Rising cases of diabetes in Georgia are linked to obesity, public health policy

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A person gets an insulin test for diabetes. The Georgia Department of Public Health says around 1 million people in the state have Type 2 diabetes.

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Dr. Griffin Rodgers

Credit: Contributed

Around 1 million people in Georgia have Type 2 diabetes, and close to a quarter million more likely have it and don’t know, according to the state Department of Public Health.

Diabetes is caused by high blood sugar or blood glucose that damages blood vessels and nerves in many parts of the body. It can lead to heart attacks and strokes, said Dr. Griffin Rodgers, director of the National Institute of Diabetes, Digestive and Kidney Diseases at NIH in Bethesda, Md.

Nationwide, diabetes affects some 38.6 million people, or about 11.2% of the U.S. adult population, he said.

"In Georgia, the prevalence is 12.7%, putting Georgians at among the top 20 states with the highest prevalence," Rodgers said.

People who are overweight, over 40, or have a family history of Type 2 diabetes are at an increased risk of developing the disease, known as prediabetes, affects more than 2 million Georgians.

The disease affects the kidneys, eyes, feet and teeth, Rodgers said, adding that Type 2 diabetes increases the risk of certain types of cancer.

Georgia's high prevalence of obesity is 35%, contributes to the development of Type 2 diabetes, Rodgers said. That's one of the reasons the state ranks so high with respect to diabetes.

Even when health care professionals initially require oral medications to treat their diabetes first, Rodgers said lifestyle changes make a difference.

"When you hear commercials on the television about lowering your A1C, that's generally about individuals with Type 2 diabetes," he said.

That's not the same for the 5% of people with Type 1 diabetes. 

"Their body essentially turns against the insulin producing cells via an autoimmune process and, because the insulin producing cells are lost, these individuals actually require insulin to live," Rodgers said. "And so certainly improving the economic circumstances and the availability of insulin for them is quite critical."

Diabetes costs around $412 billion, including medical costs and indirect costs like loss of productivity, state data show. 

The estimated annual cost of treating diabetes in Georgia grew to $11 billion annually, due in part to rising costs for insulin, Sen. Raphael Warnock's office said in a press release, noting that prices nearly doubled from 2012 to 2016, and a 40-day supply of insulin increased from about $350 to more than $650 on average for many Georgians.

“I’ve long been focused on strengthening access to affordable health care and lowering costs for Georgians, and that’s why I am proud to lead the effort in the Senate to cap patients’ out-of-pocket costs for insulin," Warnock said. "Georgians should never have to choose between paying for life’s basic essentials or life-preserving medicines.”

The senator's efforts led insulin manufacturers Eli Lilly, Sanofi, and Novo Nordisk to cut costs for their insulin products, and Medicare capped the out-of-pocket price at $35 last year.

Warnock, a Democrat, and Sen. John Kennedy (R-La.) introduced the Affordable Insulin Now Act of 2023 that would include the $35 cap for insulin-dependent people who don't have access to health insurance.

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Georgia is one of 10 states that has not taken advantage of the Affordable Care Act’s Medicaid expansion that promotes coverage to nearly all adults with incomes up to 138% of the federal poverty level ($20,783 for an individual in 2024) and provides the state with an enhanced federal matching rate (FMAP).

Gov. Brian Kemp's unique plan, Pathways to Coverage, adds eligibility for Medicaid coverage to Georgians earning less than $12,000 a year, but only if they are working, attending school or involved in job training.

Kemp said his Medicaid waiver program is a better way to provide health care for low-income Georgians, but analysts with the Georgia Budget and Policy Institute said a full federal Medicaid expansion would save taxpayer money.

The governor's office previously called the approach a "conservative reform" that reflects the state's values as a place that "honors work" and "champions individual responsibility."

Kemp said access to health insurance is not a "handout."

Amnesty International, a grassroots human rights organization, insists that access to health care is a human right, especially for people who are already marginalized due to socio-economic status, racial identity, gender identity, sexual orientation, immigration status and other factors.

"Instead of treating health care as a partisan political issue, it should be addressed as a human rights issue," the organization stated. "That would mean putting in place a system of universal, equitable, non-discriminatory health care; giving priority to a single-payer, publicly funded system, so as to guarantee access to comprehensive, quality care for all people as a right and a public good."

Between 2014 and 2018, diabetes was the cause for 104,098 hospitalizations and 154,761 ER visits in Georgia. The state reports its age-adjusted death rate for diabetes is 21.9.