Funds lag as diabetes cases soar

In Worcester, Mass., scientists are boxing their test tubes at a shuttered laboratory where just two years ago they isolated a chemical that triggers diabetes.

In Oklahoma City, health workers faced with soaring rates of Type 2 diabetes, the most common form of the disease, question whether they can afford to continue to offer classes where diabetics learn how to avoid foot amputations.

In Columbia, S.C., diabetes educators say they need more money to expand a program that uses the pulpit in black churches to preach the importance of a healthy diet and exercise.

Across the country, health care officials who rely on federal money to help stem the growing epidemic of Type 2 diabetes say they have become increasingly frustrated and alarmed.

Diabetes is the only major disease with a death rate that is still rising — up 22 percent since 1990 — and it has emerged as the leading cause of kidney failure, blindness and nontraumatic amputation.

But public health experts inside and outside the world of diabetes care say federal spending on the disease has historically fallen short of what is needed. And now the government has cut diabetes funding in the budgets for this year and next, despite the explosive growth in a disease that now figures in the deaths of 225,000 Americans each year.

"Diabetes is clearly one of the most important threats facing us," said Dr. Georges C. Benjamin, executive director of the American Public Health Association, "and its funding is decades behind other diseases."

Until this year, federal health spending had risen steadily for more than two decades, fueling expanded efforts against many diseases, including diabetes. But the experts say the commitment to Type 2 diabetes never kept pace with the spread of the disease.

The number of Type 2 diabetics in the United States has doubled in the past two decades, to an estimated 20 million, when undiagnosed cases are included, making the disease the country's fastest growing public health problem. Epidemiologists predict that one in three American children born in 2000 will join the ranks of those afflicted with Type 2.

This year, the federal government is spending $1.1 billion to study diabetes, less than a quarter of what is spent to study cancer. The government spends 10 times more per patient on cancer research, and the death rate for that disease, unlike that for diabetes, has begun to fall.