25 Years and Counting: Centers for Disease Control and Prevention Identifies Opportunities and Challenges for Diabetes Prevention and Control

The number of persons with diabetes, especially type 2 diabetes, has increased dramatically worldwide (1, 2) and is expected to grow substantially over the next several decades (3). This increased burden places more responsibility on patients, health care professionals, and society. Diabetes has always been a challenge to manage (4). Despite recent scientific advances in our understanding of its pathophysiology (5), awareness of the many factors that affect its care (6), and improved treatment options (7), diabetes still remains a complex and challenging chronic condition. Diabetes is more than merely abnormal glucose metabolism with consequent microvascular complications (8); it also involves cardiovascular disease with adverse macrovascular outcomes (9). Furthermore, recent studies have established a possible bicausal relationship between diabetes and depression (10, 11), thus supporting the link between this condition and psychological functioning.

Recognizing and incorporating the role these various factors play in the prevention and control of diabetes move us beyond solely “treating” diabetes with drugs (12). This progress offers opportunities to complement effective diabetes management with a public health approach that considers availability of medical insurance (13, 14), community resources (15), family structure and support (16), and effective health communications that include advice about risk reduction and cues to action (17).

During the past 25 years, the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC) has depended on available scientific …