to that a culture steeped in sweet tea, comfort foods and a lifestyle that does not typically align with wellness, and the challenges become greater. This November, during Diabetes Awareness Month, it is time to shine a light on the realities of diabetes in our state and what can be done to turn the tide.
Understanding Type 2 Diabetes
Type 2 diabetes is a chronic health condition that is related to insulin production and blood sugar and is generally avoidable with weight management, exercise and a healthy lifestyle. Over time, problems related to Type 2 diabetes can lead to a host of other serious health conditions and even death.
According to the South Carolina Department of Public Health, the number of adults diagnosed with the disease has more than doubled in the past 20 years. Even more troubling is that more than 88 million adults in the United States have pre-diabetes, and it is estimated that 80 percent of those people do not even know they have it.
Culture and the Diabetes Belt
“Generally, diabetes is more prevalent in a culture that encourages unhealthy lifestyle choices,” said Melvin Brown, MD, physician and owner of CharlestonMD. “If you come from a place where the culture engorges on sugars and refined carbohydrates and does not encourage a healthy lifestyle, your chances of developing diabetes are higher. This is a big factor in what is considered the Diabetes Belt.”
South Carolina is one of 15 states in the Diabetes Belt, which stretches across the Southeastern United States. These states have a higher prevalence of Type 2 diabetes compared to the rest of the country, largely due to culture. It is no surprise that the state also falls into the Heart Attack Belt and the Stroke Belt.
Rural Barriers and Food Access
In more rural areas, the “party atmosphere” is less of a factor. Instead, residents face lower income levels, limited access to quality healthy foods, fewer providers and long travel distances for appointments.
“You could spend a couple hundred dollars a week at a health food store, or you could buy cheaper ready-made meals, pick up fast food or even go out to a restaurant,” Dr. Brown noted. “You may get more food at a lower price, but the foods are typically lower quality foods that spike blood sugar.”
Provider Shortages
Appointments with specialists book months in advance. Provider shortages are severe outside metro areas. Legislative efforts could eventually expand care by allowing physician assistants and advanced practice registered nurses to operate without required physician association but those bills will not be voted on until at least early 2026.
The Path Forward: Education
Much work must be done to improve South Carolina’s trajectory. Dr. Brown believes education should be the foundation.
“Everything starts with education. People feel empowered when they make decisions,” he said. “If you decide to make a small change to drink just one less soda per day and you do that every day for a year, that is 365 cans of soda that you did not have. Education helps people be mindful of how even small steps can impact the body in a big way.”
By Anne Toole
